Note: All identifiable information has been changed to protect patient health information
Beth Lee was a 19-year-old Asian-American female who was referred for treatment at my clinic due to social anxiety following her first semester of college. As the semester progressed, Beth became increasingly anxious around her peers at school and eventually stopped attending social gatherings and large lecture classes due to fear that she would run into someone she knew and wouldn’t know what to say. Beth realized she needed to seek help when she would spend all weekend in her dorm room and started to notice a drop in her grades.
During the onset of treatment, I provided information to Beth about exposure therapy as an evidence-based treatment for social anxiety disorder, and that she would be asked to confront her social fears in a step-wise fashion over time as part of our treatment together. Importantly, I discussed with Beth that a primary component of treatment would be to track her anxiety before and after engaging in social exposure exercises, such that she could begin to understand the difference between her anticipatory anxiety and her lived experience of the event.
Beth enrolled in Blueprint at the end of our first session and was assigned the DSM-5 Severity Measure for Social Anxiety Disorder and the Acceptance and Action Questionnaire II as her outcome measures. Along with the weekly outcome measures, I asked Beth to complete two check-ins each day - directly before and after each social exposure that was assigned for the given week. I was also able to monitor Beth’s ability to complete exposure exercises by viewing Beth’s check-in data, and encouraged Beth to keep up the good work each time we met. During our therapy sessions, Beth and I would collaboratively view her data and evaluate the influence that confronting her social fears had on her overall levels of stress and anxiety. Over time, Beth came to realize that her anticipatory anxiety about social events was never as bad as the real experience, and that avoiding uncomfortable situations actually caused her symptoms to increase over time. Beth was able to complete two months of social exposure therapy using Blueprint and eventually returned back to school with her newfound confidence.
Cases such as Beth remind us of the benefits that arise when integrating Blueprint into the treatment process in a flexible and creative manner.