Hannah was a perfectionist and was not comfortable moving through tasks quickly out of a fear of failure. As a result, it was very important that Hannah felt safe as much as possible in sessions. If not, anxiety presented and progress became difficult. For example, if Hannah made a mistake while performing a speed task, she would often sabotage the rest of the task by purposely making errors and acting out. Work in sessions was done to address these defense mechanisms and to help Hannah have less anxiety and more confidence.

Processing speed was targeted through specific exercises that required Hannah to work under time constraints. Following exercises, metacognitive prompting was used to raise Hannah’s knowledge and awareness of processing speed. For example, it was important for Hannah to learn why processing speed is important in order to target her behavior and habits. Hannah was prompted consistently for “speed ratings” while performing exercises, and this was transferred to real-life in part by having Hannah match these speed ratings to everyday tasks, like worksheets or chores.

Over time, Hannah became more comfortable working through her anxiety and working quickly. This was largely facilitated by reward systems, which effectively leveraged Hannah’s competitive nature. It was also very valuable for Hannah to become more metacognitively aware, not only of her processing speed but also of her anxiety and the role this played.

Before the end of her program, Hannah was successfully admitted into a competitive middle school, with her mother citing increased processing speed scores on her clinical evaluation as a factor valued by the school. By the end of her program, Hannah was visibly a more confident learner, and teachers at Hannah’s school reported a change in her habits and ability to work more quickly.