WorkCover Queensland Psychological Treatment Progress Report

Client: Emma Brown

Date of Birth: 14/03/1985

Claim Number: WCQ-2024-048321

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

Impact of Diagnosis on Functional Capacity

Emma’s symptoms of hypervigilance, intrusive memories, and low mood have significantly reduced her capacity to concentrate and manage workplace interactions. She has reported difficulty completing administrative tasks, sustaining attention for more than 30 minutes, and engaging with colleagues due to social withdrawal.

Return to Work Capacity

Emma currently has capacity for a graduated return to work with modified duties, commencing at 10 hours per week across two to three days. It is recommended she initially avoid direct client-facing work and environments that replicate aspects of the traumatic incident. A review of hours is recommended after four weeks, with a view to increasing to 20 hours per week subject to progress.

Barriers to Return to Work

Key barriers include ongoing trauma-related avoidance of the workplace environment, low confidence in her ability to manage stress, and concern about interactions with the colleague involved in the original incident. It is recommended the employer consider redeployment to a separate team during the initial return to work period, and that Emma’s treating clinician provide a brief workplace education document for her supervisor. Emma will continue to develop coping strategies in session to manage anxiety in the workplace setting.

Treatment Provided

Emma has received trauma-focused cognitive behaviour therapy (TF-CBT), an evidence-based approach that involves identifying and challenging unhelpful thoughts, gradual exposure to trauma-related memories, and developing practical coping strategies. Ten individual sessions have been completed to date, delivered fortnightly. Treatment has focused primarily on processing the traumatic workplace incident and reducing avoidance behaviours that are contributing to her difficulty returning to work.

Outcomes Achieved

Measurable Outcomes:

1. Depression Anxiety Stress Scale – Short Form (DASS-21); Initial administration date: 03/02/2025; Initial scores: Depression 18 (Moderate), Anxiety 14 (Severe), Stress 20 (Moderate); Most recent administration date: 14/07/2025; Most recent scores: Depression 8 (Mild), Anxiety 6 (Normal), Stress 10 (Normal); Emma’s DASS-21 scores have improved meaningfully across all three subscales, indicating a reduction in overall psychological distress since commencing treatment.
2. PTSD Checklist for DSM-5 (PCL-5); Initial administration date: 03/02/2025; Initial score: 48 (Severe); Most recent administration date: 14/07/2025; Most recent score: 28 (Moderate); Emma’s PCL-5 score has decreased by 20 points, indicating a clinically significant reduction in trauma symptoms, particularly in the areas of avoidance and hyperarousal.
3. Patient Health Questionnaire – Depression (PHQ-9); Initial administration date: 03/02/2025; Initial score: 16 (Moderately Severe); Most recent administration date: 14/07/2025; Most recent score: 7 (Mild); Emma’s PHQ-9 score reflects a meaningful reduction in depressive symptoms, with improvements in sleep, concentration, and motivation most notably reported by the client.

Return to Work Support:

Treatment has directly targeted the avoidance behaviours and trauma-related beliefs that have been the primary barriers to Emma’s return to work. Through gradual exposure exercises and cognitive restructuring, Emma has developed greater confidence in her capacity to manage workplace stress, and has begun to challenge her belief that the workplace is inherently unsafe.

Progress Toward Goals

Current Functional Goals:

• By 01/09/2025, Emma will complete a graduated return to work at 10 hours per week with modified duties, as evidenced by attendance records.
• By 01/10/2025, Emma will independently use at least two coping strategies to manage anxiety during work hours, as self-reported in session.
• By 01/11/2025, Emma will increase her work hours to 20 hours per week, subject to review with her treating clinician and employer.

Progress and Support:

Emma has made solid progress toward her first goal, having completed two weeks of reduced-hours attendance. Graded exposure techniques introduced in session have supported her capacity to re-enter the workplace. Progress toward the second goal is on track, with Emma reporting regular use of controlled breathing and cognitive restructuring strategies during anxious moments at work. Planning for the third goal is underway, with a review meeting with her employer scheduled for mid-August.

Self-Management:

Emma is developing a growing repertoire of self-management strategies, including structured breathing exercises, a daily mood monitoring journal, and a grounding technique for use during intrusive memories. It is anticipated that Emma will be able to manage her condition with minimal clinical support within approximately three to four months, subject to continued progress.

Recommendations

Self-Management:

Ongoing psychological treatment is recommended at a fortnightly frequency for an estimated further six sessions. Continued TF-CBT will focus on consolidating gains, addressing residual avoidance, and building relapse prevention skills to support long-term self-management.

Return to Work:

It is recommended Emma continue her graduated return to work, increasing hours incrementally every four weeks in consultation with her employer and treating clinician. Suitable duties should initially exclude direct client-facing responsibilities. A formal review of her return to work plan is recommended at the eight-week mark, with a view to transitioning to full duties within four to five months subject to progress.

Other Recommendations:

Referral to Emma’s general practitioner is recommended to review current medication management given improvements in depressive symptoms. Emma has also been encouraged to re-engage with regular physical activity as a complementary self-management strategy, consistent with evidence-based recommendations for PTSD and depression recovery.