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Yeah, feels really hard and I want to be able to.
6cd
Okay.
7ack
I'm still feeling a little anxious, but I mean, I think it's better feels better that it's like out there. I guess that I'd like said it and I think maybe that helps.
11orq
So let's talk about this. So those type of thoughts, like I can't make a mistake or something like that. We call this automatic thoughts. And we'll have plenty of time talk about the different structures in CBT. I do want to explain it to you but over the course of several sessions, let's just take pieces of it for now. Okay. So far we believe is that your beliefs combined with a situation and create these thoughts. So you have this belief, so you're laying in bed for work, and you have this belief that you're maybe not competent. And then the situation that combines with that is, it's time to go to work. So the stress of No, it being time to actually get up and get ready to work. And then you have an automatic thought in that moment. Can right now it's one tied to dread and fear. Let's try to identify an exact one for this example. So let's use that scenario. You believe that you might not be confident you're laying in bed, and the alarm clock goes off. So you're kind of pressured to make a decision about do I get ready for work or not? What's the thought right then?
0id
if I go to work I'm going to make a mistake,
0id
So if I go, I'm going to make a mistake. And then we talked about your reactions being late. Worry, anxiety. So what we'd like to do when we identify on that felt like that is what's called self talk. And it first this may seem a little odd, right? So you have this thought that comes through it can be an image to the thought image. But it's cognitive in nature. And I can't make a mistake, like, I'm going to make a mistake. I'm going to make a mistake. That's your thought. And the self talk. This is like a rehearsed statement that you literally say to yourself, which again, I get to that seems so odd The first time I do it. So really, you're talking to yourself But over time, we believe if you can keep applying the self talk strategy that you will eventually change the outcome, the reaction and change the underlying belief. Okay? It first though it's going to seem quite foreign to you. Tell me how you how you're processing this now.
0id
So I mean, what am I supposed to say to myself?
4crq
It's a good question. We'll work on that. And that's what we can do now. Let's take a look at some self talk. So some adaptive responses so they can build. So I'm going to make a mistake. That's the automatic thought that's directly leading. Seems to be to feeling supported dread, and physically not getting work on time. Has there ever been times when you've had that thought? And you went to work on time still?
0id
Yeah.
8op
What was different about those times?
1irq
I guess I told myself, I have to get to work on time because if I don't, it's going to be even worse. If I make a mistake, and I'm late that it just, you know, it compounds and I guess I would tell myself, it's gonna be okay. You just have to get through this day.
0id
Alright, so when you do that, in essence, you are applying self talk. Okay. All right. So that's, that's really the same thing except you probably didn't have a label for it. And when you apply that it seems to work. So the message you're kind of sending yourself now you're telling yourself is I'm going to make a mistake still. But if I'm late for work, I'll be worse. So there's a little bit of positive and negative in here. Right self talk doesn't have to be all positive self talk needs to be, I think when anything realistic and sometimes realistic includes a little negativity. I'd rather focus on the more positive elements as we build this as possible though, so that's pretty good self talk you have now let's work on refining it a little bit to maximize its benefit.
0id
How many times have you gone to work and made a mistake?
1irq
I don't know. I mean, I guess none technically none that have been something I've gotten trouble for anything like that. Sometimes it's hard to tell because you know, you don't always hear from people afterwards. You can't really tell was it a mistake or not. But I guess none that it had like any major consequences.
0id
So none, but there might be a few small ones that you've just never found out about. So Less than a 10th of a percent days you come in probably very small, really, really small. The probability of a statement that you're making being true, is pretty low. The seventh thought rather, I'm going to make a mistake. Probably not supported by the evidence.
0id
Yeah, I guess that's true.
7ack
So, the automatic thought is not accurate and not useful. I just got a couple strikes against it. But it is the thought you're having so let's deal with it. I'm going to make a mistake. So what could you tell yourself as the first part of that adaptive response, which acknowledges that fear that's realistic, that acknowledges that fear of making a mistake
0id
I guess like it Everybody makes mistakes.
0id
Everybody makes mistakes. I could make a mistake today, but it's unlikely that that also be accurate. So everybody makes mistakes. I could make a mistake, but it's probably not gonna happen. Rather than I'm going to make a mistake. So you're going to have that automatic thought either way, likely for a while until you start to apply these adaptive responses. So this is what we're working on is your response. So everybody makes mistakes, I could make a mistake probably not going to happen. And will could be a next part, which is realistic, but also positive. That can help get you past the reaction of being late morning.
