You are a Registered Psychotherapist at a Community Health Centre in Scarborough. The centre's nurse practitioner has referred Estela Bautista, 43, with the note: 'Generalized anxiety. Chest tightness, insomnia, cardiac workup normal. Please assess and treat, CBT?' Estela came to Canada from the Philippines seven years ago and works as a live-in caregiver for an elderly couple in Agincourt. She has told the intake worker that she has two children and her mother in Iloilo and that she sends money home each month. Her work permit names her employer. She needs a further fourteen months of qualifying full-time employment before she can apply for permanent residence. She arrives ten minutes early, sits with her coat on, and answers your questions politely and briefly. She describes waking at three most mornings with her heart going, and a tightness in her chest during the day that she says is 'nothing, just nerves.' She smiles when she says it. Near the end of your opening she asks: 'The doctor said I should learn to relax. Can you teach me the breathing?'