Dr Myo Aung

Our Medical Marsden Park

1/9 Hollinsworth Rd

Marsden Park

NSW 2765

08.10.2025

Re: Aimee-Liegh Dixon (DOB: 25/05/2011) NBM16692 Review and mental health assessment

Dear Dr Aung,

Thank you for referring Aimee-Liegh for a PTS Young Person’s plan under Wentworth Healthcare, for therapeutic support for ‘depression and possible eating disorder’. I write to provide you with a review at the end of the referral.

Initial Presentation

Overdose on Panadol 3 weeks ago, which came to Jemma's (mother) attention after Aimee was sick for 2 days vomiting. Jemma took Aimee to ED at the recommendation of her GP, culminating in a presentation to Nepean Hospital’s Triage and Assessment Centre (TAC). She was discharged home and followed up by the Safeguards mental healthcare team in Blacktown.

At the time of her first consultation, Aimee was reluctant to engage, stating that she didn’t want to be talking to me. Hence, Aimee’s initial history was provided by Jemma, who reported that Aimee had been struggling with “high anxiety” from life stressors for some time, including bullying at school, online and in her soccer team, which she took to heart and struggling with school work.

Jemma reported that Aimee had a history of sexual assault two years prior and history of deliberate self-harm (cutting).

Strengths:

Aimee loves soccer and would like to play for the Matilda's. She has been approached by a team to play as a junior and got through the first round of trials.

Developmental history

Aimee’s father left when Jemma was 6 weeks pregnant with her and has seen Aimee twice in her life.

Aboriginal descent on father's side

Jemma was 16 at time of the unplanned pregnancy

Birth: 5 weeks early; no problems; healthy weight; breastfed for 3 months

Removed from mother at 3 months by DCJ, then foster care with Jemma's sister until 4 years old. Jemma fought for her custody and she has been with her mother since then. Prior, she had monthly access visits.

Milestones: roughly on time; walked at 15 months

Had speech therapy when younger

Some concerns about her learning as a child

Has a younger sister, Ava (age 11)

Socially she was ok

Jemma described Aimee’s childhood as "rough" due to Jemma's D/V relationships; one partner was the perpetrator of Aimee's sexual assault and he is now incarcerated.

Primary school: Marion Heights till year 1, then Cambridge Park till Year 5 (positive schooling experience).

Moved to Plumptom for Year 6, then Riverstone for a month, then started at the Ponds High School in Year 7 and is still there.

Ava's father took on both girls as his own when they were together, however Aimee decided to stop contact with him a year ago.

Bullying started in Year 7; police were involved due to threats of bashing by girls at the school.

Bullying at school includes the girls telling her she asked for the sexual assault

Supports

Sees school counsellor

Safeguards - adolescent service in Blacktown, providing 6 weeks of support

Has a safety plan

Mother supporting Aimee to get supports in place

Not engaging well at school; to start TAFE next month; wants to do childcare (Jemma's profession also)

Jemma works full time and is a single parent with a new partner, not living together.

Aimee has one close friend from primary school, who lives in Jordan Springs; they connect daily but see each other minimally.

Physical health

No physical health problems

Menses started at 10yo; regular cycle; painful

Medication

None

AOD

Denies substance use

MSE

Appearance: Medium build female of Aboriginal descent; good attention to hygiene and grooming

Behaviour: very shy initially, however warmed considerably once rapport was established.

Affect: Restricted initially, but increasingly reactive with each session.

Mood: “I’m feeling a lot better.”

Thought form: Logical; sequential; no FTD

Content: as stated above

Cognition: not formally assessed.

Orientation: oriented to person place and time.

Insight: Good. Is aware of the impact of childhood trauma and attachment disruption

Judgement: Good.

Update

At the time of her review on the 8th of October, Aimee demonstrated significant improvement in mood and functioning. Her mother reported the following:

Significant improvement in school attendance - previously frequently absent due to not feeling well, now only missing 2-3 days recently

Behavioural improvements noted including increased relaxation, more laughter at home, coming out of room to eat dinner with family, and increased communication about school

Has begun exploring career interests in childcare, similar to mother's profession

Visited mother's workplace and engaged with children for several hours

Exploring TAFE options and potential traineeship arrangement

School therapist reports Aimee is no longer a concern and is "on the right path"

Aimee agreed with the improvements outlined by her mother. On further reflection, she was able to see that the psychodynamic work had increased awareness about how adverse childhood events and disrupted attachment had created patterns and behaviours, leading to insight and capacity to change; how early life experiences influence current responses to situations; how awareness building can help to recognise when responding from trauma patterns rather than current reality. Aimee recognises that she is managing better in school social situations more effectively by focusing on trusted friendships. She has

In summary, Aimee’s final session of the current treatment plan demonstrated significant progress across multiple domains. Aimee has shown marked improvement in school attendance, family relationships, and emotional regulation. Through therapeutic work focusing on trauma-informed pattern recognition, she has developed awareness of how early life experiences influence current responses, particularly in challenging situations. Aimee is now able to step outside automatic protective responses and assess situations more accurately. Family dynamics have improved considerably with increased communication and engagement. Aimee is exploring career interests and potential training opportunities while maintaining school attendance. Early warning signs of pattern recurrence were discussed, with plans for potential future sessions if needed.

SDQ 09.10.25

Stress: 4

Emotion: 0

Behaviour: 0

Hyperactivity: 1

Difficulty socials: 3

Helpful: 9

Total difficulties: 0

Formulation

Fourteen-year-old female of Aboriginal descent, presenting with depression, DSH and possible eating disorder in background of complex psychosocial stressors, including sexual assault. Responded very well to psychotherapeutic engagement and currently stable.

Impression

Disrupted attachment as a baby

Complex psychosocial stressors

Excellent capacity for psychotherapy, with quick uptake of insight for positive impact.

Plan

At the time of her review, neither Aimee or her mother considered a need for further sessions at this time, hence, her referral has been closed.

Should Aimee require additional support at another time, I would be happy to see her.

She continues to see the school counsellor and a summary of the psychotherapeutic work has been emailed to Aimee for future reference and sharing as needed.

Yours sincerely,

Michelle Hookham