Abstract :
Background. Generalized Anxiety Disorder (GAD) is characterized by chronic, excessive, and difficult-to-control worry accompanied by cognitive, emotional, and somatic symptoms that substantially impair daily functioning. Women are disproportionately affected, and in Pakistan many individuals initially seek help from faith or traditional healers, often delaying access to evidence-based psychological care.
Case Presentation. We report the case of a 49-year-old married homemaker who presented to a private psychological rehabilitation centre in Pakistan with a six-month history of persistent, uncontrollable worry regarding her family's safety, accompanied by restlessness, fatigue, muscle tension, irritability, and morning-predominant ghabrahat (anxious agitation) following her daughter's acute illness. Assessment included a clinical interview, behavioural observation, the Mini-Mental State Examination (MMSE), Beck Anxiety Inventory (BAI), Rotter Incomplete Sentences Blank (RISB), and Thematic Apperception Test (TAT). The client obtained a BAI score of 35, indicating severe anxiety, and a RISB score of 151, indicating significant maladjustment. The clinical presentation fulfilled the diagnostic criteria for Generalized Anxiety Disorder according to the DSM-5-TR-TR (300.02/F41.1).
Intervention and Outcomes. The client received eight weekly individual Cognitive Behaviour Therapy (CBT) sessions (40–45 minutes each) incorporating psychoeducation, relaxation training, cognitive restructuring, worry management, thought records, sleep hygiene, and family counselling. By the completion of therapy, she demonstrated clinically meaningful improvement, including reduced excessive worry, improved mood, resumption of household responsibilities, decreased restrictive behaviours toward her children, and enhanced confidence in managing anxiety symptoms. Following completion of the intervention, the client was referred for continuation of psychological care and relapse-prevention planning.
Conclusion: This case demonstrates the feasibility and clinical utility of culturally adapted Cognitive Behaviour Therapy for the management of Generalized Anxiety Disorder in a private psychological rehabilitation setting in Pakistan. It highlights the importance of culturally sensitive assessment, family involvement, and evidence-based psychological interventions in promoting functional recovery and psychological well-being.