Total sessions: 7 .
Signature: _____________
Practitioner’s Record Sheet
Name: Client A Therapist:
Age: 15 years
Gender: Male
Grade: 9th
Presenting Problem: Client A has been experiencing heightened social anxiety, particularly
in classroom discussions and group settings. Symptoms include avoidance of participation,
excessive self-consciousness, trembling, and difficulty forming peer relationships. This has
led to feelings of isolation, low self-esteem, and academic challenges.
Date/ Nature of Issues brought in the session Key points /Outcomes
session the session
number
11th sept, Clinical He reported intense fear of negative Informed consent and
2024 Interview judgment, particularly in group confidentiality were
settings, where he feels everyone is established.
Session#1 evaluating his every move. He Client’s expectations and the
described avoiding class role of therapist and client
discussions and group activities due was discussed
to fear of embarrassment. he also Psychoeducation on social
mentioned physical symptoms, anxiety, its symptoms, and
such as sweating, trembling, and a the cognitive-behavioral
racing heart, which intensify in approach to treatment was
anticipation of social interactions. provided.
This avoidance has caused him to He was introduced to basic
feel increasingly isolated, lowering relaxation techniques, such
his self-esteem and contributing to as deep breathing, and
academic challenges as he avoids practiced them during the
participation-based tasks. session.
Homework: Record anxiety-
During the clinical interview, he provoking situations in a
shared insights into his family journal, noting triggers,
history. His parents described him thoughts, and feelings.
as a sensitive and reserved child. Results: He expressed relief
His mother, who experiences mild in understanding his
social anxiety, acknowledged that symptoms and felt motivated
her behavior might have influenced to observe and record his
his social apprehensions. His father, triggers.
a perfectionist, often sets high
expectations, which he finds
difficult to meet. Family
interactions tend to focus on
academic performance, with limited
discussions about emotional well-
being. His older sibling, a high
achiever, is frequently held as a
standard, increasing his feelings of
inadequacy.
18th sept, Re- He shared instances of avoiding Homework from the
2024 educative presentations and small group previous session was
Approach, activities. He expressed feelings of reviewed, revealing
Session#2 CBT inadequacy and fear of being common triggers and
judged or laughed at by peers. He thoughts.
identified several negative Following specific
automatic thoughts, such as measurable goals were
"Everyone will think I’m stupid" made
and "If I make one mistake, Psychoeducation on
everyone will hate me." Physical cognitive distortions,
symptoms, such as a racing heart including catastrophizing
and sweating, persisted during and mind reading, was
these situations. He explained that provided.
he often anticipates worst-case
scenarios before social events, He was taught thought-
which leads him to avoid them challenging techniques,
entirely. This avoidance has such as identifying
reinforced his belief that he cannot evidence against his
handle social situations. He also negative thoughts.
noted that when he does participate, The above goals were
he fixates on perceived mistakes collaboratively set,
afterward, which worsens his self- breaking them into
criticism and anxiety about future actionable steps.
interactions. Homework: Maintain a
thought journal, practice
reframing one negative
thought daily, and track
progress toward the goals.
Results: He gained insight
into how his thoughts
contributed to his anxiety
and felt motivated to work
toward these specific
objectives.
25th sept, Re- He struggled to apply thought- Conducted role-playing
2024 educative challenging techniques in real-life exercises simulating social
Approach, scenarios, reporting that his anxiety interactions, focusing on
Session#3 CBT overwhelmed him before he could challenging fears of
reframe his thoughts. He avoided a judgment and building
group discussion task at school, confidence.
feeling too paralyzed by fear to Behavioral experiments
engage. He also expressed tested the reality of his
frustration with his inability to feared outcomes (e.g.,
implement strategies learned in receiving negative
therapy when faced with high- feedback).
pressure situations, such as being Mindfulness exercises,
called on unexpectedly in class. He such as the 5-4-3-2-1
described feeling "frozen" and grounding technique, were
unable to think clearly in these introduced to manage
moments, which reinforced his anticipatory anxiety.
belief that he is incapable of Homework: Practice
handling social interactions. He mindfulness daily and
also noted that he is often unsure rehearse role-playing
how to respond in conversations, scenarios at home with a
leading to awkward silences that family member or friend.
further increase his self- Results: He demonstrated
consciousness. reduced anxiety during
role-play and expressed
increased willingness to
attempt small social tasks.
2nd Oct, Re- He reported continued difficulty Focused on building social
2024 Educative initiating conversations and skills through structured
Approach, maintaining eye contact in group activities, such as active
Session#4 CBT settings. He felt unsure of what to listening, open-ended
say and worried about saying the questioning, and
"wrong thing," leading to awkward assertiveness training.
silences. He expressed a desire to Practiced maintaining eye
connect more effectively with peers contact and initiating small
but felt stuck due to his lack of talk in role-play settings.
confidence in social skills. He also Homework: Engage in one
mentioned that when conversations brief social interaction
did occur, he often struggled to daily, such as greeting a
sustain them, feeling unsure of how peer or asking a question,
to follow up or respond in a way and record reflections in
that keeps the interaction engaging. the journal.
This difficulty often left him Results: He began feeling
feeling embarrassed and reinforced more confident in
his belief that he is "bad at initiating conversations
socializing." and reported a positive
experience when he
greeted a classmate.
9th oct Re- He described persistent physical Introduced progressive
2024 Educative symptoms, such as a racing heart muscle relaxation (PMR)
Approach, and trembling, which prevented and practiced it during the
Session#5 CBT him from feeling calm in social session.
settings. These symptoms often Discussed how relaxation
escalated when anticipating a techniques could support
feared interaction. He also noted confidence when working
that his physical symptoms toward social goals.
sometimes caused him to withdraw He practiced combining
from situations prematurely, as he deep breathing with PMR
felt that others might notice his to create a calming
nervousness, leading to routine.
embarrassment. He expressed Homework: Practice PMR
frustration with his inability to daily and use relaxation
control these physical responses, techniques before
which he believed undermined his attempting social
ability to perform well in social interactions.
settings. Results: He reported
improved control over his
physical symptoms,
feeling calmer before
initiating a conversation
with a teacher.
16th Re- He expressed concerns about Reviewed all goals and
October,2 educative sustaining his progress, particularly celebrated his progress
024 approach, in novel or high-stakes situations. Discussed strategies for
CBT While he felt more confident in maintaining gains,
Session#6 familiar settings, he worried about including regular
encountering unforeseen challenges mindfulness practice and
that might trigger regression. He ongoing use of cognitive
shared an example of an upcoming and behavioral techniques.
group presentation, where he Developed a personalized
anticipated anxiety about speaking plan for handling setbacks,
in front of classmates. He reflected emphasizing resilience,
on how past setbacks often led to self-compassion, viewing
rumination and a cycle of self- challenges as opportunities
doubt, which he hoped to avoid for growth.
moving forward. Despite these Homework: Write a
concerns, he acknowledged his reflection on progress and
accomplishments and felt identify three strategies to
motivated to build resilience by handle future challenges.
strengthening his coping Results: He felt more
mechanisms. optimistic about applying
learned strategies to
upcoming situations.
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