0id
I'm a good caseworker and I need to do my job so I can help other people and it's going to be okay.
0id
Okay, so there's a few few elements in there. It's going to be okay, I need to do my The job I help people all those all those are true So applying as you know even as you say this year with me as you say, it's gonna be okay I need to my shop. What are we actually having right now?
0id
I mean it feels a little better but it's hard you know so I felt still feel like it's dangerous I might make a mistake but I guess it helps a little bit
0id
Can you see yourself being able to in the moment and I realize this is difficult but in the moment of having that on that thought and that word come in. Can you see yourself applying this self talk?
0id
Yeah, I think I probably will because now it will be hard to have those thoughts and not think of you . Okay, I need to calm myself down a little bit.
8op
And you've already used self talk on your own before even knew about these?
5yq
Yeah. It did help in the past.
8op
A lot of the corsage to some of the effectiveness of this is based on your ability in that moment to take a step back and follow the training. Right, just like many professionals, professionals depend on their training to help them make the correct intervention correct decision. So think of this kind of like something you've learned in the training. This is a self talk. It's pre packaged, it's ready to go. You can even have it written down. Okay? Doesn't have to be short. It can be like a paragraph, or more if you want as a matter of following the protocol. Once you have the automatic thought, it's easy to descend into worry and fear. You're just looking too quick to grab a moment in there. Apply this treatment strategy. Does that make sense? Sometimes it's likely Well, most of the time, I think you would you would be able to do this. Sometimes you probably won't as important in those moments to not get discouraged. Right. So you can have a self talk for that to write something like Dr. Crowley said it was likely that once a while I wouldn't build do this.
0id
it's not gonna work every time.
0id
Make sense?
4crq
Yeah, that makes a lot of sense.
6cd
So it's the chaos of life, right in the chaos of emotions that sometimes interfere. the more times you have success, that that seems to be tied with a better chance of improving and reduction of symptoms, but allow yourself failures. Well, it's what I would expect from anybody trying to untangle all these feelings and thoughts. There's not gonna be a perfect connection between that automatic thought and applied self talk. Okay, so be easy on yourself as soon as you can,
0id
that makes sense because like, if you could just flip a switch you I would only have to have one therapy session.
0id
It'd be good shape, right? so it's a little more difficult than that. But overall, this these strategies are fairly straightforward. And you can definitely learn them and you can definitely do them. I want you to have that confidence. It's, it's normal to have mistakes occur. And to not always do it as you need to as you want to, but in the end, overall, you should be able to be able to apply them and actually It'll get easier in the future to develop your self talk for different thoughts. Okay?
0id
So you mentioned before that when you wake up in the morning, you you don't want to go to work, what's going through your mind?
1irq
I'm gonna have to, you know, hear what my coworkers have to say about what's going on. I might make another mistake. Who knows if I'm going to find out that something terrible happened to these kids when I go back to work? I guess a lot of stuff like that.
0id
So looking into one I'm going to make a mistake. That kind of connects to what we were talking about before it says the uncertainty, you're not sure of your own skills and you're afraid of an error that's going to be costly. So when you think that thought, I'm gonna make a mistake, so this is when you're, when you're in bed before you start your day, and you have that thought, what happens right then?
0id
I feel more anxious. You know, I think about like, what could happen to somebody else if I make a mistake, like kids going to the wrong home or, you know, not being with their parents when their parents you know, we're not doing anything wrong. And I just feel really like overwhelmed and it gets hard to breathe and I just want to go back to sleep and not have to face anything.
0id
So there's emotional consequences. And then the behaviors. You don't want to get out of bed.
0id
And then a lot more lately because I have trouble getting out of it.
0id
When you're staying in bed, are you under more thoughts coming up?
1irq
So this is really weighing on you. And he was edified these thoughts that seem to be connected with feelings that are unpleasant, and behaviors are unpleasant, but also maybe not useful.
0id
Yeah, they're keeping me from getting the work and stuff like that.
6cd
So we have a reference point for later on as we continue counseling. I'd like to scale this problem like maybe on a scale of one to 10, where 10 represents feelings that are nearly unbearable, right? And one not really a problem. How do you feel on that scale? Where do you rate yourself right now?
1irq
Right now in this moment, probably like a five. Around the middle. Yeah, like I'm really stressed out but I not like when I'm in bed, like I can't get out of bed, that kind of thing.
