This case study highlights a hypothetical university student based in Kelowna who sought after counselling services at Unyielding Health & Wellness, in order to overcome their academic stress and rediscover their confidence.
Background Information
Client
Emma: A 20-year-old second-year student at UBC Okanagan in Kelowna, BC
Presenting Issue
Emma sought counselling at Unyielding Health & Wellness due to overwhelming academic stress and anxiety, threatening her performance at UBC Okanagan. She expressed thoughts like, “I’m going to fail and disappoint everyone who believe in me,” and struggled with procrastination, low self-confidence, and social isolation.
Emma felt paralyzed and pulled in all directions by the pressures of balancing coursework, part-time work, and social expectations in Kelowna’s fast-paced university environment. Initially hesitant about therapy, fearing it meant she was “weak,” she was encouraged by a friend to seek help after missing deadlines and withdrawing from campus activities she normally participated in and enjoyed. Emma’s goal was to manage stress, rebuild confidence, and thrive academically and socially during her academic years.
Background
Emma, a biology major, moved to Kelowna from Vancouver for her studies at UBC Okanagan. In her second year, she faced mounting pressure from midterms, a demanding part-time job at a local café, and difficulty making friends in Kelowna’s unfamiliar social scene. She reported thoughts like, “I’m not smart enough for university,” and experienced physical symptoms like sleeplessness and tension headaches.
Her isolation grew as she avoided study groups and campus events, fearing judgment. Emma’s parents, still in Vancouver, noticed her distress during phone calls and supported her decision to try counselling. Her goal was to regain control over her studies, reduce anxiety, and feel connected to the Kelowna university community.
Therapeutic Approach
The counsellor, Tim Lamont, a Certified Canadian Counsellor (C.C.C.) with the Canadian Counselling and Psychotherapy Association (CCPA) at Unyielding Health & Wellness, used an integrative approach combining Rational Emotive Behaviour Therapy (REBT), Cognitive Behavioural Therapy (CBT), and Existential Therapy. The goals were to challenge Emma’s self-defeating beliefs, develop practical coping strategies, and help her find meaning and confidence in her university journey in Kelowna.
Initial Assessment
Process
- Using Existential Therapy, the counsellor explored Emma’s sense of disconnection with questions like, “What does success at UBC Okanagan mean to you?” Emma identified academic achievement, meaningful friendships, and personal growth as core values but felt distant from them due to stress and “not enough time”.
- With CBT, the counsellor identified cognitive distortions, such as catastrophizing (“If I fail this exam, my life is over”) and all-or-nothing thinking (“I’m either perfect or a failure”).
- REBT pinpointed irrational beliefs driving her anxiety, like, “I must always succeed to be worthy,” and “I should never struggle.” The ABC model (Activating event, Belief, Consequence) clarified how these beliefs fueled her procrastination and withdrawal.
- The counsellor assessed Emma’s anxiety, noting no immediate risk but highlighting mounting social isolation and academic pressure as concerns. A coping plan was introduced, including strategies like deep breathing before studying, scheduling campus events, and contacting her friend or parents for support.
Outcome
Emma felt validated and less ashamed of seeking help. She committed to weekly sessions for six weeks, focusing on reducing anxiety, improving study habits, and building social connections in Kelowna.
How REBT Can Help
Goals
Challenge irrational beliefs to reduce Emma’s anxiety and self-doubt, fostering confidence and self-acceptance in her university life.
Process
- The counsellor used REBT’s disputing technique to challenge Emma’s belief, “I must always succeed to be worthy.” Questions like, “Does one bad grade define your value?” helped her adopt, “I can be worthy even if I make mistakes, or get a grade that’s lower than I would prefer”.
- The belief, “I should never struggle,” was disputed with, “Is it realistic to expect university to be easy?” Emma practiced rational self-statements like, “It’s okay to struggle while I learn, that’s a natural part of the learning process.”
- Homework involved journaling three daily achievements (e.g., completing a study session, attending a campus club meeting) and practicing self-compassion affirmations during stressful moments.
- In sessions, role-playing helped Emma counter self-critical thoughts, reframing “I’m not smart enough” to “I’m capable and learning every day.”
