Naomi is a 42-year-old woman who has been working for a construction company as an architect for 10 years. She is particularly afraid of speaking up at meetings, and she feels very uncomfortable when she makes presentations. In these situations, she often experiences anxiety symptoms such as pounding heart, shaking hands, and dizziness, and she thinks that other people would notice signs of her anxiety. When her colleagues ask for her opinion at meetings, she simply says, “I agree”, although she rehearses what to say in her mind. When her colleagues watch her presentation, she speaks quickly so that she finishes before her hands start shaking, and tries to look “normal” as if she was not experiencing anxiety, by keeping her head up, looking around, and smiling. She developed her social anxiety at the age of 37. When she was about to say her opinion at a meeting, she noticed her heart pounding. Then her hands suddenly started shaking, her mind went blank, and she forgot what to say. When she was 9 years old, she had an important piano recital. She was very anxious, as she was one of the youngest pianists who performed in the recital. Her teacher advised her to “look confident when you play”. She took the advice and tried to look confident, but she lost her confidence as soon as she noticed that she had made a mistake. Naomi thought she disappointed her teacher and parents who had high expectations of her, because she did not win any awards. 1. Formulation Drawing on appropriate theoretical models of psychopathology, what would be your preliminary formulation of the client’s problems? 1.1. Predisposing Factors: Discuss the long-term factors that have left your client vulnerable to any problems she is experiencing. 1.2. Perpetuating factors: Drawing on theory and empirical research, how are the problems maintained? 2. Treatment 2.1. Establishing rapport How would you establish rapport with your client? 2.2. Treatment strategies Based on the case formulation, plan and justify one or two main psychological treatment strategies, which are applied specifically to the client. This may include your client’s potential reactions to your intervention. 1500 WORDS EXCLUSIVE OF REFERENCES AND DIAGRAMS
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