0id
How would you rate yourself when you're in bed before you go to work?
1irq
Probably like an eight.
0id
So an eight sometimes nine, right now five, so still not feeling great. Have you had to pick an emotion of standing out above the rest in anxiety, sadness, sense of dread. What would be the worst right now?
1irq
Right now probably anxiety.
0id
So five, on a scale 10 inside is really standing out more
0id
Hi, Andrea, thanks for coming in.
2gt
Hi, Thank you.
2gt
So I don't know how much you know already about sort of my role here and why you're even here. So I thought I'd start by telling you a little bit about myself. Basically, my job is to meet with all of the students I meet with everybody about once or twice a semester, and just talk with you a little bit about how things are going different behaviors that you might be engaging in thinking about any changes you might want to make for your life. If you decide that you do it's not my job to change you. I couldn't even if I wanted to. That's not my role at all. It's really to help you think about, you know, how things are going for you and how you might like making changes or moving forward. That sound okay ?
3gc
Yeah.
7ack
Oh
3gc
I'm also in the band geek. I play you know, in the Wind Ensemble in the jazz band, things like that.
3gc
Wow. You really are involved in music.
3gc
Yeah.
3gc
When did you start?
1irq
I started playing about 10 years ago, actually.
0id
Wow.
3gc
Yeah, I started on the violin first and then I went on explored a little with the piano clarinet. Finally found the center sacks.
3gc
Um, you know, just hanging out with my friends or go to the beach, things like that.
0id
It's kind of everyday, sort of thing ?
5yq
Yeah
8op
Tell me a little bit about your family.
1irq
Well, I have one older brother. He's about eight and a half years older than me, my parents and I have a Dog.
0id
Cute. What kind of dog ?
1irq
It's a golden retriever
0id
Oh, nice.
7ack
big boy.
3gc
Very funny. All right, and how are things going in school for you?
1irq
Pretty good. Grades have been pretty alright. Still like 3.7 ish.
0id
I'd like to, you know, I'd like to, of course graduate high school, hopefully go to a nice Ivy League school
0id
Ohh Alright.
3gc
or I mean, that might not happen. And then I'd like to go on become a doctor, study psychology, you need to come in psychiatrist or something.
0id
Okay. You have some pretty big dreams. It's great. It's really exciting to think about that and be looking forward to the future and those things.
7ack
Yeah.
3gc
All right. Well, one thing I'm going to ask you about is, you know, different people have sort of different things that they really value in their life, whether it's, you know, their cultural identity or their family or their friends or job or hobbies, things like that. Here's the little sheet that goes through just some basic values that might be more or less important to certain people like belonging or sense of community. Again, cultural identity or family, friendship, modesty, religion, respect, self determination and spirituality. So when you think about yourself, which of these are kind of most important to you in terms of your life?
1irq
Um, I think a sense of community and belonging.
0id
Okay.
3gc
I think those two and respect, respect.
0id
Okay,
7ack
Yeah, well, I think community and belonging I kind of related them. You know, I said I was in the marching band, I really, you know, I really enjoy being in like that team setting of, you know, being with other people and all working toward together towards that one goal. And then in terms of Respect I, I kind of view that as one of like, my major, like roles, like I really do think respect is important and to respect myself and respect those around me.
0id
Okay.
7ack
I placed great importance to them.
0id
Yeah.
7ack
And then the respect is really sort of all encompassing, not just authority, but respecting yourself, respecting your teammates or your bandmates and other people around you.
3gc
yes.
3gc
Um, sometimes if you just you know, go to the movies go to the beach, like I said, or sometimes we just get together at someone's house, play some board games and hang out.
0id
And when you're hanging out with friends, Is there ever alcohol involved.
1irq
Yeah, sometimes,
7ack
okay, can you tell me a little bit about how alcohol fits into sort of your social scene?
1irq
Well, it's mostly just for for parties or party settings is kind of to get things going and get everything loosened up, as they say,
0id
Mm hmm. And so when you go to parties, most of the time, there's alcohol there.
5yq
Yeah
8op
Okay. And how often do you think you would say you're drinking?
1irq
I'd say I'm on a not busy month, for instance, I'd say about like, two weekends out of the month to three.
0id
So about half the time you're drinking and half the time you're not.
5yq
Yeah
8op
Can you tell me what's different about the days when you choose to drink versus not to drink?
1irq