Report on Psychological Counseling for Examination Anxiety Name: Ge Unit: Xin 'anjiang Road Primary School, Hefei Abstract This case used rational emotional therapy to conduct psychological counseling for an anxious helper, made a series of effective corrections to his irrational beliefs, guided the helper to learn to use a new and reasonable cognitive style, greatly improved the anxiety, anxiety and tension of the helper, and helped him learn to use a realistic and reasonable way of thinking. While using reasonable emotional therapy, she also assisted relaxation therapy to face the upcoming entrance examination with a correct and positive attitude. This paper introduces the basic situation of this case and the process of psychological counseling in detail. Keywords case report of rational emotional therapy for general psychological problems I. General information Peng (a pseudonym), male, age 12, a sixth-grade student. Excellent grades, is the monitor. I usually get along well with my classmates. I am a role model for my classmates and a right-hand man for the class teacher. Second, the personal growth history is complete and healthy from childhood. When I was in kindergarten, I showed my smart and lovely side and won the favor of kindergarten teachers. Entering primary school, because my mother is a primary school teacher, she is strict with him and he is very sensible. He always wins his mother's favor in every exam, and her mother has always been proud of it. Passed piano amateur level 8. I also took part in remedial classes, Olympic math classes and painting classes. Study hard and have always been among the best. Learning so far, it seems that I have never failed, and it has always been smooth sailing. Help-seekers have two sides: introversion and obedience in front of teachers and parents; In front of his classmates, he is eloquent, has certain leadership ability and enjoys high prestige among his classmates. 3. Chief complaint and personal private complaint: In the past month, I have been fidgety, anxious and have a bad sleep. It is easy to be distracted in class and the work efficiency is obviously worse. I'm afraid of all kinds of exams, and I'm even more annoyed at the thought of entrance exams. Private prosecution: the results of help seekers have always been among the best, and the top three in the class. He studied very hard and earned the trust of his teachers. When visiting relatives and friends during the Spring Festival this year, relatives and friends have high expectations for the helper and think that she will be admitted to the best middle school in the market. Although my mother didn't put pressure on the helper, she showed her behavior and stayed up late every day. A month ago, in a math exam, a helper scored more than 70 points and was criticized by the math teacher. He also regretted it and blamed himself for getting such a score. How will he take the entrance examination in the future? I will be more careful in class in the future, fearing that I will fail in the exam again, but the more worried I am, the more likely I will get into trouble, and the exam will not be excellent in two weeks. In this way, the class begins to be distracted, it is difficult to concentrate, the work efficiency is obviously worse, and mistakes are always made where they should not be. I'm sweating and fidgeting at the thought of the college entrance examination in a few months. Sometimes I can't sleep over and over at night, so my sleep quality is not high. I'm worried about what will happen to me in the long run. I want to get rid of this dilemma as soon as possible and come for help. Fourth, observe and understand the situation. Help-seekers seek medical treatment alone, with good facial features, neat clothes and decent manners, and are extremely polite and self-disciplined to consultants. When I speak, I speak fluently and think clearly. I have expressed my recent panic about my grades, and my sleep quality is not high. Physically: The patient has no major physical illness, no physical pain or discomfort, and no family history of mental illness or genetic disease. Personality: stable personality, no abnormal living habits. Social function: I can study normally, be a good monitor, and communicate with my family, teachers and classmates normally. Physical examination: My mother once took a client to the hospital for a routine physical examination, and there was nothing unusual. V. Evaluation and diagnosis: (1) Evaluation: According to the clinical data, the client has normal intelligence, complete insight and no mental symptoms such as abnormal perception, hallucinations and delusions. Stable personality, no major physical illness, no family history and genetic disease history. The main problems of help seekers are bad emotional reaction and behavioral discomfort. Mainly manifested in the help-seekers have not been freed from several exam mistakes, resulting in anxiety. On the surface, its symptoms are related to exam mistakes, but in essence, it is closely related to the irrational beliefs of candidates, which belongs to the category of psychological counseling. (2) Diagnosis: general psychological problems, which belong to the diagnosis basis of anxiety disorder: 1. According to the three principles of disease and non-disease, mental illness can be ruled out if the parties are consistent in knowledge and action, stable in character, self-aware, able to take the initiative to seek medical treatment and have no mental symptoms such as hallucinations and delusions. 