Anxiety Counselling Kelowna: How A Therapist Can Help With Stress: Case Study

Below is a case study highlighting a hypothetical Kelowna resident coming to Unyielding Health & Wellness to receive counselling for anxiety and stress.

Client: Sarah, a 34-year-old marketing professional in Kelowna, BC

Presenting Issue: Sarah sought counselling at Unyielding Health & Wellness due to persistent anxiety, low self-esteem, and feelings of purposelessness. She reported chronic worry about her job performance, fear of failure, and a sense of disconnection from her life’s meaning. These issues were impacting her relationships and overall well-being.

Background: Sarah described a high-pressure work environment where she constantly feared making mistakes. She believed she was “not good enough” and that her worth depended on flawless performance. She also expressed existential concerns, feeling her life lacked purpose and questioning, “What’s the point of it all?” Sarah had no prior counselling experience but was motivated to change.

Therapeutic Approach: The counsellor employed an integrative approach combining REBT, CBT, and Existential Therapy to address Sarah’s cognitive distortions, emotional distress, and existential concerns. The goal was to help Sarah reduce anxiety, improve self-esteem, and find a sense of meaning.

Anxiety Counselling Kelowna: How A Therapist Helps With Stress

Initial Assessment 

• Goals: Build rapport, assess Sarah’s concerns, and establish a treatment plan.
• Process:
  1. The Kelowna Counsellor used Existential Therapy principles to explore Sarah’s sense of purposelessness. Through open-ended questions (e.g., “What does a meaningful life look like to you?”), the therapist helped Sarah articulate her values and how she wants to live her life, these are connection, creativity, and personal growth.
  2. Using CBT, the therapist identified Sarah’s cognitive distortions, including all-or-nothing thinking (“I’m either perfect or a failure”) and catastrophizing (“If I make a mistake, I’ll lose my job”).
  3. REBT was introduced to pinpoint irrational beliefs driving Sarah’s anxiety, such as the belief “I must always perform perfectly, or I’m worthless.” Her therapist explained the ABC model (Activating event, Belief, Consequence) to help Sarah see how her beliefs fuelled her distress.
• Outcome: Sarah felt validated and hopeful about addressing her concerns. Sarah and her therapist agreed on goals: reduce anxiety, challenge negative self-beliefs, and explore life’s meaning.

Anxiety Counselling Kelowna: How REBT Can Help With Stress

REBT: Challenging Irrational Beliefs 

• Goals: Dispute irrational beliefs and replace them with rational alternatives to reduce anxiety and improve self-esteem.
• Process:
  1. The Kelowna Therapist used REBT’s disputing technique to challenge Sarah’s irrational belief (“I must be perfect”). Through Socratic questioning (“Is it true that one mistake defines your worth?”), the counsellor helped Sarah see this belief as unrealistic and self-defeating.
  2. Sarah practiced REBT’s rational self-statements, such as “I’d prefer to do well, but mistakes don’t make me worthless.” The Therapist assigned homework to mentally pause during situations where Sarah felt inadequate and reframe them using rational, self-helping beliefs.
  3. To address emotional distress, the counsellor taught REBT-based emotional regulation techniques, like deep breathing and self-compassion exercises, to manage anxiety during work stress.
• Outcome: Sarah reported a  reduction in anxiety. She began to internalize that her worth wasn’t tied to perfection, though she still struggled with self-criticism.

Anxiety Counselling Kelowna: How CBT Can Help With Stress

CBT: Restructuring Thoughts and Behaviors 

• Goals: Modify cognitive distortions and develop adaptive behaviors to reinforce self-esteem and reduce worry.
• Process:
  1. Using CBT, her therapist guided Sarah through thought records to identify and challenge distortions like catastrophizing. For example, when Sarah worried about a work presentation, the counsellor helped her reframe “I’ll fail and be fired” to “I might make a mistake, but I can recover and learn.”
  2. The therapist introduced behavioural experiments to test Sarah’s fears. Sarah agreed to deliberately make a small mistake in a low-stakes work task (e.g., a minor typo in an email) to see if catastrophic outcomes occurred. This helped her realize her fears were exaggerated.
  3. To build self-esteem, the counsellor used CBT’s positive data log, where Sarah tracked daily successes (e.g., completing tasks, receiving positive feedback) to counter her negative self-image.
• Outcome: Sarah’s self-esteem improved, and she reported feeling more confident in meetings. Her anxiety dropped, and she began initiating social plans with friends, which she had previously avoided.

