When client comes in with his problem (e.g. ‘feeling anxious when looking up newspapers for job opportunity’), CBT framework will be used to conduct an initial assessment of the presenting issues. The client will describe problems with regards to:
1. Situations where problem occurs
- Have people noticed or commented on your anxiety? What have they said?
2. Duration
- How long have you experienced this problem?
- When did you first notice that you were feeling anxious?
- Did something happen before you start to feel anxious?
- Have you experienced any major traumatic events in the last 6 months?
3. Frequency
- Do you notice that the problem happens every time you check out on job opportunities?
- Does it happen more on some days compared to others? Why/Why not?
4. Intensity
- On a scale from 1 to 10 where 10 is really bad and 1 is not bad at all, where would you rate your level of anxiety? (i.e. SUDS scale)
- Is it always that bad? Can you think of other situations where the rating would change?
5. Course of problem
- Has there been a time in the last 1 month you have not felt anxious?
- Does it come and go?
- What has brought you to see me now?
6. Predisposing factors
- Are you aware of anyone else in your family who experiences anxiety? If yes, has he sought help for the problem? - Hospitalization, medication, etc.
- Do you have any medical health problem?
- Have you noticed frequent changes in your mood state?
Behavioral Analysis of the Problem:
Situational triggers - ‘Have you noticed that you feel more anxious when you are checking out the job advertisement with people around you?’
Behaviour triggers – ‘Have you noticed that you feel more anxious when you need to call the prospective employer for appointment?’
Cognitions – ‘Can you tell me exactly what was going through your mind when that happened?’
Affect/emotional factors – ‘Can you tell me whether there are any other moods that influence the anxiety?’
Social factors –
‘Does it make any difference whether you are interviewed by just one interviewer or a few?’
‘How would you normally respond to no reply from job application?’
‘What does your husband think about the problem?’
Physiological triggers – ‘What do you notice about your body before you experience the anxiety?’
Maintaining factors –
‘You said that you are tired of working, is this something that you would try to avoid?’
‘What would need to happen for you to let go of this problem?’
‘What have you stopped doing because of this problem?’
‘How has your life changed since having this problem?’
Coping (Environmental) Resources/Personal Strengths
‘I wonder what you do to help manage this problem.’
‘What about other times in your life when you have felt anxious – how did you get through these times – do you remember what you did?’
Client’s views of the problem & expectations of change
‘How hopeful are you that the problem will go away?’
‘What are you expecting from the treatment process?’
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