WorkCover Queensland Comprehensive Treatment Report

Client: Michael Blogs

Date of Birth: 03/11/1981

Claim Number: WCQ-2024-073912

Date of Injury: 08/07/2024

Diagnosis: Post-Traumatic Stress Disorder, Moderate (309.81); Major Depressive Disorder, Mild (296.21)

History of Work-Related Injury

Michael was involved in a serious workplace accident on 8 July 2024 while operating heavy machinery at a logistics warehouse, during which a colleague sustained significant injuries in close proximity to him. He reported experiencing intense fear and helplessness during the incident and was unable to return to work following the event. In the weeks that followed, Michael developed persistent intrusive memories, nightmares, and a strong avoidance of the workplace and anything associated with machinery. His symptoms have remained significant and have had a marked impact on his ability to work, socialise, and manage day-to-day activities.

Summary of Treatment Provided

Michael has received trauma-focused cognitive behaviour therapy (TF-CBT), an approach that helps clients process traumatic memories and reduce avoidance behaviours that maintain PTSD symptoms. Treatment commenced on 02/09/2024, with 14 individual sessions provided to date at a fortnightly frequency. The primary focus of treatment has been processing the traumatic workplace incident, reducing hyperarousal and avoidance, and building practical coping skills to support Michael’s return to daily functioning and work.

Progress Summary

Since commencing treatment, Michael has shown meaningful improvement in the frequency and intensity of intrusive memories and nightmares, reporting these have reduced from daily to two to three times per week. His avoidance behaviours have also decreased, with Michael now able to drive past his former workplace without significant distress, which was not possible at the outset of treatment. He has re-engaged with several social activities and reported improvements in his sleep and concentration. Michael and his treating clinician agree that while progress has been steady, ongoing treatment is required to consolidate gains and support a sustainable return to work.

Outcome Measures

1. PTSD Checklist for DSM-5 (PCL-5); Initial administration date: 02/09/2024; Initial score: 52 (Severe); Most recent administration date: 10/02/2025; Most recent score: 31 (Moderate); Michael’s PCL-5 score has decreased by 21 points since commencing treatment, indicating a clinically significant reduction in trauma symptoms across all clusters, particularly avoidance and hyperarousal.
2. Depression Anxiety Stress Scale – Short Form (DASS-21); Initial administration date: 02/09/2024; Initial scores: Depression 18 (Moderate), Anxiety 16 (Severe), Stress 22 (Severe); Most recent administration date: 10/02/2025; Most recent scores: Depression 10 (Mild), Anxiety 8 (Mild), Stress 12 (Moderate); Michael’s DASS-21 scores have improved across all three subscales, reflecting a meaningful reduction in overall psychological distress since treatment commenced.
3. Patient Health Questionnaire – Depression (PHQ-9); Initial administration date: 02/09/2024; Initial score: 17 (Moderately Severe); Most recent administration date: 10/02/2025; Most recent score: 9 (Mild); Michael’s PHQ-9 score has reduced by 8 points, indicating a clinically meaningful improvement in depressive symptoms, including improved sleep, concentration, and motivation.

Work Status and Improved Function

Michael remains off work at his substantive workplace but has recently commenced a graduated return to work program at an alternative site, attending two days per week in an administrative capacity. His functional capacity has improved noticeably, with Michael now able to manage household tasks, attend appointments independently, and engage in brief social outings, all of which he was unable to do consistently at the commencement of treatment.

Self-Management

Michael has developed a range of self-management strategies through treatment, including controlled breathing exercises, a grounding technique for use during intrusive memories, and a structured daily routine to support mood and sleep. He demonstrates a solid understanding of the relationship between avoidance and the maintenance of PTSD symptoms and has been actively applying cognitive restructuring skills between sessions. Michael’s engagement with self-management has been consistent, and he reports increased confidence in his ability to manage symptoms independently during the periods between sessions.

Direction of Future Treatment

Planned Interventions:

Future treatment will continue with TF-CBT, with a focus on completing the remaining trauma processing work, consolidating relapse prevention skills, and supporting a sustainable increase in Michael’s work hours. Sessions will also address residual depressive symptoms and further develop his confidence in workplace settings.

Number and Frequency of Treatment Sessions:

8 sessions, fortnightly.

Expected Duration of Rehabilitation Plan:

Approximately 4 months, with an anticipated end date of June 2025.

Functional Goals:

• By 01/04/2025, Michael will increase his graduated return to work to three days per week at the alternative site, as evidenced by attendance records.
• By 01/05/2025, Michael will independently manage distressing memories using at least two self-management strategies without requiring clinician support, as self-reported in session.
• By 30/06/2025, Michael will have transitioned to full-time duties at a suitable workplace, subject to employer and treating team review.

Return to Work Alignment:

The above goals directly support Michael’s return to work by building his capacity to tolerate work-related environments, manage stress independently, and increase his hours in a graduated and sustainable way. Achieving these goals will reduce his reliance on avoidance as a coping strategy and strengthen his confidence in performing work tasks safely.

Anticipated Self-Management:

It is anticipated that Michael will be able to manage his condition independently, without ongoing professional support, within approximately four to six months, subject to continued progress at the current rate.

Other Contributing Factors

Michael reported a prior history of anxiety in his early twenties, for which he did not seek formal treatment. He also identified ongoing financial stress related to his period off work as a contributing factor to his current low mood. While these factors are not the primary cause of his current presentation, they are likely amplifying the impact of the work-related injury and are being addressed within the current treatment plan where relevant.

Barriers to Rehabilitation Progress and Return to Work

Identified Barriers:

• Residual trauma-related avoidance of the original workplace and machinery, which limits Michael’s capacity to return to his substantive role
• Ongoing low mood and fatigue affecting motivation and capacity to increase work hours
• Financial stress arising from the period off work, contributing to heightened anxiety
• Uncertainty about workplace safety and whether the conditions that led to the incident have been addressed by the employer

Suggestions to Overcome Barriers:

• Continue graded exposure work in session to progressively reduce avoidance of work-related environments, with a view to reintroducing Michael to his substantive workplace setting in a controlled way
• Incorporate behavioural activation strategies into ongoing sessions to target low mood and fatigue and support Michael’s capacity to increase his work hours
• Referral to a financial counselling service is recommended to alleviate financial stress and reduce its contribution to Michael’s overall symptom burden
• Clinician to liaise with Michael’s rehabilitation coordinator to request confirmation from the employer that workplace safety has been reviewed and that appropriate measures have been implemented prior to any return to the substantive site