Psychological Treatment · 02

COGNITIVE BEHAVIORAL THERAPY.

A structured, evidence-based approach targeting the interaction between thoughts, feelings, and behaviors — first-line treatment for Generalized Anxiety Disorder.

Definition

Cognitive Behavioral Therapy (CBT) is a short-term, goal-oriented psychotherapy that focuses on the relationship between cognitions, emotions, and behaviors. Clients learn to identify distorted thinking patterns, evaluate them against evidence, and replace them with more balanced, adaptive thoughts. Behavioral techniques — exposure, relaxation, and skill practice — reinforce cognitive change.

How & When CBT Is Used for Anxiety

CBT is considered a first-line psychological treatment for GAD. It is typically delivered over 12–20 weekly sessions and is well suited to clients whose worry is driven by catastrophic interpretations of future events. For Mr. M, CBT directly targets pre-match catastrophizing, perfectionism, and physical arousal symptoms.

Treatment Goals

COGNITIVE RESTRUCTURING

Identify and reframe catastrophic pre-match thoughts.

BEHAVIORAL SKILLS

Build a repeatable routine for high-pressure moments.

PHYSIOLOGICAL REGULATION

Reduce arousal through diaphragmatic breathing.

Session 06 · Cognitive Restructuring

CHALLENGING THE THOUGHT.

Tell me about the thought that arrived just before the qualifier last week.

It hit me in the tunnel — 'if I miss this penalty, I will let everyone down.'

What's the evidence that one missed penalty would actually let everyone down?

When I say it out loud... I've missed penalties before. My team still won. Fans still came back.

What might be a more balanced version of that thought?

I have prepared. One mistake does not define the match — or me.

CBT Worksheet

THOUGHT RECORD.

A structured worksheet completed in-session and as between-session homework. Patterns become visible only when they're written down.

Situation

Pre-match warm-up before a high-stakes qualifier.

Automatic Thought

If I miss this penalty I will let everyone down.

Emotion

Anxiety 9/10 · Dread 8/10

Evidence For

Public scrutiny. Past misses were heavily covered by media.

Evidence Against

Past misses did not end the team's results. Coaches and teammates still trust me. I have a strong conversion rate.

Balanced Thought

I am prepared. A single missed penalty does not erase the value I bring.

Outcome

Belief in original thought 90% → 45%. Anxiety 8/10 → 4/10.

Belief in negative thought

Before90%

After45%

Self-rated anxiety

Before80%

After40%

Session Outcome

Mr. M completes the in-session thought record about the upcoming qualifier, reducing his belief in the thought "I will fail my team" from 90% to 45%. He practises diaphragmatic breathing for two minutes and reports a self-rated anxiety drop from 8/10 to 4/10. Between-session homework: one thought record per day and daily breathing practice. Progress is measurable, structured, and directly tied to the symptoms targeted in his treatment plan.

STRENGTHS

Strong empirical evidence for anxiety disorders
Structured, time-limited, goal-directed
Provides concrete skills clients can use independently

LIMITATIONS

Requires consistent homework and engagement
May not address deeper underlying issues
Less effective without established rapport