CASE STUDY ANALYSIS WITH COUNSELLING PLAN
CASE DETAILS
Arjun is a 20 year-old who reports to you that he feels depressed and is experiencing a
significant amount of stress about school. He spends much of his day in his hostel playing
video games and has a hard time identifying what is enjoyable in a typical day. He rarely
attends class and has avoided reaching out to his professors to try to salvage his grades this
semester. Arjun has always been a self-described shy person and has had a very small and
consistent group of friends from elementary through high school. Notably, his level of stress
significantly amplified when he began college. You learn that when meeting new people,
he has a hard time concentrating on the interaction because he is busy worrying about what
they will think of him – he assumes they will find him “dumb,” “boring,” or a “loser.”
When he loses his concentration, he stutters, is at a loss for words, and starts to sweat,
which only serves to make him feel more uneasy. After the interaction, he replays the
conversation over and over again, focusing on the “stupid” things he said. Similarly, he has
a long-standing history of being uncomfortable with authority figures and has had a hard
time raising his hand in class and approaching teachers. Since starting college, he has been
isolating more, turning down invitations from his roommate to go eat or hang out, ignoring
his cell phone when it rings, and habitually skipping class. His concerns about how others
view him are what drive him to engage in these avoidance behaviors .
I. KEY PROBLEMS IDENTIFICATION :
Arjun, a 20-year-old college student, is experiencing significant depression and stress
related to his academic environment.
1. Social Anxiety: Arjun fears being judged by others, making him avoid social interactions
and new situations, leading to avoidance of interactions and activities that could help him
adjust to college life.
2. Depression: He feels down, has lost interest in activities, and is neglecting his studies. His
lack of enjoyment in daily activities, social withdrawal, and neglect of academic
responsibilities suggest underlying depressive symptoms.
3. Avoidant Behavior: Arjun’s tendency to avoid classes, social invitations, and interactions
with authority figures reflects a pattern of avoidance that exacerbates his anxiety and
isolation. He avoids classes and social invitations, which increases his feelings of isolation.
4. Academic Stress: Pressure from school adds to his anxiety and feelings of inadequacy. His
struggles in managing academic expectations contribute to his stress and feelings of
inadequacy, further diminishing his motivation.
II. COUNSELLING PLAN
o ASSESSMENT TECHNIQUES
1. Clinical Interviews: Conduct a structured clinical interview to explore Arjun’s
history, current symptoms, and behavioral patterns in depth. Talk to Arjun to
understand his feelings and behaviors.
2. Standardized Assessments: Use assessment tools such as the Beck Depression
Inventory (BDI) and the Social Anxiety Questionnaire to quantify the severity of
his depression and social anxiety. Use questionnaires to measure his depression and
anxiety levels.
3. Behavioral Observation: Observe Arjun in social settings (e.g., group therapy) to
assess his interactions and anxiety triggers. Watch how he interacts in social settings
(like group therapy).
4. Self-Monitoring Journals: Encourage Arjun to maintain a daily journal to track his
moods, social interactions, and avoidance behaviors. Ask him to keep a diary of his
moods and interactions.
o GOALS FOR THERAPY
1. Reduce Anxiety Symptoms: Help Arjun manage and reduce his anxiety related
to social interactions and academic performance. Help Arjun manage his fears
in social situations.
2. Increase Engagement: Encourage Arjun to participate more in academic and
social activities, gradually reducing avoidance behaviors. Encourage him to join
classes and social activities.
3. Enhance Coping Strategies: Equip Arjun with effective coping mechanisms to
handle stress and anxiety in both academic and social settings. Teach him
strategies to handle stress and anxiety.
4. Improve Self-Esteem: Work on building Arjun’s self-esteem and self-
acceptance to mitigate negative self-perceptions. Help him feel better about
himself and his abilities.
o SPECIFIC INTERVENTIONS
1. Cognitive Behavioral Therapy (CBT): Focus on identifying and challenging
Arjun’s negative thoughts regarding himself and his interactions with others.
Help Arjun change negative thoughts about himself and others.
2. Exposure Therapy: Gradual exposure to feared social situations (e.g., attending
a class, speaking with a professor) to reduce avoidance behaviors. Gradually
face feared social situations to reduce anxiety.
3. Relaxation Techniques: Teach Arjun relaxation strategies such as deep
breathing, mindfulness, and progressive muscle relaxation to manage anxiety
symptoms. Teach breathing exercises and mindfulness to calm himself.
4. Social Skills Training: Provide skills training to help Arjun develop effective
communication techniques and improve his confidence in social situations.
Practice communication skills to build confidence.
5. Goal Setting: Collaboratively establish small, achievable goals for each session
to gradually increase Arjun’s engagement in social and academic activities. Set
small, achievable goals for him to work toward.
III. SESSION PLAN
Session 1: [Assessment and Rapport Building]
o Conduct initial assessment (clinical interview, BDI).
o Discuss Arjun’s experiences, feelings, and goals for therapy.
o Introduce basic relaxation techniques.
Session 2: [Cognitive Restructuring]
o Identify negative thoughts related to social interactions.
o Begin cognitive restructuring exercises.
o Set a goal for Arjun to attend at least one class this week.
Session 3: Exposure and Behavioral Activation
o Discuss avoidance patterns and their impact on Arjun’s mood.
o Develop a plan for gradual exposure to social situations (e.g., meeting a classmate).
o Encourage engagement in enjoyable activities, discussing potential hobbies or
interests.
Session 4: Social Skills and Coping Strategies
o Conduct role-playing exercises to practice social interactions.
o Introduce more advanced relaxation techniques and coping strategies.
o Review progress, celebrate successes, and adjust goals as needed.
IV. CONCLUSION
Arjun's case presents significant challenges related to social anxiety and depression that
require a structured therapeutic approach. By utilizing assessment techniques, setting clear
therapy goals, and implementing targeted interventions, Arjun can work toward improved
mental health, greater social engagement, and academic success. Regular evaluation of his
progress and adaptation of strategies will be essential for effective treatment.
