Case Study
Patient Demographic: Client Age: 20 Sex: Female Gender: Female Sexuality: Heterosexual Ethnicity: Asian Relationship Status: Single Counseling Setting: College counseling clinic Type of Counseling: Individual counseling Presenting Problem: Panic attacks Diagnosis: Provisional diagnosis: panic disorder (F41.0)
Mental Status Exam: Mental Status Exam: The client is oriented to person, place, time, and situation. The client does not appear anxious or depressed and was friendly and eng
Presenting Problem: You are a counselor working in a college counseling department. The client comes in after being late to class several times over the last month due to reported “freak-outs” in the morning. The client experiences the following panic symptoms: accelerated heart rate, sweating, shaking, shortness of breath, and a feeling of impending doom. The client reports a feeling of impending doom when she wakes up on days when she has classes, and this anxiety tends to escalate into fear of having a panic attack on a daily basis, often making her late to her first class. The client is worried that she will have panic attacks every day for the rest of her life. She says that her parents have put a lot of pressure on her to get a high grade point average at college. The client is worried about how this pressure and the panic attacks are going to affect her doing well at college and engaging socially.
Other Contexts: aged. Family History: The client reports that she is close with her parents but that they often have high expectations of her and that she worries about disappointing them. The client has an older brother who is 25 and is a lawyer. The client says some of the pressure is wanting to be as successful as her brother because she thinks her parents are really proud of him.  You provide psychoeducation on mindfulness activities to support the client in managing her morning panic attacks

Question: You provide psychoeducation on mindfulness activities to support the client in managing her morning panic attacks. All of the following are mindfulness strategies, EXCEPT:
(A): Deep breathing exercises
(B): Body scanning
(C): Cognitive reframing
(D): Coloring or drawing

Correct Answer: Cognitive reframing
Explanation: Mindfulness is the experience of focusing only on present thoughts and feelings and learning to accept the current situation. This can be helpful in simplifying a seemingly overwhelming situation by focusing on simply existing in the moment. Some techniques to use in mindfulness include coloring or drawing, deep breathing, and body scanning. Coloring or drawing focuses the client’s mind on a singular activity and helps to focus on the present. Deep breathing and body scanning focus on bodily functions and support calming the body and focusing the mind. Cognitive reframing may cause more distress because it involves working through thoughts instead of accepting a situation and focusing on the present. Cognitive reframing can be very helpful for anxiety, but when cognitive functioning is impaired by anxiety, it can be more helpful to focus the body and mind on the present. Therefore, the correct answer is (C)
Competency: counseling skills and interventions