2. According to the standard of symptomatology, the parties show symptoms such as anxiety, irritability and sleep disorder. According to the severity standard, the response intensity of the subjects is not strong, and the response is limited within the scope of the examination, which does not affect logical thinking, avoidance and generalization, and does not affect social function. Judging from the course of disease, the course of disease is only 1 more than a month. Generally speaking, the psychological problems of help seekers are not serious and the time is short, so serious psychological problems and neurotic psychological problems can be ruled out. (1) Psychological test scale: SAS score, with a gross score of 52 and a standard score of 65, indicating moderate anxiety. B) According to the above diagnosis, it is a general psychological problem. Differential diagnosis: 1. Differentiation from mental illness: According to the three principles of disease and non-disease, mental illness is characterized by patients' inconsistent knowledge and feelings, lack of self-awareness, generally not taking the initiative to seek medical treatment, hallucinations, delusions, logical thinking obstacles and abnormal behavior. The party concerned is consistent in knowing and doing, stable in character, self-aware, able to take the initiative to seek medical treatment, and free from mental symptoms such as hallucinations and delusions, and can rule out mental illness. 2. Differentiate from serious psychological problems: Serious psychological problems have strong reaction intensity, and the reaction has been generalized, which has a serious impact on social function, and the course of disease is more than 2 months. However, the psychological problems of help seekers are not serious, which have no serious impact on social function and last for a short time. So we can rule out serious psychological problems. 3. Differentiate from anxiety neurosis: anxiety neurosis is mainly symptom anxiety, with persistent pain, which can not be solved, and has a serious impact on social function, generalization and avoidance. The reaction has nothing to do with the initial event itself and lasts for a long time, more than 3 months or more than half a year. Although the main symptom of help seekers is anxiety, it has not seriously affected social function and logical thinking, nor has it appeared generalized avoidance, and it only lasted for more than a month, so anxiety neurosis was ruled out. Etiological analysis 1 biological reasons: there is no obvious biological reason for the problem of the helper. 2 Social reasons: (1) Negative life events, unsatisfactory exams several times, and serious frustration in self-confidence. (2) In family education, parents expect too much from help-seekers. (3) School teachers and classmates expect too much from help seekers. 3 Psychological reasons: (1) There are obvious cognitive errors: as a top student, you must do well in every exam to ensure that you can get into the best junior high school. (2) The purpose of learning is to please parents and prove their strength in front of teachers and classmates. (3) Pursuing perfection in personality and being competitive. (4) Being troubled by anxiety and unable to solve it. The consulting objectives, methods and principles of intransitive verbs 1. Consulting objectives: Based on the above assessment and diagnosis, the following consulting objectives are determined through consultation with customers. Specific objectives: According to reasonable emotional therapy, help the help-seekers to analyze the emotional distress caused by irrational beliefs caused by abnormal exams, reduce the emotional distress caused by irrational beliefs and the consequences of bad behavior as much as possible, relieve the anxiety and worry of the help-seekers and improve their sleep. Learned muscle relaxation techniques and initially controlled psychological tension. Long-term goal: change unreasonable beliefs and unreasonable behavior patterns and establish new reasonable beliefs and behavior patterns. 