Anxiety Counselling Kelowna: How Existential Therapy Can Help With Stress

Existential Therapy: Finding Meaning 

• Goals: Address Sarah’s existential concerns and help her align her life with her values.
• Process:
  1. Sarah’s Kelowna counsellor used Existential Therapy to explore Sarah’s sense of purposelessness. Through reflective dialogue, Sarah identified that creativity (e.g., painting) and helping others gave her a sense of fulfillment and purpose.
  2. The therapist encouraged Sarah to confront existential anxiety by embracing freedom and responsibility. For example, Sarah explored how she could make choices aligned with her values, like volunteering at a local community center.
  3. To integrate meaning-making, the counsellor used logotherapy-inspired exercises (a branch of existential therapy), asking Sarah to envision a future where she felt purposeful. Sarah set a goal to start attending a weekly art class to reconnect with her creative side.
• Outcome: Sarah reported a renewed sense of purpose. She joined an art group in Kelowna and volunteered once a month, which boosted her mood and sense of connection and her place in the community. Her existential distress decreased significantly.

Anxiety Counselling Kelowna: Integration, Results, and Termination Of Kelowna Therapy

 Integration and Termination 

• Goals: Consolidate gains, plan for maintenance, and prepare for therapy conclusion.
• Process:
  1. The therapist reviewed Sarah’s progress, integrating REBT and CBT by reinforcing rational beliefs and cognitive strategies for managing future stress. Sarah practiced a “self-coaching” script to handle work anxiety independently.
  2. Using Existential Therapy, the therapist helped Sarah reflect on her growth in finding meaning. Sarah articulated that she now saw life as “a journey to create my own purpose, even with uncertainty.”
  3. The counsellor assigned a maintenance plan: Sarah would continue journaling rational self-statements, engage in weekly creative activities, and check in with her values during stressful times. Her counsellor offered follow-up sessions as needed.
• Outcome: Sarah rated her anxiety at 2/10 and felt confident in her ability to manage setbacks. She described feeling “grounded and hopeful” and valued her new sense of purpose through creativity and community involvement.

Results

Sarah achieved significant improvements:

• Anxiety Reduction: Self-reported anxiety decreased from 8/10 to 2/10.
• Self-Esteem: Sarah’s self-perception shifted from “not good enough” to “capable and worthy, even with imperfections.”
• Purpose: Sarah found meaning through creative pursuits and volunteering, aligning her life with her values of connection and growth.
• Behavioral Changes: She initiated social activities, took on new work challenges with less fear, and maintained a consistent self-care routine.

Why This Approach Worked

• REBT: Addressed Sarah’s irrational beliefs head-on, reducing emotional distress by challenging the root of her anxiety and low self-esteem. The ABC model helped her understand and disrupt negative thought patterns.
• CBT: Provided practical tools (thought records, behavioral experiments) to restructure distorted thinking and build confidence through evidence-based successes.
• Existential Therapy: Tackled Sarah’s deeper questions about meaning, helping her find purpose through values-driven actions, which complemented the cognitive work.
• Integration: Combining REBT’s focus on irrational beliefs, CBT’s structured cognitive-behavioral strategies, and Existential Therapy’s exploration of meaning created a holistic approach that addressed both immediate symptoms and long-term fulfillment.

Written By Tim Lamont C.C.C.

Disclaimer: The client name, details, and background used in this case study were generated with the assistance of Grok, an AI developed by xAI. AI enhances the results found within the case study, however it can make mistakes. The information and analysis presented in this case study have been critically reviewed and validated by a human therapist, who remains solely responsible for its application. Any resemblance to real persons, living or deceased, or actual events is purely coincidental. Therapists at Unyielding Health & Wellness uphold client confidentiality to the highest standard in accordance with Canadian and British Columbian privacy laws, including the Personal Information Protection Act (PIPA).