Emily, 35, an elementary school teacher, has suffered from generalized anxiety disorder for 3 years. Symptoms include persistent worry ("catastrophizing"), muscle tension, difficulty falling asleep, and physical symptoms such as palpitations. She spends 4-5 hours daily in "what if..." thought loops, resulting in decreased work quality and avoidance of social activities. GAD-7 scale score: 21 (severe).
Customized Treatment Plan
Utilizing a three-dimensional intervention combining Cognitive Behavioral Therapy (CBT) + Acceptance and Commitment Therapy (ACT) + physiological regulation:
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Cognitive Detachment Phase (Weeks 1-5)
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Use the "Thought Observer" technique to identify automatic negative thoughts (e.g., "The parents' meeting will suddenly complain about me")
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Create an anxiety journal: record the actual occurrence probability of 100 worry events (only 3% came true)
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Value-Driven Actions (Weeks 6-12)
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Clarify core values through "Funeral Meditation": "Be a nurturing educator"
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Design graded exposure:
✓ Proactively explain anxiety status to the principal (actually received support)
✓ Gradually resume speaking in teaching research meetings (from 1 minute to full presentations)
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Body Retraining (Throughout)
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10 minutes daily of Progressive Muscle Relaxation (PMR)
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Use the "4-7-8 breathing technique" to interrupt anxiety spirals
Key Turning Point
In week 9, Emily successfully applied the "RAIN technique" (Recognize-Allow-Investigate-Non-identification) during an anxiety attack for the first time, reducing anxiety intensity from 9 to 4 (on a scale of 10). In week 14, she proactively organized an outdoor class activity without over-preparing contingency plans.
Treatment Outcomes
6-month evaluation:
✓ GAD-7 score dropped to 5 (mild)
✓ Sleep efficiency improved to 85% (from 62%)
✓ Resumed piano hobby and established a teacher psychological support group
Counselor's Closing Remarks
"GAD is like an alarm that never turns off. Emily’s growth teaches us that treatment is not about silencing the alarm, but about cultivating the wisdom to manage the alarm system—hearing the alarm, but not letting it control life."