2. Methods: In this case, the helper thinks that academic excellence is needed to play a normal role in the entrance examination. Only by being admitted to the best junior high school can we be worthy of our parents and teachers. It can be seen that their anxiety is closely related to irrational beliefs. Ellis, a famous American psychologist, advocated rational emotional therapy in the 1950s. This method aims to change the irrational concept of the help-seekers through pure theoretical analysis and logical speculation, thus helping them solve their emotional and behavioral problems. This theory emphasizes that the source of emotions is individual thoughts and concepts. Individuals can change their emotions by changing these factors, establish a reasonable and correct rational concept, and promote the psychological health and personality development of help seekers. The specific method of muscle relaxation training is to concentrate all muscle groups in the whole body to make the muscles tense, feel and maintain the muscle tension carefully, relieve the muscle tension after 5 seconds, and pay attention to the soft, weak and warm feeling of the muscles after relaxation. In this process, you will experience a change from tension to relaxation, and your mood will become happy in this process. 3. Principle: rational emotional therapy, also known as ABC theory, is used, in which A stands for induced event and B stands for personal view, explanation and evaluation of this event. C stands for the individual's emotional response and behavioral results after this incident. What triggers people's mood and behavior changes is not the induced event, but the individual's interpretation and evaluation of the induced event. Help-seekers often use some irrational knowledge and beliefs that are not in harmony with reality to analyze and look at things, thus generating self-anxiety. By changing their irrational knowledge, attitudes and views on things, they can change their bad emotions and behaviors. Helpers can correctly face some setbacks in life, thus promoting the harmonious development of body and mind. The principle of muscle relaxation training is based on the fact that muscle relaxation and emotional tension are a pair of mutually restrictive conditions. At the same time, these two States in an individual cannot coexist at the same time. The emergence or strengthening of one country will inevitably lead to the weakening or elimination of another country. Therefore, the relaxation technique is a set of techniques to deeply relax the muscles of the whole body and fight against the tension in the relaxed state, so as to achieve the purpose of relieving and eliminating tension. Seven. Rights and obligations of both parties In the consultation process, the rights and obligations of the helper: Rights: (1) The helper can choose a consultant according to his own wishes; (2) If you are not satisfied with the consultation process, you can ask to change the consultant; (3) The right to know, negotiate and choose the consulting scheme, consulting fee and consulting time. Obligation: (1) Abide by the relevant regulations of the consulting organization; (2) Observe and implement the agreed consultation scheme, consultation expenses and consultation time; (3) Respect the consultant, observe the appointment time, and inform the consultant in advance if there are special circumstances. In the process of consultation, the rights and obligations of psychological counselors: rights: (1) the right to know personal data related to psychological problems of visitors; (2) the right to choose suitable customers; (3) Have the right to refer or terminate the consultation in a responsible manner. Obligation: (1) Abide by the relevant regulations of the consulting organization; (2) Abide by and implement the agreed rules such as negotiation scheme, negotiation cost and negotiation time. (3) Respect the helper, observe the appointment time, and inform the consultant in advance if there are special circumstances. 8. Consultation time and cost (1) Time: once a week, 50 minutes each time. (2) Charge: It belongs to school work and is free. IX: Consultation Process (1) Purpose of the first consultation: to collect information, establish consultation relationship, conduct psychological diagnosis, and establish consultation objectives. Methods: At the beginning of consultation, fully respect the help-seekers. Collect the detailed information of the helper by inhaling the conversation, and give unconditional positive attention by listening. Establish a good consultation relationship with the clients, and let the clients do the self-rating anxiety scale (SAS). The crude score of SAS is 52, and the standard score is 65, indicating that they have moderate anxiety. Initially determine the main problems of the help seekers. Explain the ABC theory of reasonable emotional therapy to the help-seekers, make the help-seekers try to accept the theory, make the help-seekers realize the relationship of ABC, and make her make a preliminary analysis with her own problems. Homework: It is suggested that the help-seeker record the contents that have troubled her recently, and at the same time let her write down her emotions, behavior troubles (c) and induced events (a), and make a preliminary analysis to find out the unreasonable places. Conclusion: Try to get help seekers to find