Case study. generalized anxiety disorder (gad)

To illustrate the application of the techniques learned, let us consider the case of "Laura," a 35-year-old woman who comes to the clinic complaining of constant and excessive worry about multiple aspects of her life: her job performance, her parents' health, her finances, and her children's future.

These worries cause her muscle tension, sleep problems, and frequent irritability that affects her relationships.

Evaluation and Case Conceptualization

After an initial evaluation, which would include a clinical interview and possibly a questionnaire such as the PSWQ (Penn State Worry Questionnaire), it is observed that Laura meets the criteria for Generalized Anxiety Disorder.

Her worries are difficult to control, cause her significant distress, and have been present most days for over six months.

Her thinking style is identified as tending toward catastrophizing ("If I make a mistake at work, I'll get fired") and overestimating the likelihood of negative events.

Physiologically, she presents a constant activation of the sympathetic nervous system.

Behavioral, she tends to ruminate and seek reassurance from her partner.

CBT-Based Treatment Plan

Laura's treatment plan would focus on:

• Psychoeducation: Explaining the nature of GAD, the vicious cycle of worry, and the adaptive function of anxiety, differentiating it from her current experience.

• Relaxation Techniques Training: She would be taught diaphragmatic breathing and progressive muscle relaxation to manage physical tension.

• Cognitive Restructuring: We would work on identifying her negative automatic thoughts and cognitive distortions (especially catastrophizing and overgeneralization). Using Socratic debate and evidence-seeking, more realistic and adaptive alternative thinking would be encouraged. You would be asked to keep a worry self-record for analysis.

• Exposure to Uncertainty: You would gradually be encouraged to tolerate uncertainty and reduce reassurance-seeking behaviors. This might involve "postponing worry" exercises to a specific time of day.

• Problem-Solving Techniques: For worries that are about r