LITMIR.BIZ

      1 Excessive Worry (1)*The client described symptoms of unrealistic preoccupations with worry that something dire will happen.The client showed some recognition that excessive worry is beyond the scope of rationality but feels unable to control it.The worry symptoms have continued for longer than 6 months.The client has worry symptoms more days than not.The client described that they worry excessively about two or more events or activities.The client reported that worry about events or activities has diminished and they are living with more of a sense of peace and confidence.

      2 Excessive Worry About Recent Stressor (2)The client described symptoms of unrealistic preoccupations with worry in response to a recent stressor.The client showed some recognition that excessive worry is beyond the scope of rationality but feels unable to control it.The worry symptoms have continued for longer than 6 months.The client has worry symptoms more days than not.The client described that they worry about recent stressors.The client reported that worry about recent stressors has diminished, and they are living with more of a sense of peace and confidence.

      3 Excessive Worry (3)The client described symptoms of excessive and/or unrealistic worry.The client's symptoms of excessive and/or unrealistic worry have not decreased.The client's symptoms of excessive and/or unrealistic worry have decreased through therapeutic techniques.

      4 Motor Tension (4)The client described a history of restlessness, tiredness, muscle tension, and shaking.The client moved about in their chair frequently and sat stiffly.The client said that they are unable to relax and are always restless and stressed.The client reported that they have been successful in reducing levels of tension and in increasing levels of relaxation.

      5 Autonomic Hyperactivity (5)The client reported symptoms of autonomic hyperactivity (e.g., heart palpitations, dry mouth, tightness in the throat, shortness of breath).The client reported periods of nausea and diarrhea when anxiety levels escalate.The client stated that tension headaches are also occurring, along with other anxiety- related problems.Anxiety-related symptoms have diminished as the client has learned new coping mechanisms.

      6 Hypervigilance (6)The client related that they constantly feel on edge, that sleep is interrupted, and that concentration is difficult.The client reported being irritable in interactions with others, as their patience is thin and they are worrying about everything.The client's family members report that the client is difficult to get along with, as their irritability level is high.The client's level of tension has decreased, sleep has improved, and irritability has diminished as new anxiety-coping skills have been implemented.

      7 Excessive Worry Based on Cognitive Biases (7)The client described symptoms of preoccupation with worry that something dire will happen that is driven largely by cognitive biases.The client showed some recognition that their uncontrolled worry is irrational.The client described worries about issues related to family, personal safety, health, employment, and many other things but cannot identify any rational reason for these worries.The client reported that worries regarding life's circumstances have diminished, and they are living with more of a sense of peace and confidence.

      8 Substance Abuse Response (8)The client identified a pattern of substance abuse in response to excessive anxiety.The client has not decreased substance abuse in response to excessive anxiety.The client identified a decrease in the pattern of substance abuse in response to excessive anxiety.The client has stopped abusing substances in response to excessive anxiety.

      9 Substance Abuse to Control Anxiety Symptoms (9)The client described a history of substance abuse as an attempt to control anxiety symptoms.The client identified substance abuse as a self-medication tool regarding anxiety symptoms.The client identified a decrease in the abuse of substances related to controlling anxiety symptoms.The client has maintained total abstinence despite ongoing anxiety symptoms.

      1 Build Trust and Establish Rapport (1)*Caring was conveyed to the client through support, warmth, and empathy.The client was provided with nonjudgmental support and a level of trust was developed.The client was urged to feel safe in expressing anxiety symptoms.The client began to express feelings more freely as rapport and trust level have increased.The client has continued to experience difficulty being open and direct about the expression of painful feelings; the client was encouraged to use the safe haven of therapy to express these difficult issues.

      2 Focus on Strengthening Therapeutic Relationship (2)The relationship with the client was strengthened using empirically supported factors.The relationship with client was strengthened through the implementation of a collaborative approach, agreement on goals, demonstration of empathy, verbalization of positive regard, and collection of client feedback.The client reacted positively to the relationship-strengthening measures taken.The client verbalized feeling supported and understood during therapy sessions.Despite attempts to strengthen the therapeutic relationship, the client reports feeling distant and misunderstood.The client has indicated that sessions are not helpful and will be terminating therapy.

      3 Assess Nature of Anxiety Symptoms (3)The client was asked to describe past experiences of anxiety and their impact on functioning, including the focus, excessiveness, uncontrollability, type, frequency intensity, and duration of symptoms.The Anxiety and

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