Dr Farah Fahd

Advanced Medical Practice

George St

Windsor

NSW 2756

02.06.2025

Re: Racquel Osmotherly (DOB: 09.05.2003) NBM15307 MHCP Review

Dear Dr Fahad,

Thank you for referring Racquel Osmotherly for an ATSI plan under Wentworth Healthcare’s PTS program for psychological support for ‘major depressive disorder and PTSD’ in March, 2025. I am her allocated provider and write to provide you with a report at the end of her plan.

Racquel attended her first appointment on the 2nd of April 2025. She engaged well and opened up about the challenges she was experiencing. She attended weekly to monthly consultations, with her review being held on the 2nd of June, 2025. In short, Racquel has progressed very well and no longer needs to see me at this time, hence her referral has been closed (see update below).

Initial presentation

Racquel presented with a deterioration in mental health following domestic violence from her ex-partner. They had separated after a one-year relationship. A few months later, Racquel started a relationship with her current partner, after which her ex started stalking her and threatened to hurt her and her new partner. There was one incident of physical assault and verbal threat and an attempted break and enter to their home. He was subsequently placed under and AVO and going through court with a range of charges, however was currently on bail.

Racquel reported a deterioration in mood, hypervigilance, always looking behind her back; checking locks on the house. She was not sleeping and you (her GP) had prescribed melatonin, however it was not resolving the issue. Racquel was also having nightmares and crying a lot.

Her GP diagnosed CPTSD

Racquel has a previous history of D/V in relationship 3 - 4 years ago, which led to her first presentation to see me (see below). Her new partner is 40yo and has his own business in transport and runs a children's charity. They are currently living together on his property.

Racquel continues to be estranged from her mother. She has a relationship with her father, however she does not feel emotionally connected.

Objective

Crying in session when talking of difficulties SLow to engage but warmed up once talking

Assessment

Anxiety and hyper vigilance associated with recent D/V and ongoing threat of violence

Plan

Discussed emotional regulation techniques, including breathing - box breathing; and grounding techniques

Mental health history

Previous presentation to see me in May 2023:

At that time, Racquel presented with deterioration in mood following the breakup of the relationship with her partner, with whom she had been living. In that relationship, she had been the victim of domestic violence, including emotional and psychological. Her way of coping had been to “shut off and run away”, so she had never spoken about these difficulties or processed them.

In addition to this, she was impacted by a breakdown in the relationship with her mother, following her parent’s complicated separation and mother’s new relationship. Her mother had recently withdrawn contact, which caused feelings of abandonment, and a lack of support whilst managing her own recent breakup.

Racquel has had several traumatic events in her life, including the death of her close friend during a mutual water-skiing event, and the death of a patron of the family restaurant in a MVA three years prior. These have been impactful.

Supports

Racquel works at the family restaurant to help her father Since last consultations, Racquel completed a Cert4 in Community Services work and got a lot of satisfaction helping other people. She would like to return to therapy caring profession.

Update

At the time of her review on the 2nd of June 2025, Racquel reported significant improvement. She stated:

“Everything's going well; Life is good; everything is positive.”

Court is in July (for her ex-partner’s AVO), which brings up anxiety about seeing him, however she has been able to put it out of my mind.

Racquel continues to work for her father in hospitality, however is looking for a job in disability support services.

Raquel reported that the anxiety and panic symptoms have all settled down. She described her mood as “a lot better than before”. She denies thoughts of self-harm or suicidal ideation.

Sleep has improved and she is sleeping through the night. Appetite is normal.

She stated that it had been helpful being able to talk to someone.

Plan

Racquel has requested to close the referral as no longer needs psychological support. She is aware that should she need support at another time, to see her GP for a new referral.

Regards,

Michelle Hookham