NURS 6650 Clinical Supervision – anxiety disorder Essay

NURS 6650 Clinical Supervision – anxiety disorder Essay

consider a client whom you do not think is adequately progressing according to expected clinical outcomes.
Reflect on a child or adolescent client you are currently counseling or have previously counseled at your practicum site who has been diagnosed with an anxiety disorder.
Describe the client. Note: Do not use the client’s actual name.
Explain your therapeutic approach with the client, including the perceived effectiveness of your approach.
Identify any additional information about this client that may potentially impact expected outcomes.


J.T is a 16 year old Caucasian male patient. He presents to the clinic with the claim that he experienced increased anxiety. He has been experiencing anxiety attacks for the last six months which have increased intensely for the last two weeks. He has been on anxiety medication during the last one week and reports minimal positive progression.  He reports increased insomnia and shakiness since the beginning of his treatment plan and considers the drugs ‘futile and more sickening’. NURS 6650 Clinical Supervision – anxiety disorder Essay The symptoms are currently affecting his daily activities. He is often tensed and has difficulties paying attention in class and finishing his assignments.

On examination, J.T. feels stressed all the time and worries about failing his examinations constantly. He is also afraid of making presentations in class which increases tension since one of his teachers expects the class members to participate in public speaking from time to time. He exhibits normal speech volume, rate and coherent articulation. He appears tensed but with intact language skills. The general demeanor and facial expressions demonstrate a stressed mood. The affect is appropriate, congruent and affluent with no delusion and hallucination signs. He does not abuse drugs but he is under pressure to try by his peers. Cognitive functioning and memory are age appropriate and intact. NURS 6650 Clinical Supervision – anxiety disorder Essay.

Therapeutic Approach

The patient will be treated using thee cognitive behavioral therapy which is considered to the most effective approach towards anxiety disorder management. This will be combined with the exposure therapy which was not included in the previous treatment plan. The objective of these combined techniques will be to overcome the clients fear, calm their mind and reduce their levels of anxiety. Exposure therapy will involve exposing the client to his fearful situations to relieve the tension that triggers anxiety (Topper et al., 2017). The client will be requested to think of the scary situations and direct exposure through systematic desensitization. Relaxation techniques will be applied to confront the trigger in this case NURS 6650 Clinical Supervision – anxiety disorder Essay.

Cognitive behavior therapy addresses negative distortions and behaviors thus changing our perception of the selves and the world (Hofmann & Otto, 2017). This in turn develops positive behaviors that help in the adaptation to the reality and reduction of fears that trigger anxiety. This will modify the client’s thoughts and behaviors as well as his cognitions to determine the anxiety triggers. Moreover, it will address the reactions and behaviors towards different situations particularly public speaking, socialization and examination situations which are identified as the key triggers to his anxiety. This will be followed by the process of cognitive restructuring or thought challenging which will entail the identification of the client’s thoughts, challenging the negative ones through evaluation of the provoking thoughts, questioning evidence, analyzing beliefs and evaluating the reality of negative predictions (Stein & Sareen, 2015). Consequently, the negative thoughts will be replaced by the realistic thoughts.

Additional information

The history of the client’s sickness will be an added advantage to accurate diagnosis and treatment. This will help learn the previous mental conditions experience before and the type of treatment that were effective in the management of the condition. Moreover the family history will facilitate the identification of probable disorders that might run in the family and hence improve clinical decision-making. Additionally, information regarding their allergies will help determine the cause of minimal progress of the treatment plan that involved the use of medication (Lader, 2015). This is because; allergies could worsen the client’s symptoms rather than improve them and hence risk the patient’s safety NURS 6650 Clinical Supervision – anxiety disorder Essay.


Hofmann, S. G., & Otto, M. W. (2017). Cognitive behavioral therapy for social anxiety disorder: Evidence-based and disorder specific treatment techniques. Routledge.

Lader, M. (2015). Generalized anxiety disorder. Encyclopedia of psychopharmacology, 699-702.

Stein, M. B., & Sareen, J. (2015). Generalized anxiety disorder. New England Journal of Medicine373(21), 2059-2068.

Topper, M., Emmelkamp, P. M., Watkins, E., & Ehring, T. (2017). Prevention of anxiety disorders and depression by targeting excessive worry and rumination in adolescents and young adults: A randomized controlled trial. Behaviour research and therapy90, 123-136 NURS 6650 Clinical Supervision – anxiety disorder Essay.

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