YASU Review Note

Young Adult Support Unit – Review Appointment Situation Date: 01/11/2024 Time: 10:30 AM Attendees: Patient (Liam Smith), Mother (Sarah Smith) Clinician: Dr. Eleanor Vance, Clinical Psychologist Appointment type: Face-to-face, clinic setting Patient arrived for appointment and provided verbal consent to participate in the session. Background: Liam Smith, he/him, aged 19, is currently being seen in the Young Adult Support Unit for management of Generalised Anxiety Disorder (GAD) and co-occurring social anxiety. He was initially referred due to significant academic distress, social withdrawal, and frequent panic attacks over the past six months, which have impacted his ability to attend university and maintain friendships. He is currently engaging in cognitive behavioural therapy (CBT). Presentation: * Dressing: Casually dressed, clean and appropriate. * Appearance: Well-groomed, maintained eye contact inconsistently. * Affect: Anxious, slightly restricted, but improved from previous sessions. * Speech: Normal rate and rhythm, coherent, occasional pauses when discussing difficult topics. * Thought content: Expressed ongoing worries about academic performance and future career prospects, but reported a reduction in intrusive negative thoughts. Current Risks Identified: No risks identified in session. Patient reports/updates Liam reported a significant improvement in his ability to manage anxiety symptoms in social situations, specifically mentioning a recent successful outing with friends. He has been consistently applying the relaxation techniques discussed in previous sessions and noted a decrease in the frequency of panic attacks from three times a week to once every two weeks. He is also attending university lectures more regularly, although he still experiences some anticipatory anxiety. Therapy goals/session focus: The primary therapy goal for this session was to reinforce coping strategies for social anxiety and to introduce techniques for managing academic stress more effectively. The session also focused on reviewing progress made with relaxation techniques and exploring potential barriers to further progress in university attendance. Intervention: * Reviewed cognitive restructuring techniques for challenging negative thoughts related to academic performance. * Practiced diaphragmatic breathing exercises and progressive muscle relaxation. * Discussed exposure hierarchy for increasing university attendance, starting with attending a short tutorial. * Provided psychoeducation on the link between stress and physical symptoms. Plans: * Next appointment scheduled for 15 November 2024, to continue working on exposure therapy for university attendance. * Patient to continue daily practice of relaxation techniques and record thoughts/feelings in a thought diary. * Referral to university's academic support services for assistance with study skills and time management. * Follow-up phone call with mother in one week to discuss patient's progress and support needs.