Cognitive Behavioral Therapy Worksheet for Bethany Franks

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Date: December 19, 2024
Session: 1/13
Patient ID: PH9-8
PC1-5-14
GAD Level: 7
Risk Level: 0

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Patient Condition Summary

Bethany has presented with increased anxiety related to her work environment, primarily characterized by a heightened perception of danger, especially in interactions with female colleagues. This shift in perception may stem from a previous trauma involving a seizure experienced while working alongside a female peer.

Recent Incident

During an emergency response while attending to an intoxicated individual, Bethany encountered inappropriate physical contact from a colleague, referred to as "Nick." This incident led to substantial emotional distress, including anxiety and feelings of isolation. Despite submitting a formal statement regarding the incident, Bethany has faced delays in receiving feedback, exacerbating her feelings of anger and worry about future interactions.

Goals

1. Reduction of Anxiety: Minimize anxiety associated with working alongside unfamiliar staff members.
2. Restoration of Confidence: Foster a sense of confidence in interactions with female colleagues to help Bethany feel more secure professionally.
3. Coping Strategies: Develop and implement effective coping strategies for managing anxiety and establishing a sense of safety in the workplace.

Cognitive Behavioral Therapy Exercises

1. Identifying Negative Thoughts

• Instructions: Write down any negative thoughts or beliefs you have regarding your workplace and interactions with colleagues.

  Negative Thought	Evidence For	Evidence Against	New Balanced Thought
  I will always feel anxious around women.	Past negative experiences.	Not all interactions have been negative.	I can manage my anxiety with practice.
  Others will judge me for my anxiety.	Limited past interactions.	Positive feedback from colleagues.	Colleagues understand that anxiety is common.

2. Gradual Exposure Hierarchy

• Instructions: List situations related to your work that trigger anxiety, and rank them from least to most anxiety-provoking. Gradually expose yourself to these situations over time.

  Situation	Anxiety Level (0-10)	Action Plan
  Greeting a female colleague	4	Initiate small conversations during breaks.
  Discussing work assignments with a female peer	6	Schedule a one-on-one meeting to discuss projects.
  Attending a team meeting with female colleagues	7	Prepare points to discuss before the meeting.
  Collaborating on a project with a new female staff member	9	Arrange introductions and be clear in communication.

3. Coping Strategies

• Instructions: Identify specific coping strategies that you can use during anxious moments.

  • Breathing Exercises: Practice deep breathing for 5-10 minutes when you start to feel anxious. Inhale through your nose for 4 counts, hold for 4, and exhale through your mouth for 6 counts.
  • Grounding Techniques: Identify five things you can see, four you can touch, three you can hear, two you can smell, and one you can taste to help ground yourself in the present moment.
  • Thought Stopping: When negative thoughts arise, mentally say "stop" and replace them with positive affirmations.

4. Goal Setting for Next Week

• Instructions: Identify one manageable goal to work on for the upcoming week related to the above exercises.

  • Goal: This week, I will initiate at least one conversation with a female colleague about non-work-related topics to build comfort in interacting.

Reflection

• What thoughts or feelings did you experience while completing this worksheet?

• What do you hope to achieve by continuing therapy?

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Resources for Additional Support:

• Breathing Techniques for Relaxation: [Insert link or description of resource]
• Trauma-Informed Care: [Insert link or description of resource]
• Peer Support Groups: [Local resources or online forums]

Next Appointment

• Date: [insert date]
• Time: [insert time]
• Location: [insert location]

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Therapist Signature:
Date:

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