Respond to the following scenario by,

1. Identify barriers, specific to the client's context that might limit therapeutic success.

2. Provide a brief, clear outline of how to implement (1) CBT, (2) Sports Psychology counselling, (3) Mindfulness-based interventions and (4) Physiological evaluation and guidance in this scenario.

3. How best to monitor the client's progress throughout the intervention.

4. Identify how to best evaluate the success of the CBT in this scenario.

5. State one way that the benefits of CBT, implemented in this scenario, could be sustained for the client.

Scenario

Casey is a 17-year-old female. She is an athlete, a competitive cyclist. She is a promising elite performer in her age group but is presently underperforming in comparison to her earlier standards. During her first session with the psychologist, she said that she felt like she had been "training too much and too intensely" in the previous pre-season and described what appeared to many symptoms of overtraining syndrome, including prolonged fatigue. During a previous competition, she finished last, which was an unexpected shock. As a result, she felt ashamed and became extremely nervous before competitions, specifically before uphill stages. Her feelings of anxiety persisted during the entirety of her last season and have continued into the new season, which has just begun. The anxiety has already caused her to avoid at least one race this season. In her first session, she also said, "I just want to perform like I used to, without this anxiety." She has also said that just being at a competition site and talking with friends causes her distress, and that her anxieties are heightened before a race and increase as the start of the race approaches. She worries about races for several weeks beforehand. Her anxietywhich centres around a feeling of being frightenedis also heightened when she experiences lactic acid build up in her thighs, also called 'heavy legs'. In response to her physiological and social anxieties associated with her sport, she tends to decrease her pace during competition, especially in uphill sections, and avoids training with her peers. Her aim is to compete again like she used to, without feeling excessive anxiety.