I feel like my brain never stops. Even when things are fine, I’m still scanning for what could go wrong.

Session Goal:

Introduce the CBT model and help Daniel identify his worry patterns.

Milestones:

Psychoeducation on anxiety and cognitive-behavioral cycles

Tips for Therapist:

Help Daniel articulate how his thoughts, feelings, and behaviors interact during worry episodes. Normalize anxiety and introduce the CBT cycle of interpretation → anxiety → behavior.

I got an email from my manager and immediately assumed I screwed something up. I couldn’t focus for the rest of the day.

Session Goal:

Teach Daniel to recognize and label his cognitive distortions.

Milestones:

Cognitive distortion identification (e.g., catastrophizing, mind reading)

Tips for Therapist:

Use examples from his work life to help him spot patterns like catastrophizing or jumping to conclusions. Begin to create some distance from automatic thoughts.

I started writing out all the things that might go wrong before our release deadline. It didn’t help. I just felt more tense.

Session Goal:

Help Daniel examine and reframe unhelpful thoughts.

Milestones:

Cognitive restructuring using thought records

Tips for Therapist:

Practice a full thought record: situation → thought → emotion → evidence → alternative thought. Reinforce more balanced and flexible thinking styles.

I tried breathing exercises, but I get frustrated when they don’t work instantly. Uncertainty just feels... unbearable.

Session Goal:

Introduce tolerance-building for uncertainty and explore relaxation strategies.

Milestones:

Relaxation skills and graded exposure to uncertainty

Tips for Therapist:

Validate his difficulty tolerating uncertainty. Practice short uncertainty-tolerance exercises. Set small exposure goals (e.g., leave email unread, delay reassurance).

I lie in bed for hours thinking about what I missed or could’ve done better. It’s the worst part of my day.

Session Goal:

Address anxiety-related insomnia and evening rumination.

Milestones:

Behavioral strategies for sleep and rumination management

Tips for Therapist:

Introduce a wind-down routine, reduce screen time, and restructure evening self-talk. Use stimulus control and cognitive defusion where appropriate.

Things still come up, but I feel less hijacked by my thoughts now. I can step back a bit more.

Session Goal:

Reinforce Daniel’s CBT skills and plan for relapse prevention.

Milestones:

Skill generalization and long-term self-monitoring

Tips for Therapist:

Highlight his progress and reinforce skills that work. Co-create a coping card or toolkit. Encourage reflection on past progress and what resilience now looks like.