Abby is a 20-year-old female college student. For at least the last 3 months, Abby has experienced ongoing anxiety and worry without a specific cause for these feelings. She has been restless and has noticed that her muscles feel tense and that these symptoms are beginning to affect her behavior in a way that is causing her to become distressed and that is preventing her from being able to complete her normal tasks. Abby correctly believed that it was normal to feel a little anxious sometimes; however, as the semester has progressed, she has not begun to feel significantly more comfortable.
On the recommendation of a friend, Abby visited the university’s counseling center and talked to Dr. Smith. Dr. Smith was warm and welcoming and, after discussing the limits of confidentiality with Abby and obtaining informed consent, encouraged Abby to describe her concerns. Dr. Smith listened attentively and asked Abby a few questions. They both agreed on an appointment date and time for the next week. Dr. Smith gave Abby a homework assignment to keep a written log of the negative thoughts or assumptions she has during the week and the circumstances under which those thoughts occurred. Abby was asked to bring the log with her to her next appointment.
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