Case study clinical example CBT: First session with a client with symptoms of depression (CBT model)

Summary

In this emotional dialogue, Lucy, a university English student, opens up about her struggle with persistent feelings of sadness and low motivation. She reveals her sense of isolation, difficulty in confiding in friends or family, and the pressure of high academic and parental expectations. Lucy's downward spiral began with exam stress and her parents' marital issues, leading to a cycle of negative thoughts and feelings of unworthiness. The conversation highlights her internal conflict and the challenge of coping with mental health struggles while navigating university life.

Takeaways

• 😔 The individual, Lucy, has been feeling down and unmotivated for several months, with her condition worsening recently.
• 🏥 Lucy was referred to the service by her GP three months ago, indicating her prolonged struggle with her emotional state.
• 📚 She is an English student at university and lives away from home with friends, but feels isolated and unable to confide in them about her feelings.
• 🤔 Lucy's low mood seems to have started during exam preparation, compounded by her parents' marital issues and her own academic stress.
• 😔 She feels guilty and believes that if she performed better academically, it might have improved her parents' situation.
• 📉 Lucy's academic performance did not meet her own high standards, leading to self-criticism and a further decline in her mood.
• 🚫 She experiences difficulty in reaching out for help, feeling that no one would understand or listen to her struggles.
• 😞 Lucy's negative thoughts include feelings of worthlessness, believing she doesn't deserve to be at university, and that her efforts are pointless.
• 😡 Along with sadness, Lucy also experiences anger and frustration, likely directed at her situation and herself.
• 🛌 She has lost interest in activities she once enjoyed and has a lack of motivation to even attend lectures, which she finds stressful.
• 💤 Lucy's physical state reflects her emotional state, with feelings of being drained, lethargic, and struggling with sleep.

Q & A

Why was Lucy referred to the counselor?

Lucy was referred to the counselor by her GP because she had been feeling quite down and hadn't been feeling well for a while, and she thought it was time to see someone about it.

How long has Lucy been feeling down?

Lucy has been feeling down for quite a few months before seeing the GP, and it has gotten worse in the past few months.

What has been the impact of Lucy's low mood on her daily life?

Lucy's low mood has led to a lack of motivation, making it hard for her to do things she used to enjoy and causing her to isolate herself from friends and family.

How does Lucy feel about her friends' understanding of her situation?

Lucy feels that her friends are lovely and she gets along well with them, but she doesn't feel they understand what she's going through, so she hides her feelings from them.

What was the initial trigger for Lucy's low mood?

The initial trigger for Lucy's low mood was the stress from revising for exams and her parents going through marital problems around the same time.

How did Lucy's parents' marital issues affect her?

Lucy's parents' marital issues added to her stress and affected her emotionally, making her feel guilty and responsible for trying to fix things by doing well in her exams.

How did Lucy perform in her exams?

Lucy did not perform well in her exams, which added to her feelings of guilt and failure, as she had put a lot of pressure on herself to succeed.

What are Lucy's thoughts about her self-worth and abilities?

Lucy has high standards for herself and feels unworthy and inadequate when she doesn't meet those standards. She also feels she doesn't deserve to be at university if she can't perform well.

What emotions does Lucy experience when she has negative thoughts about herself?

When Lucy has negative thoughts about herself, she experiences sadness, anger, frustration, and embarrassment.

How does Lucy's physical state reflect her emotional state?

Lucy's physical state reflects her emotional state as she feels drained, lethargic, and struggles with sleep, which is indicative of her overall stress and depression.

What coping mechanism does Lucy use to deal with her negative thoughts?

Lucy uses avoidance as a coping mechanism, trying to push out negative thoughts and not think about them, which she finds somewhat relieving but acknowledges might make things worse in the long run.