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Case Studies
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Topic starter
18/03/2026 6:29 am
Dear Colleagues and Students,
I recently published a new clinical case study on the Psychology Roots academic blog. The article details the assessment and treatment of adolescent Social Anxiety Disorder within a school-based setting. I am sharing a summary here to foster discussion regarding the integration of cognitive restructuring and behavioral activation in treating severe anxiety presentations.
Clinical Overview
The case examines Ms. B.A., a 15-year-old female student presenting with profound social withdrawal and physiological arousal. The clinical presentation included:
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Severe autonomic symptoms, including dry mouth, sweating, difficulty breathing, and trembling during social evaluation.
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Avoidance of peer communication and a freezing response when called upon in the classroom.
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Psychometric confirmation using the Social Phobia Inventory, yielding a score of 66 , and the Brief Fear of Negative Evaluation Scale, resulting in a score of 45.
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A formal DSM-5 diagnosis of Social Anxiety Disorder, coded as 300.23 (F40.10).
Intervention Framework
The therapeutic plan spanned ten structured sessions. The intervention utilized a multimodal approach:
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Cognitive Behavioral Therapy: Identifying irrational thoughts and constructing an anxiety hierarchy to challenge fears of negative evaluation.
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Behavioral Modification: Implementing a token economy to reinforce positive behaviors, such as sustained eye contact and verbal interaction.
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Somatic Management: Utilizing Progressive Muscle Relaxation and deep breathing to lower the baseline autonomic arousal of the client.
Clinical Outcomes
Post-intervention evaluation confirmed a significant reduction in anxiety symptomatology. The client successfully increased classroom participation, initiated communication with peers, and demonstrated improved eye contact.
I encourage you to read the full article on the Psychology Roots blog for a detailed breakdown of the session-by-session methodology.
In your clinical or academic experience, how do you balance cognitive restructuring with immediate behavioral reinforcement when an adolescent client exhibits a severe physiological freeze response?
Best regards,
Professor Aamir Ranjha
Senior Clinical Psychologist