This detailed clinical case study presents the cognitive behavioral therapy (CBT) treatment of a 20-year-old patient diagnosed with social phobia and a moderate depressive episode. It covers diagnostic procedures, therapeutic goals, and treatment progress within a psychosomatic inpatient setting. The report highlights psychoeducation, exposure therapy, and cognitive restructuring techniques used to address social anxiety and depressive symptoms. This practical and academically grounded case offers valuable insights for clinicians and students in psychological psychotherapy.
Table of Contents
- Current Case History
- Biographical & Social History
- Psychopathological Findings
- Diagnostics
- Therapeutic Goals
- Course of Therapy
- Outcome
- Critical Reflection
- References
Objective & Themes
This document presents a detailed case report for the State Examination in Psychological Psychotherapy, focusing on the cognitive behavioral therapy of a patient diagnosed with Social Phobia (ICD-10: F40.1) and a Moderate Depressive Episode (ICD-10: F32.1). The primary objective is to illustrate the therapeutic process, interventions, and observed outcomes within an inpatient setting for this specific patient.
- Application of Cognitive Behavioral Therapy (CBT) principles.
- Therapeutic approaches for Social Phobia (ICD-10: F40.1).
- Intervention strategies for Moderate Depressive Episode (ICD-10: F32.1).
- Detailed case study methodology in psychotherapy.
- Inpatient treatment in psychosomatic medicine and psychotherapy.
- Analysis of psychopathological findings and patient's biographical background.
Excerpt from the Book
Cognitive Behavioral Therapy of a Patient with Social Phobia (ICD-10: F40.1) and Moderate Depressive Episode (ICD-10: F32.1)
The patient attended individual sessions punctually and reliably. Initially, he appeared anxious and tense, requiring significant time to respond and speaking in a very quiet voice. Through an empathic and supportive approach, trust was gradually established, allowing for a constructive therapeutic relationship. The initial sessions were primarily psychoeducational (Angenendt & Hohagen, 2013), helping the patient deepen his understanding of the disorder and begin building trust. Psychoeducation addressed the function of anxiety, the anxiety curve, and the vicious cycle of fear.
A connection was made through discussion of the patient's resources (characters from the series 'Dr. Who'), allowing him to gradually express his feelings and desires. Dysfunctional core beliefs were identified, reflected upon, and initially modified. Constructive responses to negative cognitions (e.g., ‘I will say something wrong. Others will laugh at me.') were discussed. To cope with social fears, an anxiety hierarchy was collaboratively developed, and behavioral experiments and exposure exercises were conducted (Stangier, Clark, & Ehlers, 2006). The patient was motivated to engage in exposure and quickly noticed small improvements. He was able to maintain more eye contact. Over time, he accumulated positive corrective experiences (e.g., riding public transport, shopping). With supportive encouragement, he managed to attend the clinic's internal school and gained further positive experiences.
During therapy, he made progress in identifying personal needs and feelings. Strategies for reducing tension were developed (e.g., listening to music, abdominal breathing) and effectively applied. To address depression, resource-activating activities were introduced (Hautzinger, 2013), such as drawing, nature walks, and maintaining a joy diary. When experiencing strong emotions, especially anger, he tended to withdraw into silence. This behavior was partially explored and reflected upon in later sessions.
Summary of Chapters
Current Case History: This chapter describes the patient's presenting symptoms and initial clinical picture upon admission, detailing his social anxiety, depressive symptoms, and academic difficulties.
Biographical & Social History: This section delves into the patient's early life experiences, complex family dynamics, and developmental background, highlighting the significant stressors and unmet needs that contributed to his current psychological state.
Psychopathological Findings: Here, the observed psychological state of the patient during examination is outlined, covering his appearance, affect, communication difficulties, and the absence of psychotic symptoms.
Diagnostics: This chapter presents the results of standardized psychological assessments like the KPD-38 and BDI-II, confirming the formal diagnoses of Social Phobia (F40.1) and Moderate Depressive Episode (F32.1).