Outcome
Emma’s anxiety decreased, and she reported feeling less defined by perfectionism, gaining confidence to tackle her studies and engage socially at UBC Okanagan.
How CBT Can Help
Goals
Modify cognitive distortions and develop adaptive behaviors to manage Emma’s anxiety, improve academic performance, and increase campus engagement.
Process
- Using CBT, the counsellor guided Emma through thought records to reframe distortions. For example, “I’ll fail everything” became, “I can prepare and improve from setbacks with effort”.
- Behavioral experiments tested her fears. Emma committed to joining a UBC Okanagan study group to challenge, “No one will like me.” She found the group supportive, boosting her confidence.
- A positive data log tracked achievements, like submitting assignments on time or attending a student event, reinforcing her sense of progress.
- The counsellor co-created a coping plan with strategies (e.g., mindfulness exercises, breaking tasks into smaller steps), reasons for staying engaged (e.g., career goals, friendships), and contacts (e.g., friend, parents, academic advisor).
Outcome
Emma improved her study habits, submitted assignments on time, and joined two campus clubs, reducing her anxiety from 8/10 to 4/10 and feeling more in control.
How Existential Therapy Can Help
Goals
Address Emma’s sense of disconnection and align her actions with values to foster meaning and purpose in her university experience.
Process
- The counsellor used Existential Therapy to explore Emma’s question, “Why am I even here?” Asking, “What makes university meaningful for you?” revealed her passion for biology, learning, and building connections.
- Logotherapy-inspired exercises encouraged Emma to envision a fulfilling university life, such as leading a biology club or volunteering at Kelowna’s environmental events, aligning with her values.
- The counsellor supported small, values-driven actions, like attending a UBC Okanagan science seminar or joining a local hiking group, to connect with her interests and community.
- Reflective discussions helped Emma accept academic challenges as part of her growth, reducing her fear of failure.
Outcome
Emma reported renewed purpose, volunteering at a Kelowna environmental fair and joining a biology study group. She felt more connected to UBC Okanagan’s community.
Integration, Results, and Termination
Goals
Consolidate progress, plan for maintenance, and prepare for therapy conclusion.
Process
- The counsellor integrated REBT and CBT to reinforce rational beliefs and coping strategies. Emma practiced a “self-coaching” script for anxious moments (e.g., “I can learn from mistakes”) and used thought records to manage triggers like exam stress and group projects.
- Existential Therapy helped Emma reflect on her growth, embracing learning and connection as anchors of meaning. She set a goal to lead a biology study group at UBC Okanagan.
- A maintenance plan included journaling achievements, continuing club involvement, and attending one campus event monthly.
- The counsellor reviewed the coping plan, ensuring Emma’s confidence in using it. Follow-up sessions were offered as needed.
Results
Emma achieved significant improvements:
- Anxiety Reduction: Anxiety dropped from 8/10 to 3/10, with coping strategies providing security.
- Increased Engagement: Emma joined two campus clubs, volunteered at an environmental event, and led a study session, boosting social connection.
- Self-Confidence and Purpose: She regained confidence in her academic abilities and found meaning through biology and community involvement.
- Resilience: Emma managed academic pressures with REBT and CBT strategies, reporting a stronger sense of control.
Why This Approach Worked
- REBT: Addressed irrational beliefs like “I must always succeed,” reducing anxiety and fostering self-acceptance, key to navigating university stress.
- CBT: Provided structured tools like thought records and behavioral experiments, helping Emma manage anxiety and engage in Kelowna’s university community through actionable steps.
- Existential Therapy: Tackled her sense of disconnection, reconnecting her with values like learning and community, fostering purpose in her studies.
- Integration: Combining REBT’s belief-challenging, CBT’s practical strategies, and Existential Therapy’s focus on meaning created a holistic approach, addressing emotional, cognitive, and existential needs.
- Local Relevance: The counsellor’s use of Kelowna-specific activities (e.g., environmental fairs, UBC Okanagan clubs) and Unyielding Health & Wellness’s confidential environment in Kelowna’s Landmark District alleviated Emma’s hesitation, building trust.
Written By: Timothy 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).
