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An Anxious Adolescent - part 1

This is a transcript of a series of 3 counselling sessions I had with a year 10 student. I used Albert Ellis' ABC Theory of Emotional Disturbance to help him. I am a Rational Emotive Behaviour Counsellor.
This student feels anxious over something that has happened. He asked another student if he had a problem (are you OK? Can I help?). This was misinterpreted (what do you mean I have a problem?) and he responded aggressively. The student was taken aback and then began to mull over the response he received. He asked a trusted teacher if the esteem in which other teachers held him was now diminished. The teacher said not in any way but the student remained preoccupied and went to see the counsellor outlining what had happened and how best to deal with the situation.


In the counsellors office

Student: I am concerned about how a student responded to me. I am caring and I didn’t intend to offend him when I asked him how he felt and if I could help. I am worried that he thinks I intended to offend him. I want to be a nurse one day; everyone knows I like to help.

Counsellor: So you asked him if he had a problem and he didn’t appreciate the questions. He felt annoyed. Is that right?

Student: Yes and I don’t understand why he felt that way. Anyone who knows me would say that I am caring and I am genuine when I ask how someone is.

Counsellor: You are caring and considerate of others generally and you are known for this. One individual has interpreted your intentions in a negative way and you feel upset and worried about this.

Student: Yes I do. I asked Mr S. if the other teachers would think less of me because I have offended someone. I am worried about this.

Counsellor: Using the Emotional Thermometer how would you rate the intensity of how you feel? How strong is your worry?



Student: It is around 9/10.

Counsellor: That’s strong. How often do you feel like this and for how long?

Student: Most of the time I feel anxious about things.

Counsellor: How does this affect your day-to-day life? Does it help you achieve your goals or get in the way?

Student: I can’t focus on what I have to do.

Counsellor: That would be stronger than concern or worry. Do you know what
anxiety is?

Student: Yes I do.


Counsellor: From what you tell me you feel anxious a lot of the time because you want everyone to like you and you think it would be terrible if anyone thought badly of you. You really care about what others think of you.  Do you think you care too much? Do you need other people to approve of you for you to feel OK?

Student: How did you know that?

Counsellor: The belief that ‘I am OK only if others think I am’ is an unhealthy belief because it stops you from working towards your goals. You feel nervous and worried a lot of the time (unhealthy negative feelings) because you think it would be terrible if anyone knew you made mistakes or didn’t seem to approve of you.

Student: This stops me from being successful because I can’t concentrate on my work because I feel very worried a lot of the time! I worry too much about what others think of me but I can’t seem to stop doing this.

Counsellor: You have the tendency to believe that everyone must like you because you are a likeable and caring person and others should recognise this. Is this fair to say?


Student: Yeah. I just can’t handle it. What can I do?

Counsellor: We will look at your belief that you need everyone’s approval to be OK and why this is keeping you anxious. We will work on this next time we meet. In the meantime remind yourself that you don’t need other people’s approval to be OK. You can prefer it but you don’t need it.
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