Therapeutic Goals: This section lists the specific objectives established for the patient's treatment, including fostering a therapeutic alliance, developing an illness model, and improving emotional regulation and coping strategies.
Course of Therapy: This chapter describes the chronological progression of treatment sessions, detailing the psychoeducational interventions, behavioral experiments, exposure exercises, and resource-activating activities employed.
Outcome: This section summarizes the observed changes and improvements in the patient's condition at the end of the inpatient treatment, noting a deeper understanding of his illness and enhanced coping skills.
Critical Reflection: This chapter provides an evaluation of the therapeutic process, discussing challenges such as initial verbal inhibition, the potential for overwhelming the patient in an inpatient setting, and recommendations for continued care.
References: This final section lists all academic sources and literature cited throughout the case report, providing support for the therapeutic approaches and diagnostic criteria used.
Keywords
Cognitive Behavioral Therapy (CBT), Social Phobia, Moderate Depressive Episode, Case Report, Psychotherapy, Inpatient Treatment, Psychoeducation, Exposure Therapy, Anxiety Hierarchy, Core Beliefs, Emotion Regulation, Coping Strategies, Diagnostic Assessment, Clinical Psychology
Frequently Asked Questions
What is this work fundamentally about?
This work is fundamentally a case report detailing the cognitive behavioral therapy of a male patient diagnosed with Social Phobia (ICD-10: F40.1) and a Moderate Depressive Episode (ICD-10: F32.1), presented as part of a State Examination in Psychological Psychotherapy.
What are the central thematic areas?
The central thematic areas include the diagnosis and treatment of social phobia and depression using Cognitive Behavioral Therapy (CBT), the role of biographical factors in psychological distress, diagnostic assessment methods, and the structure of an inpatient therapeutic course.
What is the primary objective or the research question?
The primary objective is to document and analyze the therapeutic process, specific interventions, and observed outcomes for a patient undergoing CBT for co-occurring Social Phobia and Moderate Depressive Episode within an inpatient setting.
Which scientific method is used?
The scientific method primarily used is a case study approach, which involves documenting the detailed individual course of therapy, including diagnostic assessments and therapeutic interventions, for a single patient.
What is covered in the main part?
The main part covers the patient's current case history, biographical and social background, psychopathological findings, diagnostic results, therapeutic goals, the detailed course of therapy, and the observed outcome of the treatment.
Which keywords characterize the work?
Key words characterizing this work include Cognitive Behavioral Therapy, Social Phobia, Moderate Depressive Episode, Case Report, Psychotherapy, Inpatient Treatment, Psychoeducation, Exposure Therapy, and Emotion Regulation.
What specific diagnostic tools were used to assess the patient's condition?
The Clinical Psychological Diagnostic System 38 (KPD-38) and the Beck Depression Inventory (BDI-II) were administered to assess the patient's psychological distress, perceived social problems, behavioral competence, general life satisfaction, and depressive symptom severity.
How did the therapist address the patient's social fears and avoidance behaviors?
The therapist collaboratively developed an anxiety hierarchy, conducted behavioral experiments, and employed exposure exercises to help the patient face his social fears, leading to the accumulation of positive corrective experiences and improved social interaction, such as maintaining eye contact.
What were some of the challenges identified in the "Critical Reflection" regarding the therapy process?
Challenges noted included the patient's severe inhibition in verbal expression which initially limited therapeutic work, the potential for the inpatient setting to overwhelm the patient, and the recommendation for continued partial hospitalization and outpatient therapy to sustain therapeutic gains and further address diagnostic considerations like avoidant personality disorder.
- Citar trabajo
- Anonymous (Autor), 2020, Cognitive Behavioral Therapy of a Patient with Social Phobia and Moderate Depressive Episode, Múnich, GRIN Verlag, https://www.grin.com/document/1600918
