Case Study: Sarah - Cognitive Behavioral Therapy and Recovery Plan

This case study presents Sarah, who experiences anxiety and substance abuse following a breakup and perceived rejection. The analysis identifies risk areas and proposes a comprehensive approach to address her mental health challenges. The assessment includes screening tools like the Montreal Cognitive Assessment. The case study emphasizes Cognitive Behavioral Therapy (CBT) using the ABC model to address distorted thoughts and maladaptive behaviors. Suggested interventions involve creating a safe environment, stress regulation, self-management skills, medication, and CBT. A recovery support plan is outlined, focusing on self-care, lifestyle modifications, peer support, and spiritual self-care. Long-term treatment includes self-management strategies and creative activities. The expected recovery duration is approximately 24 weeks. References supporting the methodologies are also provided.

SARAH CASE STUDY
-PRESENTED BY:

Case Presentation:
• The client mentioned in the case study, Sarah
had a recent breakup
• Her friend invited her to a party to get over the
breakup phase
• She meets Tom at the party and likes his
company. They exchange numbers to keep in
touch. The client consumes a lot of alcohol at
the party.
• The following day, she receives no message
from Tom and feels rejected and anxious.
• She reports ‘being sick’ at work and cuts off
social communication and consumes alcohol to
keep herself distracted.

Risk Areas Identified
• The high risk areas identified from the
case study includes, feelings of
nervousness and anxiety
• Also, substance-abuse and addiction
can be identified as a high risk area
that could lead to major mental
health concerns.

Assessment Criteria:
 Thorough screening
 Comprehensive Assessment
 Formal Diagnosis

Cognitive Behavioural Therapy:
 Cognitive behavioural therapy or CBT, is
referred to as a psychosocial therapeutic
intervention that significantly improves
mental health issues.
 CBT aims to develop a positive
perspective towards life on the basis of
positive thoughts, coping tactics and
emotional stability (Gallagher et al.,
2013)
 It helps in channelizing the negative
thoughts into positive ideas and well-
being

Rationale of administering CBT
 Cognitive behavioural therapy can segregated
into two segments, cognition and behaviour
 Sarah is affected by her breakup and is
reported to harbour negative feelings which
increases on being ignored by Tom
 She is into substance abuse and prefers to
remain socially secluded
 Administration of CBT has been reported to
facilitate correction of distorted thoughts and
maladaptive social behaviour
 CBT has been reported to yield positive results
in treating PTSD, anxiety, personality disorder
and depression

Evidence based strategies
 CBT is assisted to patients after the
mental state evaluation
 CBT makes use of mindfulness-based
therapies and primarily focuses on
the thought content and emotions of
the client to assist recovery
(Memoria et al., 2013)

Assessment Tools:
 A number of assessment tools can be used to
evaluate the mental health status of the client
 In order to access Sarah, the Montreal Cognitive
Assessment tool could be used to evaluate her
cognitive ability
 The test evaluates the client on the basis of
multiple cognitive domains that include,
language, attention, memory, visuo-spatial,
executive function and abstract thinking
 The score range is from 0-30 with <26 suggesting
impaired mental health Julayanont et al., 2017)
 The screening test is highly reliable, accurate and
convenient to use

Models for CBT:
 The ABC model has been found to be effective
in administering CBT (Jun & Park,2013)
 The model essentially covers three important
aspects that incorporate activation of an event,
negative feelings associated with the event and
the outcome as a result of the feelings
 The ABC model evaluates the feelings on the
basis of which negative feelings might have
developed in an individual
 The model further states that the negative
feeling does not develop on account of the
activating event but is caused due to the
irrational beliefs that lead to the consequence

Suggested intervention:
 Suggested interventions would
comprise of the following:
 Ensuring a safe environment
 Regulating the stress-causing events
 Imparting self-management skills to
effectively deal with anxiety
 Administration of anti-abuse medication
 Administration of CBT to cope with
stress and ensure a positive
environment

Preliminary Care:
 The preliminary care would comprise
of reinforcing a safe environment so
as to regulate the dearth of feelings
related to anxiety in the client
 The psychotherapist must actively
stabilise the thought content of the
client through one to one counselling
 Administration of anti-alcohol drug
such as disulfiram in mild doses to
control addiction (Bystritsky et al.,
2013)

Recovery Support Plan:
 The recovery support plan would
widely comprise of five important
elements such as (Aldao et al.,2014),
 Physical self-care
 Life-style modification
 Mental/ Emotional self-care
 Peer support
 Spiritual self-care

Long-term treatment care
 Long term treatment care would
include imparting education about
self-management strategies so as to
avoid stress causing elements
 Involvement in creative activities
such as gardening or crafting can
help in focusing on the positive
aspects of life and boost up her
confidence level (Julayanont et al.,
2017)

Expected Duration of Recovery
 It can be expected that at the end of
24 weeks, the client could start
feeling much energised and better

References:
Aldao, A., Jazaieri, H., Goldin, P. R., & Gross, J. J. (2014). Adaptive and maladaptive emotion regulation
strategies: Interactive effects during CBT for social anxiety disorder. Journal of Anxiety Disorders, 28(4),
382-389.
Bystritsky, A., Khalsa, S. S., Cameron, M. E., & Schiffman, J. (2013). Current diagnosis and treatment of
anxiety disorders. Pharmacy and Therapeutics, 38(1), 30.
Gallagher, M. W., Payne, L. A., White, K. S., Shear, K. M., Woods, S. W., Gorman, J. M., & Barlow, D. H.
(2013). Mechanisms of change in cognitive behavioral therapy for panic disorder: the unique effects of
self-efficacy and anxiety sensitivity. Behaviour research and therapy, 51(11), 767-777.
Julayanont, P., & Nasreddine, Z. S. (2017). Montreal Cognitive Assessment (MoCA): concept and clinical
review. In Cognitive screening instruments (pp. 139-195). Springer, Cham.
Jun, H.J. and Park, M.K., 2013. Cognitive behavioral therapy for tinnitus: evidence and efficacy. Korean
journal of audiology, 17(3), p.101.
Memória, C. M., Yassuda, M. S., Nakano, E. Y., & Forlenza, O. V. (2013). Brief screening for mild cognitive
impairment: validation of the Brazilian version of the Montreal cognitive assessment. International
Journal of Geriatric Psychiatry, 28(1), 34-40.

Thank you!!