ACC267 Psychological services progress report

**ACC267** **Psychological Services Progress Report** This form is completed by the provider with details of the services provided to date and the functional objectives achieved **Provider Details** Provider Name: Dr Helena Macarthur Signature: Address (fax number/E mail): Tāmaki Psychology Clinic, Level 2, 188 Symonds Street, Auckland 1010; fax 09 309 6483; h.macarthur@tamakipsych.co.nz Date: 02/06/2026 **Claimant Details** Claimant's name: Liam Brennan Claim number: 10073258 Date of birth: 03/08/1990 Date of injury: 12/02/2026 **Case Manager Details** Case Manager Name: Aroha Te Rangi Branch: Auckland Central **Psychological Service Details** | Functional objectives achieved | Comments | |---|---| | 1. Reduction in post-traumatic anxiety symptoms, measured by PCL-5 score reduction | PCL-5 score reduced from 54 at session 1 to 38 at session 6, reflecting a clinically meaningful reduction in re-experiencing and avoidance items. Hyperarousal items remain elevated. | | 2. Resumption of independent travel to and from work | Liam has resumed independent bus travel five days per week for the past three weeks. The graduated exposure hierarchy reached completion at session 5. | | 3. Sleep continuity improvements | Sleep onset has improved from over 90 minutes to under 30 minutes on most nights. Continuity remains variable, with two to three night wakings per week. PSQI reduced from 16 to 11. | | 4. Re-engagement in at least one social activity per week | Liam has attended his Saturday futsal team for three consecutive weeks, with reported enjoyment and reduced anticipatory anxiety. | Specific outcome to be achieved from remaining sessions: Consolidation of trauma-focused cognitive restructuring with a focus on residual safety behaviours and shame-related cognitions identified during sessions 5 and 6. Continued reduction in PCL-5 to below the clinical threshold of 33, sustained reduction in hyperarousal items, and stable return to full pre-injury work hours and social engagement. Relapse prevention work to be completed in the final two sessions. | Functional objectives to be achieved | Date to be achieved | How objectives will be measured | |---|---|---| | 1. PCL-5 total score reduced to below 33 and sustained across two consecutive administrations | 14/08/2026 | PCL-5 re-administration at sessions 9 and 12 | | 2. Hyperarousal subscale items reduced by at least 40 percent from baseline | 14/08/2026 | PCL-5 cluster D items reviewed at sessions 9 and 12 | | 3. Return to full pre-injury work hours (40 hours per week) without trauma-related sick leave for at least four consecutive weeks | 28/08/2026 | Employer attendance record; self-report reviewed at sessions 10 and 12 | | 4. Sleep continuity of 6 hours or more per night on at least 5 of 7 nights per week | 14/08/2026 | Sleep diary; PSQI reduction to below 8 by session 12 | | 5. Identification and rehearsal of a personalised relapse prevention plan with three named warning signs and three named coping responses | 28/08/2026 | Written relapse prevention plan completed and reviewed in final session | Reasons for any amendments to intended psychological services: The original action plan allocated two sessions to in vivo bus travel exposure. This was completed in one session due to Liam's faster than anticipated progress on the graduated hierarchy. The remaining session has been reallocated to cognitive restructuring of shame-related cognitions that emerged during exposure work, which were not anticipated at the time of the action plan. No additional cost implications. Claimant Signature: Date: 02/06/2026 **Request for further sessions** (Case Manager approval required before commencing further sessions) Number of sessions required: 5 Date to be completed: 28/08/2026 Reason for more sessions: Liam has made strong progress over the initial 10 sessions but has not yet reached the clinical threshold for symptom remission on the PCL-5, with hyperarousal items remaining clinically elevated. Five additional sessions are requested to consolidate gains, address residual shame-related cognitions identified late in the initial block, complete the return-to-full-hours work transition with active workplace support, and develop and rehearse a personalised relapse prevention plan. Without these additional sessions there is a meaningful risk of partial relapse and incomplete return to pre-injury functioning, particularly around sustained full-time work attendance. | Functional objectives to be achieved | Date to be achieved | How objectives will be measured | |---|---|---| | 1. PCL-5 total score reduced to below 33, sustained across sessions 14 and 15 | 28/08/2026 | PCL-5 re-administration at sessions 13 and 15 | | 2. Sustained pre-injury work hours (40 hours per week) for four consecutive weeks at programme close | 28/08/2026 | Employer attendance record; self-report at session 15 | | 3. Completion and rehearsal of personalised relapse prevention plan | 28/08/2026 | Written plan reviewed in final session | Progress towards independence achieved to date: Liam has demonstrated significant progress towards independence over the initial 10 sessions. He has resumed independent travel to and from work without family support, has returned to 30 hours per week in his pre-injury role, has re-engaged in his Saturday social activity, and has independently scheduled and attended his most recent GP review. He reports increased confidence in his ability to apply learned skills outside of session, and his partner has reported observable improvements in his mood and engagement at home. Other comments: Liam's employer has been supportive throughout the programme and has confirmed in writing that the additional five sessions can be accommodated within his current modified hours arrangement, with a planned return to 40 hours per week in week three of the further block. Liam has expressed clear motivation to complete the relapse prevention work and views the additional sessions as the final piece before discharge. **Case Manager Approval** (required for further sessions) Case Manager Signature: Date: *The information collected on this form will only be used to fulfil the requirements of the Accident Compensation Act 2001. In the collection, use and storage of information, ACC will at all times comply with the obligations of the Privacy Act 1993 and the Health Information Privacy Code 1994.* **Items for Clinician Review** [ ] Provider Details, Address: confirm fax number 09 309 6483 against current clinic contact details; this number was stated verbally and the clinic may now use a different fax service. [ ] Psychological Service Details, PCL-5 baseline: PCL-5 baseline recorded as 54 from session 1; confirm against the original action plan baseline before submission, as the action plan referenced an assessment-phase score that may differ. [ ] Functional objectives to be achieved: target date 28/08/2026 for full return to 40 hours per week is contingent on employer's written confirmation; verify the latest employer correspondence is on file. [ ] Request for further sessions, Number of sessions: 5 sessions requested; confirm this is within the remaining purchase order allocation, or whether a new purchase order is required. [ ] Other comments: written employer confirmation referenced; confirm the email or letter is attached or on file with the case manager.