out their irrational beliefs. (2) The second consultation task: By further explaining ABC theory of rational emotional therapy, help the clients understand that the root cause of their emotional and behavioral discomfort is not the event, but the disharmony between their own knowledge and beliefs and reality, find out these unreasonable beliefs, and make further analysis according to the clients' problems, so as to urge them to change their unreasonable beliefs and then change their bad emotional and behavioral patterns. Methods: Socrates' debate was used to inspire seekers to understand irrational beliefs and behavior patterns, and rational beliefs were used instead to establish new rational beliefs. Process: First, help seekers understand the core role of their irrational beliefs in psychological problems. Counselor: Tell me about your homework. Helper: I didn't care too much about my thoughts before. Through memories, it turns out that I have been too concerned about the exam results. I can't accept failing in exams several times in a row, and I don't know how to face it. All kinds of bad ideas came out of my head. Consultant: Can you elaborate on some bad ideas? Helper: If you can't get into a key junior high school, there will be no hope for a key university. This will disappoint your family, teachers and relatives, and you will be ashamed to face them. As a monitor, my classmates who usually admire me will also make fun of me. In short, I feel very distressed. (triggering event a: failed several exams. Specific result c: I feel very distressed. ) Consultant: Do you mean that if you fail these exams, you will not be admitted to key middle schools and universities? Helper: Yes, I'm sure I can't pass the exam 168. Consultant: What makes you so sure? Helper: If you want to be admitted to 168, you basically have to achieve excellent results in every subject. Now my math scores have regressed by more than 20 points. Such a big retrogression will definitely fail the exam. (unreasonable belief of the helper: I will definitely fail the exam. ) Consultant: Is that your own estimate? Helper: Yes. Consultant: Can you guarantee that your estimate is accurate? Caller: (pause)No. Counselor: You think you failed the exam several times. Is this your own idea or is it based on science? Helper: It's my own idea. Counselor: Your idea is just your subjective opinion. There is no scientific basis at all, and there is no guarantee that they must be true. Failing the exam several times does not mean that your learning ability is poor, and it does not mean that your knowledge base is poor. In fact, almost half of the students who take the key middle schools in our school every year are the best in the last exam. They entered key middle schools with a solid knowledge base and good psychological quality. Even if your score is close to the key middle school by then, there are still many choices. Yucai and no.42 middle school are also key points. Do you think so? Helper: Then I'll try. Counselor: OK, please help yourself. Helper: I feel better now that I think about it. Through talking with the help seekers, I found their unreasonable belief: you failed to get into the key middle school after several exams. After finding ideas that affect your emotions, find reasons to refute these ideas, thus enhancing your self-confidence. In the same way, help the seekers understand the core role of their irrational beliefs in psychological problems and gradually find out other irrational beliefs. Irrational beliefs include: (1) As a monitor, you should be excellent in every exam so that you can go to the best middle school. (2) Only by being admitted to the best middle school can you become a good boy and a good student in the eyes of parents and teachers. Then replace irrational belief with rational belief, and debate its irrational belief from rationality to sensibility and from generality to concreteness. Let help seekers learn to use rational thinking mode, help them completely improve their anxiety, tension and worry about maladjustment, and promote their mental health and harmonious development. The key is to learn to use "hope" and "want" instead of "must" and "should", so as to establish new reasonable beliefs and improve self-confidence. The rational belief gradually established is: 1. Although I am the monitor, I can't get good grades in every exam. A few mistakes mean nothing. Through my efforts, I am still an excellent student even if I can't get into the best school. I don't study to please my parents and teachers, but to realize my life value, personal growth and make contributions to society in the future. If you want to achieve stable results, you have to relax and then relax. Conclusion: Through Socratic debate, help seekers realize their unreasonable beliefs and learn to replace "must" and "should" with "hope" and "want". (c) The third consulting objective: When the clients have gradually established a reasonable and correct rational concept, the clients