Nursing Assignment: HEBCHSI106 Case Study of Anxiety and CBT

This nursing assignment presents a detailed case study of a patient named Sarah, who is experiencing anxiety following a breakup and exhibiting symptoms of substance abuse. The report identifies key risk areas, including social isolation and alcohol consumption, and discusses the application of Cognitive Behavioral Therapy (CBT) as a primary intervention. It explores assessment tools like the Montreal Cognitive Assessment and utilizes the ABC model of CBT. The report proposes interventions such as creating a safe environment, incorporating self-management skills, and administering anti-abuse medication if needed. It emphasizes the importance of primary care, including therapy and mindfulness-based practices, and outlines a long-term treatment plan incorporating CBT and creative activities. The expected recovery timeframe is within six months, focusing on the elimination of negative thought processes and the cultivation of a positive outlook to address anxiety, stress, and depression. References to relevant studies are included to support the analysis and recommendations.

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the Student:
Name of the University:
Author Note:

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Introduction:
A disturbed state of mind predominated by negative feelings is called anxiety. Studies
show that about 18% females and it is more prevalent in women who have gone through
separation or divorce and 11% males are a victim of anxiety globally. 28% of the global
population has experienced depression, emotional turmoil and anxiety in some form or the
other. According to studies there are four kinds of four kinds of anxiety (Khoury et al., 2013).
They are as follows:
 Generalized anxiety disorder
 Social anxiety disorder or Phobia
 Panic disorder
Post-traumatic disorder:
Anxiety is a product of a deep environmental episode and can trigger at any age and is
not specific for a particular place or age group. A deep understanding is required to deal with
anxiety as the symptoms may not be physical; one has to take the psychological symptoms
into consideration. It should be noted that professional help must be advised if any symptoms
are noticed and dealing with such victims and symptoms should be taken seriously and with
utmost sincerity.
In this report a case study of a subject named ‘Sarah’ has been discussed who has
recently experienced a breakup and has shown multiple symptoms of anxiety. In this report
there is a thorough discourse on the key facts of the subject and the case study and a complete
understanding on the effective implementation of the cognitive behavioural therapy to
advocate standard healing.

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Case Scenario:
In this segment the key features of the case study has been discoursed. In the case
study it has been stated that the subject ‘Sarah’ has recently experienced a breakup. Having
gained that information, her friends have invited her to a party as a sympathetic gesture and
to help her recover from the sensitive event. In the party the subject meets a man named Tom
and enjoys his company. Out of the fondness for each other’s company they decided to
exchange numbers in the hopes for a prolonged connection. The subject consumes a
significant amount of alcohol at the party. The next day she had hopes to get messages from
Tom but no such thing happens due to which the subject feels further violated and rejected.
Out of anxiousness she refuses to go to work by reporting being sick and further the subject
starts consuming alcohol hoping that to be a source of distraction and out of the feeling of
rejection and anxiousness she breaks all tie with her social life.
Identified risk areas:
Two serious risk areas can be identified from this case study. First, the feeling of
rejection and anxiousness making the subject separate her from all social communications
which is quite a grave situation. Second,consumption of alcohol (substance abuse) which
could lead to severe physical and mental issues.
Criteria for assessment:
There are three ways I which assessment criteria can be made. They are, through
screening, comprehensive assessment and formal diagnosis.
Cognitive behavioural therapy:
A psychological therapeutic intervention that significantly mends mental health issues
is called Cognitive Behavioural Therapy (CBT). Studies show that CBT helps to cultivate a

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positive perspective towards life on the basis of positive thoughts, coping tactics and
emotional stability (Ehde et al., 2014); (Gu et al.,2015). The idea of CBT is to focus on
positive thoughts and eliminate all the negative thoughts and develop complete mental
wellbeing (Eysenck, 2014).
Foundation of administering CBT:
Reports suggests that CBT helps in yielding positive results in treating anxiety and
other disorders related to depression. If the case study in hand is taken into consideration,
we’ll be able to understand and appreciate the need of CBT for victims of anxiety. In this
case the subject ‘Sarah’ has gone through a breakup and is in complete emotional turmoil and
it got elevated and worsened when she felt ignored by Tom, a feeling of distress and
rejection, which has made her socially isolated and pushed her into substance abuse. All the
consequences of her breakup and anxiety have led to an integration of negative thoughts and
actions. By properly administering CBT, all her negative thoughts and anxiousness could be
eliminated and she can be returned to the path of positivity which will lead to the
discontinuation of bad habits such as substance abuse and will help her to return to her
normal social behaviour.
Assessment tools:
There are number of tools and strategies that are implemented while dealing with
victims of anxiety and depression. In the case in consideration, while dealing with the subject
in question, Montreal Cognitive Assessment tool could be used to evaluate the cognitive
ability of the subject (Lader, 2015). Multiple cognitive domains such as language, attention,
memory, executive function are used in this tool to appraise subjects such as Sarah and they
are evaluated in the form of a score. The score ranges from 0-30 in which <26 suggests
diminished mental health. This test is extremely convenient, accurate and consistent.

