Session duration was 45 minutes, conducted in-office. Client presented as appearing stuck and expressed feeling trapped between anxiety and avoidance. Client stated, "I know what I should be doing, but I just can't make myself do it." Client reported wanting to apply for new jobs due to dissatisfaction with their current role but described experiencing a wave of anxiety whenever attempting to work on their resume or look at job postings, leading to avoidance and subsequent feelings of guilt, which exacerbates the anxiety. Therapist discussed the cycle of anxiety and avoidance, emphasizing that eliminating anxiety is not the goal but rather learning to move forward despite discomfort. Therapist introduced ACT defusion exercises, including noticing anxious thoughts, saying them in different ways, singing them, using a cartoon voice, and repeating them until they lost intensity. Client laughed during the exercise and reported the thoughts felt less heavy afterward. Values clarification work was conducted, during which client identified growth, challenge, and contributing something meaningful as core values. Therapist helped client connect job applications to value-aligned actions, reframing anxiety as a sign of caring rather than a signal of wrongdoing. Homework assigned includes taking one small value-aligned action, such as updating one section of the resume, and practicing defusion techniques when anxious thoughts arise. Client appeared slightly more willing to try by the end of the session. Follow-up session scheduled for next week to review progress.
SIMPLE Note Example
Acceptance and Commitment Therapy (ACT)
Client used ACT defusion exercises and values clarification to move forward despite anxiety and avoidance.
Generated SIMPLE Note:
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Client Session Summary:
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Today's session was 45 minutes, in-office. Ravi came in looking stuck and said he's been feeling trapped between his anxiety and his avoidance. He said quote 'I know what I should be doing, but I just can't make myself do it' unquote. He talked about how he's been wanting to apply for new jobs because he's unhappy in his current role, but every time he sits down to work on his resume or look at job postings, this wave of anxiety hits and he just shuts down. Then he feels terrible about avoiding it, which makes the anxiety worse.
We talked about how anxiety and avoidance feed into each other, and that trying to get rid of the anxiety first isn't really the answer, it's about learning to move forward even with the discomfort present. I introduced some ACT defusion exercises to help him get some distance from the anxious thoughts. We practiced noticing the thought and then saying it in different ways, singing it, saying it in a cartoon voice, repeating it over and over until it lost some of its power. He laughed a little, which was good, and said it felt less heavy when he did that.
Then we did some values clarification work. I asked him what really matters to him, beyond just escaping the anxiety. He said growth, challenge, and feeling like he's contributing something meaningful. We talked about how applying for jobs is actually a value-aligned action, even if it brings up anxiety. The anxiety doesn't mean he's doing the wrong thing, it just means he cares. His homework is to pick one small value-aligned action this week, like updating one section of his resume, and to practice defusion when the anxious thoughts show up. He doesn't have to feel ready or confident, he just has to take the action.
Actually, one more thing, he seemed a little more willing to try by the end. We'll meet again next week to see how it went.
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