report that they still feel anxious. The second time, they got a rough score of 44 points and a standard score of 55 points. The data shows that the anxiety has been obviously weakened, but it still exists. We can consider using muscle relaxation training to reduce their anxiety. The principle of muscle relaxation training is based on the fact that body muscle relaxation and emotional tension are a pair of mutually restrictive States. At the same time, these two States in an individual cannot coexist at the same time. The emergence or strengthening of one country will inevitably lead to the weakening or elimination of another country. Therefore, the relaxation technique is a set of techniques to deeply relax the muscles of the whole body and fight against the tension in the relaxed state, so as to achieve the purpose of relieving and eliminating tension. Process: Ask the helper to wear comfortable and loose clothes, remove all decorations, do not wear eyes, especially contact eyes, and do muscle relaxation exercises with the teacher. Help-seekers can sit in chairs and keep themselves comfortable. Counselor: Now, let's do relaxation exercises, try to be comfortable, close our eyes, relax some muscle groups according to my instructions, and pay attention to the different feelings when we are nervous and relaxed. Muscle tension in each group is 5 seconds, then slowly relax 10 seconds, and then do the second or next group of muscle exercises. 1. Make a fist and bend your wrist: Make a fist with both hands, bend your wrist upward, and feel the tension of your hands and forearms (hold for 5 seconds). Loosen your fist, straighten your wrist, relax naturally, and pay attention to the feeling of relaxation (pause 10 second). 2. Bend your elbow and shrug your shoulders: bend your forearm upwards and rotate outward, and raise your shoulders to your ears (hold for 5 seconds). Now relax and experience the different feelings of tension and relaxation (stop 10 second). 3. Curse frown: lean back against the chair and frown (5 seconds). Stretch your brows, relax your neck and experience the feeling of tension and relaxation (pause 10 second). 4. Close your eyes and grind your teeth: close your eyes, grit your teeth, put your mouth back, close your lips, and have a sense of tension on your face (5 seconds). Relax naturally and experience the feeling of relaxation (10 second). 5. Chin against the chest: Chin is close to the chest and feel the tension of the muscles in the front of the neck (5 seconds). Now relax (10 second). 6. Arch your back and chest: Now pay attention to your back muscles, arch your back, hold your chest and abdomen. Can you feel the tension in your back? (5 seconds). Now relax, you feel relaxed (10 second). 7. Inhale and shrink your chest: Now take a deep breath and hold your breath (5 seconds). Ok, breathe and relax, and feel the difference between tension and relaxation (10 second). 8. Hold your breath: Now focus on the abdomen, tighten the abdominal muscles, hold your breath (5 seconds), breathe, 9. Lift the anus and close the buttocks: contract the anal sphincter and buttocks muscles and feel nervous (5 seconds). Now relax (10 second). 10. Stretch your legs and lift your toes: straighten your legs and lift your toes upward, so that the muscles of your feet, calves and thighs are tense (5 seconds). Now relax, relax all over. . Take a 5-minute break and practice all your muscles again. The goal is to let the seekers learn to relax the muscles of the 10 group at first. Assignment: Let the help-seekers practice muscle relaxation in a quiet room at home, 1-2 times a day, each time for about 30 minutes. With the proficiency of practice, it can be reduced to about 20 minutes or less each time, and the number of exercises per day can also be reduced to once. The time for relaxation training should generally be arranged one hour after lunch or before going to bed at night. After a period of intense and relaxing interactive practice, you should be able to fully relax at will when necessary. It should be noted that relaxation training can not be effective overnight, and it must be practiced for weeks or even months to get obvious results. So keep training. In addition, a table can be used to record and evaluate the daily training situation, and the level of 1 to 5 can be used to indicate the depth of relaxation. 