Cognitive Behavioral Therapy (CBT) for Anxiety: James' Case Study

This case study examines James, a 36-year-old man struggling with anxiety and social interaction difficulties, impacting his work and family life. The assignment details James' specific problems, including his introverted nature, shyness, and anticipatory anxiety related to customer interactions at his workplace. It outlines a comprehensive CBT treatment plan, encompassing strategies like sufficient sleep, self-talk, facing fears, and reframing negative thoughts. The study further describes treatment sessions, including the use of cognitive restructuring and exposure therapy to help James manage his anxiety. The conclusion emphasizes the importance of CBT in addressing anticipatory anxiety and improving social interactions, highlighting its potential to improve the quality of life for individuals facing similar challenges. The study references several books and journal articles supporting the application of CBT in treating anxiety disorders.

Case Study of James CBT
methods

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
Details of problem........................................................................................................................3
Treatment plan.............................................................................................................................4
Treatment sessions.......................................................................................................................5
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
James a 36-year-old man is living with his wife and three children, he is suffering from
anxiety problem and is very shy and afraid to communicate with people. It is his wife who is
taking care of him and family and she was responsible for carrying out and dealing with family
matters of which James was not able to do. As he is kind of introvert and feels shy and afraid to
deal with strangers. James has been working in a locally owned music store in which James has
been working after finishing his highs school. Before the store was owned by National music
chain, he was very comfortable working, and he also felt a part of family. Then the scenario
completely changed for him when the business turned fast which forced James to engage with
more and more customer and this is how problem of anxiety started for James.
MAIN BODY
Details of problem
James is an introvert person and he had problems in dealing with strangers and is
suffering from anxiety problem and for which he started to go for treatment and in within the
clinical interview, James expresses about the problem he was facing and even he was very shy
from the beginning of the session and hardly used to make eye contact with the clinical staff.
After a few minutes of session James became relaxed and started to discuss about the problems
he was facing. In an clinical interview James discussed about the various thing about his life and
the problems he faced. James was living with his family with three children but was very shy
person and had afraid to deal with people (Paul Modi and Patel, 2016). His life was complicated
as he was not able to face people and talk to them even he was not able to take the responsibility
of the family proper which was done by his wife. His wife was a great support for him which has
minimised his problems to certain extent but his wife can not support him all the time as he had a
job to do. James was not able to get involves in social arrangement for which his wife was
always supporting him. Even the background of James was not good and during his school life
he had a same problem which he never dealt with. James was avoiding all social responsibilities
except his job. So, these were the social problem that he was facing and was not able to deal with
them individually.
For James situation became much worse when his job process change and gave rise to his
complications in his life (Filiz-Ozbay and et.al., 2018). As James was working in locally owned
music store for very long time, and he was able to develop a comfort zone in there and always

felt that he had been a part of family where he could easily perform his tasks which was the
reason that he has been able to work for so long in the company. Also, the previous management
of the company was slow and manageable due to which he faced no problems in dealing with
customers. But the complete scenarios changed for him when a business was owned by national
music chain. New management made the business fast and company also expected James to
increase his engagement with customer. This was the problem that was faced by James as he was
not able to communicate effectively with customers. In order to perform his duties has had to
face various problems like he used to stumble and choke when he used to have face to face
communication with customers. He was afraid that customer may not understand him, and he
was also embarrassed about it. This is the reason due to which he was suffering from anxiety
disorder beside he has no friend to talk with which is also a problem for him. So, this is the
problem that James was not able to deal with his customers effectively, and he though that he is
making everyone else uncomfortable and ill at ease. Also, due to which he felt anticipatory
anxiety in him when he felt that he had to perform any task in public. Also, more he think about
the situation more he felt uncomfortable.
Treatment plan
As James has been suffering for various problem like shyness and being afraid of people
in order communicate with them. His inability to deal with customers in his workplace has given
rise to anticipatory anxiety in him and it was really important for him to deal with so that he can
perform his job effectively. So, for this a proper treatment plan should be provided which can
help in decreasing anxiety in James (O’Sullivan, Bosqui and Shannon, 2016). Following steps
should be followed in treatment plan for decreasing anxiety and help James to face his customers
effectively:
Get enough sleep: In order to overcome the issue of anxiety he should get enough sleep which
may help ameliorate anticipatory anxiety and if he not getting enough sleep it could exacerbate
the situation. The reason behind this is that lack of sleep fires up the brain regions which are
associated with processing of emotions known as amygdala as well as insular cortex. Getting
enough sleep may help in prevention of processing of emotions, and he would feel better.
Talk to himself: As James does not have any friend to share his feeling with and at a particular
there is no one behind him to support him. So, he should to talk to him as he may talk to his
friend and support him and give confidence that he can do it. As every one needs a kind support

