Client Case
Presenting Issues
Client reported intense fear and avoidance of driving after a minor car accident six months prior. Symptoms included panic-like responses when approaching driving scenarios, especially on motorways or at night.
Background Information
The client is a 46-year-old parent and full-time carer. The accident occurred in wet conditions, resulting in no injuries but moderate vehicle damage. Since then, the client has relied on public transport or others for travel, despite previously being a confident and regular driver.
Assesment
Client displayed symptoms of situational anxiety and trauma-related stress. Common triggers included merging onto fast roads, night driving, or driving in rain. Physical symptoms included rapid heartbeat, breathlessness, and a sense of losing control. Cognitively, the client reported intrusive images of the crash and persistent “what if” thoughts.
Treatment Plan
Goals
- Reduce fear and physiological responses associated with driving
- Regain confidence and independence in common driving scenarios
- Replace avoidance behaviours with gradual exposure and coping strategies
Intervention Strategies
- Psychoeducation on trauma responses and anxiety cycles
- Guided hypnotherapy focused on safety, control, and confidence
- Cognitive restructuring to address catastrophic thinking
- Gradual in vivo exposure (e.g., short familiar routes, then gradually increasing distance and complexity)
- Relaxation training for in-the-moment symptom management
Frequency and Duration
6 weekly sessions, with 1 follow-up session 4 weeks later
Results
- Client now comfortably drives locally and is beginning to reintroduce motorway routes
- Panic symptoms have decreased significantly
- Increased confidence and reduced dependency on others for transport
- Reports improved sense of autonomy and overall well-being
"I never thought I’d feel calm behind the wheel again. I’m back to driving — slowly and on my terms — and it feels like I’ve got my freedom back."
Case Details
Symptoms Encountered
Racing heart, shortness of breath, sweating, shaking hands, tight chest, nausea, dizziness, dry mouth, muscle tension, intrusive thoughts about the accident, flashbacks or visual imagery of the crash, fear of losing control, avoidance of driving, panic attacks when approaching high-speed roads or certain locations, hypervigilance while driving, sleep disturbances before planned journeys, irritability when pressured to drive.