Guidance Counsellor Mental Health Session
**Referral reason / presenting issue:** Student presented with increased anxiety symptoms, particularly social anxiety in group settings, impacting her ability to participate in classroom activities and extracurriculars.
**Background / Context**
16-year-old female student, referred by her English teacher due to observed withdrawal and reluctance to present in class. Previous history of mild social anxiety in primary school which had reportedly improved. Parents aware of current difficulties and supportive of counselling. No prior formal mental health interventions.
**Session Summary**
Student appeared somewhat withdrawn initially, maintaining limited eye contact. Affect was flat. Discussed feelings of overwhelm and fear of judgment when speaking in front of others. Expressed a desire to improve her confidence but felt trapped by her anxiety. Engagement improved as the session progressed, particularly when discussing her interests outside of school. Insight into her anxiety triggers and avoidance behaviours was fair. Main themes included social comparison and fear of failure.
**Intervention / Strategies**
Introduced basic psychoeducation on the 'fight or flight' response and how anxiety manifests. Discussed initial coping strategies, including diaphragmatic breathing techniques and identifying positive self-talk statements. Explored the concept of a 'brave ladder' for social situations. Provided a handout on anxiety management techniques for adolescents. Agreed to explore CBT strategies in future sessions.
**Risk / Safety**
No disclosures of self-harm, suicidal ideation, violence, or abuse. Student reported feeling generally safe and denied any intent to harm herself or others. Identified protective factors including a supportive family and a close friend. No immediate safety concerns identified.
**Outcomes**
Student reported feeling slightly less overwhelmed by the end of the session, expressing a sense of relief at having shared her concerns. Understood the breathing technique and agreed to practice it. Expressed willingness to engage in further sessions to develop confidence.
**Plan / Follow-up**
Scheduled a follow-up session for next week, 1 November 2024, to continue exploring CBT techniques and further develop coping strategies. Agreed to notify the English teacher (with student's consent) regarding ongoing support to ensure consistency in the classroom approach.