Objective: To explore the effect of cognitive behavioral therapy (CBT) on college students withtest anxiety, and the effect of case conceptualization on the intervention of individual. Methods: A collegestudent with test anxiety was selected to intervene through emotion recording exercises, recognition andtesting of automatic thinking, and relaxation training etc. Results: The subjects’ subjective anxiety levelwas significantly reduced, and his/her cognitive was more flexible, so that the relaxation method could beused effectively. Conclusion: Cognitive behavioral therapy can significantly improve test anxiety in collegestudents, and case conceptualization can effectively guide case intervention.