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CBT models:
The ABC model is an effective model for effectively administering CBT. The model
takes into consideration the consequences leading to negative thoughts and actions and aims
at identifying event leading to the negative thoughts and suggests strategies to eliminate them
(Poulsen et al., 2014).
Proposed Interventions:
A safe environment must be warranted for the subjects in question. All the events
leading to the consequences should be evaluated and the upcoming events must be closely
regulated so that there aren’t any causes for worsening the situation any further. Self-
management skills must be incorporated in the subject’s routine so that she can combat and
deal with anxiety (Spielberger et al., 2017). To cope up with substance abuse, anti-abuse
medication can be administered depending on the amount of alcohol the subject consumes.
Most importantly CBT must be incorporated to combat with all the negativity and restore
positive thoughts and vibes.
Primary care:
The first thing to ensure is a safe and loving environment as environment has a huge
impact on the rate of recovery. Therapy must be incorporated and there must be a proper plan
for sessions of psychotherapy in association with mindfulness based therapy such as yoga and
meditation (Wells, 2013). Addiction must be dealt with by administering drugs and
inculcating meditation in the routine of the subject.
Effective long term treatment care:
Training on self-management should be imparted to cope up and recover completely.
Creative activities and hobbies should be encouraged along with the inculcation of CBT.

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Expected recovery time-frame:
Within 6 months a pattern of recovery will be experienced by the subject with a
healthy social life and slowly leading to discontinuation of substance abuse and leading to a
path of positivity.
Conclusion:
Anxiety is a serious issue which may not have much physical symptoms but the
psychological symptoms can be devastating. Management of recovery of anxiety can be done
effectively by administering cognitive therapy which depends of numerous factors which
must be screened properly to identify and administer the right kind of cognitive risk
assessment tools. After identification of the risk and the core of the problem interventional
strategies must be incorporated to give the right kind of treatment and support for recovery.
The recovery strategies must be directed towards the elimination of all forms of negative
thought process and should be aimed at inculcating a positive beginning so as to eliminate all
forms of anxiety, stress and depression.

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References:
Ehde, D. M., Dillworth, T. M., & Turner, J. A. (2014). Cognitive-behavioral therapy for
individuals with chronic pain: efficacy, innovations, and directions for
research. American Psychologist, 69(2), 153.
Eysenck, M. (2014). Anxiety and cognition: A unified theory. Psychology Press.pp.56-64
Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2015). How do mindfulness-based cognitive
therapy and mindfulness-based stress reduction improve mental health and wellbeing?
A systematic review and meta-analysis of mediation studies. Clinical psychology
review, 37, 1-12.
Khoury, B., Lecomte, T., Fortin, G., Masse, M., Therien, P., Bouchard, V., ... & Hofmann, S.
G. (2013). Mindfulness-based therapy: a comprehensive meta-analysis. Clinical
psychology review, 33(6), 763-771.
Lader, M. (2015). Generalized anxiety disorder. In Encyclopedia of
psychopharmacology (pp. 699-702). Springer, Berlin, Heidelberg.
Poulsen, S., Lunn, S., Daniel, S. I., Folke, S., Mathiesen, B. B., Katznelson, H., & Fairburn,
C. G. (2014). A randomized controlled trial of psychoanalytic psychotherapy or
cognitive-behavioral therapy for bulimia nervosa. FOCUS, 12(4), 450-458.
Spielberger, C. D., Gonzalez-Reigosa, F., Martinez-Urrutia, A., Natalicio, L. F., & Natalicio,
D. S. (2017). The state-trait anxiety inventory. Revista Interamericana de
Psicologia/Interamerican Journal of Psychology, 5(3 & 4).

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Wells, A. (2013). Cognitive therapy of anxiety disorders: A practice manual and conceptual
guide. John Wiley & Sons.pp.33-38