DAP Note

Data

The client reported increased anxiety before weekly project reviews, with repeated checking of work messages and delayed sleep on two evenings. They had used the previously agreed evening email boundary on three days and noticed that anxiety reduced without further checking on two occasions. The therapist reviewed one thought record, clarified the sequence from ambiguous feedback to a prediction of criticism, and used guided questioning to compare the feared outcome with the available evidence. The client identified that checking provided short-term relief but increased fatigue and preferred a brief written reminder to pause before reopening email. The therapist directly asked about current suicidal thoughts, self-harm thoughts and thoughts of harming others; the client denied all three.

Assessment

Work-related anxiety remained linked with threat-based interpretations of ambiguous feedback and reassurance-seeking through repeated checking. The client had made modest progress toward reducing checking, supported by a clear evening boundary, while fear of overlooking a serious problem remained a barrier. The client was able to apply guided questioning to the current example and identified a workable pause point, supporting continued CBT-oriented work on the maintaining cycle. Direct risk assessment did not indicate a current suicide, self-harm or harm-to-others concern in this session.

Plan

Continue CBT-oriented work on threat appraisal and reassurance-seeking, reviewing whether the evening boundary remains workable. The client agreed to complete two brief records of the trigger, prediction, checking response and outcome, and to use the written pause reminder before reopening work email. The next session will review these records and refine the maintaining cycle; the usual fortnightly appointment was retained.