Client Case

Presenting Issues
Client reported intense anxiety leading up to presentations at work. Symptoms included dry mouth, increased heart rate, mental blanking, and avoidance behaviours.
Background Information
The client is a 39-year-old marketing executive. The anxiety began during university presentations but worsened with job responsibilities. Despite being knowledgeable in their field, the client avoided promotion opportunities involving public speaking and reported growing frustration and self-doubt.
Assesment
Client demonstrated anticipatory anxiety days before presentations, overestimated negative outcomes (e.g., “I’ll freeze and embarrass myself”), and experienced physical symptoms consistent with performance anxiety. Cognitive distortions and past negative experiences were contributing factors.

Treatment Plan

Goals
Intervention Strategies
Frequency and Duration
6 weekly sessions over 6 weeks, with ongoing email check-ins between sessions

Results

  1. Significant reduction in anticipatory anxiety

  2. Successfully delivered a work presentation with only mild nervousness

  3. Reports improved self-esteem and willingness to accept future speaking opportunities

  4. Implemented daily calming techniques and self-talk strategies

"I still get a little nervous, but it’s no longer something I dread. I feel prepared, calm, and proud of how far I’ve come."

Case Details

Symptoms Encountered
Dry mouth, racing heart, shaky hands, sweating, nausea, muscle tension, blanking or forgetting words, difficulty making eye contact, fear of being judged, negative self-talk, avoidance of speaking opportunities, trouble sleeping before an event, over-preparing or procrastinating, feeling overwhelmed or panicked in front of a group.