Report to the Gutachter (expert reviewer) · PTV 3
Conversion of short-term therapy into long-term therapy
1. Relevant sociodemographic data
The 35-year-old patient works full time as an administrative clerk in the HR department of a medium-sized company. [P1 · 21.04.2026] She has lived with her partner for four years; she has no children. [P1 · 21.04.2026]
2. Symptoms and mental status
The patient presented because of pronounced fear of speaking up in meetings and of telephone calls with unfamiliar people; for about a year she has avoided team meetings whenever possible. [P1 · 21.04.2026] She reported blushing, palpitations and the worry of “appearing incompetent”, as well as low mood, reduced drive and brooding in the evening. [P2 · 28.04.2026]
On mental status examination the patient was alert and fully oriented, approachable, initially tense. Thought form was orderly; thought content was dominated by fears of negative evaluation. Mood was low, affective range slightly restricted. There was no evidence of psychotic experiences. The patient credibly denied acute suicidality. [P2 · 28.04.2026]
At the start of treatment the PHQ-9 total score was 19 points [PHQ-9 · 19], the GAD-7 total score 15 points. [GAD-7 · 15]
3. Somatic findings / Konsiliarbericht (physician’s consultation report)
According to the GP’s Konsiliarbericht there are no somatic findings that explain the symptoms; thyroid values were unremarkable. [Konsiliarbericht · 22.05.2026] There is no medication. [Konsiliarbericht · 22.05.2026]
4. Life history, history of the illness and functional analysis (Bedingungsmodell)
Life history and illness history
The patient grew up as the older of two daughters; her father reportedly judged her school performance strictly and commented on her mistakes in front of others. [P3 · 05.05.2026] At school she was reportedly teased for weeks after a failed presentation in the seventh school year; since then she has avoided speaking in front of groups. [P3 · 05.05.2026] The symptoms intensified about a year ago after a new head of department arrived and regular presentations to the team became part of her role. [P1 · 21.04.2026] There was no previous psychotherapeutic treatment. [P1 · 21.04.2026]
Functional analysis
Triggering situations are meetings in which her own contribution is expected. [S2 · 09.06.2026] Cognitively, thoughts such as “Everyone can see I’m blushing” occur; emotionally, fear and shame; physically, blushing and palpitations. [S2 · 09.06.2026] As safety behaviours, the patient relies on pre-written note cards, avoids eye contact and speaks up only at the end of a meeting. [S3 · 16.06.2026] In the short term this reduces tension; in the long term the conviction remains that she would fail without these precautions, and avoidance reinforces withdrawal and low mood. [S3 · 16.06.2026]
Course of the short-term therapy
During short-term therapy, an individual disorder model was developed, safety behaviours were identified and behavioural experiments were started. [S6 · 14.07.2026] In the twelfth session the patient carried out the exposure “speaking up in the team meeting” for the first time without safety behaviour; subjective tension fell from 70 to 35. [S12 · 03.09.2026] The PHQ-9 total score was most recently 14 points, compared with 19 points at the start of treatment. [PHQ-9 · 14] The GAD-7 total score was most recently 11 points. [GAD-7 · 11] The patient continues to avoid telephone calls with unfamiliar people; she has twice cancelled planned exercises for this. [S15 · 24.09.2026] Overall, her occupational strain has decreased markedly.Not sourced
5. Diagnosis at the time of the application
Section taken from the therapist’s verbatim input. The software does not suggest diagnoses.
- F40.1 G Social phobia [Therapist input · 01.10.2026]
- F32.1 G Moderate depressive episode [Therapist input · 01.10.2026]
6. Treatment plan and prognosis
Goals, plan and prognosis taken from the therapist’s verbatim input and lightly edited for language. The software adds no content.
Therapy goals
- Speaking up in meetings without safety behaviour, at least twice a week. [Therapist input · 01.10.2026]
- Telephone calls with unfamiliar people without prior avoidance. [Therapist input · 01.10.2026]
- Reducing withdrawal and brooding; resuming social activities outside work. [Therapist input · 01.10.2026]
- Relapse prevention with a written emergency plan. [Therapist input · 01.10.2026]
Treatment plan
Continuation of the behavioural experiments and exposures in social situations, extended to telephone calls; external focus of attention; cognitive work on fears of evaluation; activity scheduling; and, to conclude, relapse prevention. Conversion to long-term therapy is requested for a total of 60 hours, including the hours already delivered. [Therapist input · 01.10.2026]
Prognosis
The patient is motivated and completes most exercises between sessions; the persistent avoidance of telephone calls and the long duration of the problem support longer treatment. The prognosis is assessed as favourable if treatment is continued. [Therapist input · 01.10.2026]