1 stands for the shallowest relaxation state, and 5 stands for the deepest relaxation state. From this, you can know the progress of your own practice, and it is also convenient for consultants to check and guide. (4) The goal of the fourth consultation: continue to consolidate the rational beliefs and behavior patterns learned by the seekers, know how to accept and let go of themselves, and realize self-growth and personality perfection. Check the records of the helper's muscle relaxation training, and use imagination to relax while the helper gradually relaxes the muscle training. Methods: Establish a new and reasonable belief and behavior pattern for the help-seekers, strengthen it in time, and imagine relaxing exercises. Process: consultation interview summary: imagine handing out papers immediately during the exam, I don't know what kind of questions it is. At this time, most candidates may be nervous and their hearts will be in their throats. Some people may be nervous all over their muscles, and the tension rate will increase. At this point, your muscles are tense, your palms are sweaty and your legs and feet are numb. What should you do? Assistant: OK, let me imagine (silence for a moment) ... I can close my eyes gently. At first, I felt heavy head, heavy shoulders, heavy upper arms, heavy forearms, heavy legs and sweaty palms ... Consultant: Please think about it. How do you relax tense muscles? Assistant: I think I can try to relax my muscles gradually and let me feel my breathing. Now I take a deep breath and hold my breath (5 seconds) Ok, breathe and relax, (10 second). Lean your head back and frown (5 seconds). Stretch your brows and relax your neck (stop 10 second). Now focus on your abdomen, tighten your abdominal muscles, hold your breath (5 seconds), and breathe. Consultant: How do you feel now? Helper: I feel much better. My heart is calm, my whole body is relaxed and I don't feel nervous. I think I can adjust my mood during the exam. Counselor: Good. Congratulations on your initial learning to adjust your nervousness. You should practice more in your later life. After relaxing all the muscles, you can continue to give yourself some hints: now I feel very quiet and relaxed ... very quiet and relaxed ... my whole body is relaxed ... (I count from 1 50) ... and finally open my eyes. It works better this way. Summary: Affirm the self-change of the help-seekers, emphasize the consultation points, let the help-seekers further understand the cause and effect of their own problems, make clear the direction of their future efforts, and help the help-seekers to use the learned methods and experiences to deal with the problems in their lives, thus promoting the all-round and healthy development of their body and mind. (v) The fifth consultation is the last one. During the consultation process, I asked the client to do the self-rating anxiety scale (SAS) for the third time, and got a score of about 36, with a standard score of 45, suggesting moderate anxiety. Helper feels okay. She does a relaxation exercise before going to bed every day, and her sleep quality has been greatly improved. She told me happily that she had taught her classmates to relax muscle training. Students hope I can teach them more relaxation skills in psychology class. In the whole consultation, I adopted a relatively passive attitude, put the help-seekers in an automatic role, and guided the help-seekers to analyze and deal with their own problems with their own knowledge and skills in an independent, autonomous and positive role and way. That's how I ended this consultation. "Can you learn a lot from this, such as how to think rationally, how to deal with anxiety without being overwhelmed by anxiety, how to relax yourself quickly and so on? You should think about it and apply it to your future life. I believe you will become healthier and more mature. " Help seekers are full of confidence in their future study and life. X. Evaluation of counseling effect: Self-evaluation of help-seekers: The sleep status of help-seekers has improved, their mood has improved, and their academic performance has been obviously stable. Teachers' and classmates' comments: Help-seekers are enthusiastic and efficient. Counselor's evaluation: Help-seekers have some understanding of their own problems. After treatment, the SAS rough score was 36, and the standard score was 45, suggesting moderate anxiety. (Help-seekers should have some anxiety in the face of the upcoming senior high school entrance examination, which can be regarded as moderate anxiety. Help-seekers learn simple relaxation methods to cope with some stressful situations in life and study. XI。 Consultation summary: In this case, the counselor established a good consultation relationship with the client, got a comprehensive understanding of the client's situation, gained the trust of the client, parents and teachers, got their cooperation, and gave appropriate relief to the client. In the process of consultation, reasonable emotional therapy is used to understand their bad cognitive patterns and help visitors establish rational and reasonable beliefs and behavior patterns. In the process of consultation, I found that even if the visitors have established rational beliefs and behavior patterns, they still have anxiety, so I used relaxation therapy to train the visitors to relax their muscles and make the consultation effect better. References: (1) Guo Nianfeng, Psychological Counselor (Level 3), Beijing: Ethnic Publishing House,No. 1 Edition (2) July 2005, Guo Nianfeng, Psychological Counselor (Level 2), Beijing: Ethnic Publishing House,No. 1 Edition (3).