to deal a problem, so he should use compassionate words for himself, Self compassion can
prevent him feeling from isolated and will make him more mindful and will motivate him.
Face his face: He should try to ask various questions to himself like what does he fear about and
try to face it. One he will identify his anxiety he can work towards a changing his thought
process about his fear. Like minimising the possibilities of negative consequences he may have
while performing his job.
Reframe his thinking: He must reframe his thinking which can help in overcoming the faulty
thoughts which he as before facing his customers. By developing a positive thinking in his mind
about the situations faced while dealing with customers will help James in overcoming the
problem.
Treatment sessions
In order to help James to deal with a problem he should be provided with a proper
cognitive behaviour therapy (CBT), which is the best therapy which can help him to overcome
the issue. As James has anticipatory anxiety CBT can be help full for him and it may include
various sessions of treatment and can be explained below:
Session 1- It includes stopping of negative thought cycles in James, this can be helpful for him as
he always has a negative thought in his mind in dealing with customers like feeling embarrassed
or he won't be able to talk with them (Divine, 2016). Making James to stop negative thoughts in
his mind can help him which can be done if he is able to divert his mind towards other things.
Also, main purpose of this session will be to stop negative thoughts in mind. He will be provided
to follow the practises in order to bring changes in his daily life like recognition of when he is
going to do something which can make him feel worse but should do something which will
make him feel good and will be helpful for him.
Session 2- In this session James will be provided with exposure therapy which is a form of CBT
which can be useful for James to deal with his problem. This therapy will be started with the
items as well as situations which cause anxiety in him and the anxiety he feels will be made to
tolerate and he will be made to stay in the situation up to 2 hours until the level of anxiety
reduces (Chisholm and et.al., 2016). After this session, he will be asked to make friends and talk
to them which will minimise his fear to make friends. This will also help James to deal with his
customers in the future.

CONCLUSION
It can be concluded that if any person is suffering from anticipatory anxiety it may cause
many complication in a person. Also, it will make him difficult to deal or talk to people who are
stranger to him. If people face problems in communicating with other people it can give rise to
anticipatory anxiety in them which may further make situations complicated for them. Also, it
can be concluded the in order minimise such type of problems it is vital to CBT to people which
can help in facing the problem effectively and will make their life better.

REFERENCES
Books and Journal
Paul, J., Modi, A. and Patel, J., 2016. Predicting green product consumption using theory of
planned behavior and reasoned action. Journal of retailing and consumer services. 29.
pp.123-134.
Filiz-Ozbay, E and et.al., 2018. The role of cognitive ability and personality traits for men and
women in gift exchange outcomes. Experimental Economics. 21(3). pp.650-672.
O’Sullivan, C., Bosqui, T. and Shannon, C., 2016. Psychological interventions for children and
young people affected by armed conflict or political violence: a systematic literature
review. Intervention. 14(20). pp.142-164.
Divine, A., 2016. Relationships Among Self-Efficacy, Implicit Associations, Motives and
Exercise Behaviour.
Chisholm and et.al., 2016. Investigating the feasibility and acceptability of health psychology-
informed obesity training for medical students. Psychology, health & medicine. 21(3).
pp.368-376.