Case Study: Anxiety in a Public Speaker (Diversity: Cultural Differences in Emotional Expression)

Presenting Problem: A young Asian American woman experiences intense anxiety and avoidance behaviors when asked to give public presentations.

Cognitive-Behavioral Conceptualization: Her anxiety likely stems from negative automatic thoughts (NATs) about her performance and potential negative evaluations from the audience. These thoughts might trigger physiological arousal (increased heart rate, sweating) and behavioral avoidance (cancelling presentations).

Assessment Questions:

1. “What specific thoughts come to mind when you anticipate giving a presentation?” (Targets NATs)
2. “How realistic do you believe these thoughts are, and what evidence supports or refutes them?” (Challenges negative thinking patterns)

Treatment Goals:

1. Reduce anxiety associated with public speaking.
2. Develop coping skills to manage negative thoughts and challenge unhelpful beliefs.

Treatment Plan:

Cognitive restructuring will be used to identify and challenge negative automatic thoughts. Relaxation techniques will be introduced to manage physiological arousal. Role-playing and exposure exercises will be implemented to build confidence and desensitize the client to public speaking situations.

Outcome Measure: Self-reported anxiety levels before and after presentations, along with observing a decrease in avoidance behaviors. This aligns with CBT’s focus on changing thoughts, feelings, and behaviors.

Merit of CBT: CBT offers a structured, goal-oriented approach to address anxiety by equipping individuals with practical tools for managing their thoughts and behaviors.

Limitation of CBT: CBT might not fully address cultural factors influencing emotional expression. In this case, exploring cultural norms around public speaking and potential pressures to conform within the Asian American community could be valuable.

Diversity and CBT: Cultural norms can influence how individuals express and perceive emotions. Some Asian American cultures might emphasize social harmony and avoiding drawing attention to oneself. Exploring these cultural aspects alongside CBT techniques can provide a more comprehensive approach to managing anxiety in public speaking situations.