Tom: C major
Verse 1
Cm
Bb
Many thanks for referring mark.
C
F
C
He attended with his wife and
F
C
F
C
I saw him with my colleague
Murphy today
Bb
F
C
F
C
F
March 27th 2018 as you know
C
Bb
Dm
F
C
F
C
F
He has a serious an d significant history of childhood abuse and has
C
F
C
F
Bb
C
had extended periods of treatment in secondary care mental health
services in the past
This has included a range of psychological interventions
F
C
F
including a period of long -term and individual
C
Cm
F
psychotherapy.
Bb
F
C
As you see he was discharged from services but
F
C
F
Bb
Dm
feel that he needs additional support
Bb
C
F
at this point.
C
F
It seems that one trigger may be renewed interest
C
Eb
Bb
C
from the police following other evidence given
by a witness.
Dm
C
He is also experiencing abusive phone calls
F
C
from his father which he tries to avoid but
F
C
F
finds disturbing.
Bb
C
F
He is specifically looking for a time limited psy
C
F
C
Dm
chological intervention to help him address
C
F
the symptoms that he has now.
C
F
C
Bb
He recognizes that support with no clear en
C
d date would not be in his best interest.
Dm
Bb
C
Our intention is to ask our psychology colleagues
F
C
to review the case and consider whether to
F
C
F
Bb
offer further assessment.
C
F
C
F
C
He is aware that his past diagnoses have in
F
C
Dm
C
cluded emotionally unstable personality disorder,
F
C
Bb
Dm
Bb
C
He was previously assessed by the post -traumatic
F
C
stress disorder clinic in 2006 and offered
Dm
C
F
treatment but did not
take it up at that point.
C
F
C
He said he may be interested
Dm
Bb
C
in working with you and
DR now.
F
C
Having been off antidepressants for
Dm
C
some time he recently restarted
F
C
Sertraline and has been
F
Eb
Bb
on this in the past.
C
He says it has never really
helped him.
Sertraline can be used for
Dm
F
C
F
PTS D and you may want to try
C
F
C
a hydrate that the dose to see
if it is elective.
Cm
Dm
Bb
C
However it is not you could
consider switching to
F
Mirtazapine.
C
Eb
Bb
He says he has not tried this
F
C
Murtazapine does get used for
F
C
Bb
Dm
Bb
C
PTSD and can help with sleep.
He does report sleep difficulties
Cm
so is interested in this.
Bb
C
He did not report any signific
F
ant physical health problems.
Bb
He said that whilst he has used alcohol significantly
in the past that he had not been drinking
for the past two months.
The breathalyzer did not show
any signs of alcohol today.
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