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Case conceptualisation for John, a 20 year-old male presenting with social phobia: Presenting problem/s: Social phobia Physiological symptoms of anxiety - nausea, dizziness, blushing, sweating Avoiding and failing university classes due to extent of social anxiety  Emotions: Anxiety/fear Embarrassment Shame/humiliation  Precipitating factors: Attending university course Social interaction in both class and on-campus settings  Academic content becoming increasingly difficult (due to both lack of attendance and failing subjects) Beliefs/assumptions: “I am boring”, “People think I am boring” “I have nothing interesting to say” “I’m an idiot”, “a freak”, “a loser” “Everyone is looking at me” - fear of judgement from others  Vulnerability factors: Shy and quiet temperament Longstanding difficulties with social interaction  History of bullying at school  Quiet parents (?may have role-modelled an internalising or avoidant coping style, may not wish to upset or disappoint them)  Maintenance processes:  Avoidance cycle of social interaction (eg. pretending to be reading/emailing and avoiding sitting near other students, hence other students do not approach him and he struggles even more to make friends, and he feels increasingly boring and like a “loser” as a result)  Skipping classes and failing subjects further contributing to low self-esteem and feelings of being an “idiot” Physical symptoms exacerbating self-consciousness and fear of further embarrassing himself in front of others  Low self-esteem and hypercritical self-percept Treatment targets:  Challenging underlying thoughts and beliefs about his self-worth and fears  Graded exposure therapy Graded return-to-university plan through liaison with course coordinator to enable support for John to catch up on core class material and to complete work in a manageable way

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社会恐怖症を呈している20歳の男性、ジョンの症例概念化： 問題の提示： 社会恐怖症 不安の生理学的症状-吐き気、めまい、赤面、発汗 社会不安の程度による大学の授業の回避と失敗 感情： 不安/恐怖 恥ずかしさ 恥/屈辱 沈殿因子

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Case conceptualization of John, a 20-year-old man with social phobia: Problem presentation: Physiological Symptoms of Social Anxiety-Nausea, Dizziness, Blush, Sweat Avoidance and Failure of College Classes Due to Degree of Social Anxiety Emotions: Anxiety / fear embarrassment shame / humiliation Precipitation factor

INTO JAPANESE

社会恐怖症の20歳の男性、ジョンの症例概念化： 問題の提示： 社会不安の生理学的症状-吐き気、めまい、赤面、発汗の回避、および社会不安の程度による大学の授業の失敗 感情： 不安/恐れ恥ずかしさ/屈辱 降水係数

BACK INTO ENGLISH

Case conceptualization of John, a 20-year-old man with social phobia: Problem presentation: Physiological Symptoms of Social Anxiety-Nausea, dizziness, blush, avoidance of sweating, and failure of college classes due to the degree of social anxiety Emotions: Anxiety / fear embarrassment / humiliation Precipitation coefficient

INTO JAPANESE

社会恐怖症の20歳の男性、ジョンの症例概念化： 問題の提示： 社会不安の生理学的症状-吐き気、めまい、赤面、発汗の回避、および社会不安の程度による大学の授業の失敗 感情： 不安/恐怖の恥ずかしさ/屈辱 降水係数

BACK INTO ENGLISH

Case conceptualization of John, a 20-year-old man with social phobia: Problem presentation: Physiological Symptoms of Social Anxiety-Nausea, dizziness, blush, avoidance of sweating, and failure of college classes due to the degree of social anxiety Emotions: Anxiety / fear embarrassment / humiliation Precipitation coefficient