Background Information
Beryl had been referred by her General Practitioner and was described as having panic attacks and agoraphobic tendencies. She had undertaken counselling in a group setting before, as well as a 'listening therapy' approach 18 months previously. Although she felt listened to during counselling, her problems had recently become much worse. Beryl required assistance from her husband each time she left the home to run errands or visit with friends and family. She had 2 teenage children still living at home. Beryl's father had died 5 years ago and her mother had recently been diagnosed with having dementia. Beryl was seeing her GP on a regular basis, seeking re-assurance with chest pains. She had undergone a number of medical tests and her physical health was good for her age.
The Assessment
Beryl reported that she first experienced panic attacks as a teenager, and could remember difficult arguments with her father. Her GP prescribed medication for anxiety and panic attacks when she was in her early twenties, during a stressful time in her work environment, being married with 2 small children and running a home. The work situation was not resolved and Beryl was eventually made redundant. She remained at home, looking after the children and her husband. Beryl's father died when she in her thirties, which left Beryl feeling responsible for her mother, who could not adjust to losing her husband.
The Approach
Rational Emotive Behaviour Therapy (REBT) was selected because it can teach the client how to replace negative thinking with positive thinking and uses cognitive exercises to dispel irrational beliefs.
In the initial assessment, there was clear evidence that Beryl wanted to make a change and she was keen to engage in homework tasks. She was able to focus on the relevant issues for therapy and her treatment goals were discussed and agreed. At times of increased stress for Beryl, a