Keywords anxiety; Cognitive therapy system; desensitization therapy
Visitor: Xia Mou, female, 16 years old, a senior one student, living with her parents. My father is a technician and my mother is a teacher in the middle school where the visitors are located. Parents have no personality disorder and other neurotic disorders, and the family has no history of mental illness. Parents have high expectations of them, so they are strict in their studies. The family's economic situation is good, and the relationship between parents is also good. Since childhood, they are competitive, lively and cheerful, extroverted, with strong self-esteem, and always pursue perfection. The main complaint is that he is "afraid of the chemistry exam and very nervous". SCL-90, SDS and SAS psychological tests were selected. The results showed that the scores of somatization, depression and anxiety were higher than the norm, and there were mild depression and moderate anxiety.
Cause analysis: (1) Biological causes. Visitor 16 years old, senior one last semester, needs to adapt to the new study and life. In addition, adolescent girls in the developmental stage have strong self-esteem and fragile hearts, and the failure of one exam can easily be generalized to every exam; Hospital examination showed no organic lesions. (2) Social reasons. Xia's self-confidence was frustrated because he experienced an exciting negative life event; In Xia's growing environment, her parents and teachers have always cared about her, making her strict and perfect, thinking that she can't and won't fail. (3) Psychological reasons. Personality factors: high self-demand and strong competitiveness; Misunderstanding or misjudgment of practical problems: fear of failing the chemistry exam, affecting your total score, and fear of failure; Wrong idea: I think I should not fail, and once I fail, I will be depressed; Persistent negative memories: a failed exam has been bothering me.
Consultation goal: (1) Specific goal and short-term goal: to eliminate summer worries and anxiety. Using positive self-suggestion and relaxation skills in daily life can reduce their anxiety level and enhance their self-confidence. (2) Ultimate goal and long-term goal: make visitors form a correct self-concept, improve their ability to cope with setbacks, and promote their perfect personality and normal psychological development.
Initial consultation: the purpose is to establish a good trust and consultation relationship with visitors, collect information, make psychological diagnosis and determine the consultation objectives. Methods: When you meet Xia for the first time, you should let Xia relax, accept a counselor, correctly view the purpose of this consultation and avoid psychological pressure. Through listening, * * *' s goodwill and unconditional positive attention, Xia can relax, tell her own situation completely, collect detailed information and complete the psychological test.
The second consultation: analyze the problem and implement the treatment. The purpose is: (1) to make Xia realize that his problems are caused by his bad cognition and establish a correct and positive cognition; (2) Learn to relax. Methods: Interview, cognitive reconstruction, behavior relaxation training and positive self-suggestion. Cognitive reconstruction: The consultant discussed with Xia Mou the bad cognition of being afraid of chemistry exam, the time and place where it appeared, and helped Xia Mou to stop these negative thinking and establish correct or positive thinking.
For example, "As long as I prepare well as before, I will definitely pass the chemistry exam", "The teacher will help me", "I believe I can do it" and "I am still an excellent student". Behavior relaxation training: under the guidance of psychological counselors, gradually relax muscles, such as sitting in a chair, first tense and then relaxed, and finally realize the state of whole body relaxation by understanding the difference between tension and relaxation in the order of arms, head, trunk and legs.
Homework assignment: (1) reflect on the reasons why I didn't do well in the previous chemistry exam, and reflect on my inner thoughts, physical and emotional changes, and the finer the better. (2) According to the relaxation method taught by the counselor, train 1 ~ 2 times a day and relax all over in 15 ~ 20 minutes.