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Exam Anxiety No 2: Applying Therapeutic Cards with CBT

The following is a suggestion for the application of "The River" Set or the "Roads" Deck when working with adolescent or adult clients experiencing anxiety related to tests.

The client is invited to choose four cards and to place them alongside each other so that they form a continuum (see photo).

Each of the four cards represents a different stage of the client's anxiety: 

  • 1st Card: What their anxiety 'looks like' on the day before an exam

  • 2nd Card: Their anxiety on the morning of the exam

  • 3rd Card: Their anxiety during the exam

  • 4th Card: Their level of anxiety the day after the exam 

The fact that the card-continuum is a concrete and visual representation of the client's anxiety makes it easier for the client to externalise that anxiety. In this manner, the client can examine the way his/her anxiety changes over time as an outside observer. 

Likewise, the therapist can invite the client to build separate, more specific, card-continuums to represent the physical, emotional, behavioural, or cognitive aspects of that anxiety over time. Together, they can compare these continuums and discuss the ways in which the different aspects affect each other.

As the card-continuum is placed in front of the client and therapist, it becomes easier for the client to share his/her experience of anxiety with the therapist. In addition, the therapist gains many opportunities for making therapeutic interventions based on this visual/thematic representation.

Numerous other suggestions for using the cards are described in detail in "The River" guidebook. 

To learn how to use these cards and others, please join one of our online workshops 



Written by Gali Salpeter - Story & Therapy

Expressive Therapist. Spec. Drama and NarrativeTherapy (M.A.)(NFKUT)(I.C.E.T)

The River Set- Anxiety.jpg
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