Dr Carrie Stanney

Advanced Medical Practice

Shop 5/29 Eldon St

Pitt Town

NSW 2756

12.11.24

Re: Keith Quiney (DOB: 14/12/1970) GP MHCP Review

Dear Dr Stanney,

Thank you for referring Keith Quiney for a GP mental healthcare plan for psychological support for a work related stressor. He had a previous referral to see me for anxiety and depression in August 2023.

Keith attended his first appointment on the 21st of June, 2024. He had a total of seven sessions, with his review being held on the 23rd of September, 2024, at which time he was doing very well. I write to provide you with feedback at the close of this referral.

Initial Presentation

At the time of his new referral, Keith spoke about bullying and harassment in a work situation, which had escalated to a formal complaints’ procedure. Keith expressed high levels of anxiety about the situation, particularly the lack of due process and procedural fairness, for a complaint he considered had no foundation. He was anxious about his financial and job security.

MSE:

Keith presented in casual clothing; neat and good attention to hygiene and grooming.

Sitting forward in chair, visibly distressed about work situation and crying when speaking of the stress. Described mood as “high anxiety”

Speech: normal rate tone and volume

Thought form: logical and sequential;

Content: as stated above No alteration in perception

Oriented to time place and person

Good insight and judgement - seeking help to manage.

Past history

Diagnosed with anxiety and depression in 2023 by his GP.

Supports

Keith lives at home with his wife, their 12 year old son, and his mother in law.

Update

Over the past five months Keith’s mood varied, attributed to the workplace matter, with anxiety about his future, financial security and potential damage to his reputation. The work situation escalated in August, 2024, causing heightened anxiety, with Keith reporting that he was not coping; not sleeping; had low self-esteem, low mood and suicidal ideation. He was given sick leave at that time, and we increased the psychological support. By September, Keith accepted a redundancy package from his employer, formally concluding the workplace matter. Keith has since commenced a new position with a company in Newcastle, the region his family are wanting to relocate to and has reported that he is loving the new challenge and in a much better place.

Over the course of this plan, a range of psychotherapeutic interventions were utilised to support Keith’s recovery. He gained great clarity and insight through these activities, including exploration of adverse early life experiences leading to low self-worth, negative core beliefs and limiting assumptions about himself. We also explored coping strategies for managing anxiety and emotional regulation, with good effect.

Keith stated that it had been very helpful to have someone to talk to; that he is feeling much more optimistic about his future and no longer required further support at this time.

Formulation from initial consult

54-year-old employed business executive, living in his own home, with his wife, 13-year-old son and mother in law, presenting with anxiety associated with a workplace issue, which has since resolved. He is currently progressing very well and no longer requires psychological support.

Impression:

Situational crisis, resolved.

Plan

Referral has been closed. Should Keith require support at another time, I would be happy to see him.

Regards,

Michelle Hookham