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Case Study


Susan Sibma

Young Adult Female Depressed, stressed, anxious, constant sense of guilt.

Introduction to Client

In earlier therapy, 20-year-old female was referred by her mother for help with her low mood and extended periods of crying. She was a university student with two older brothers, who had completed their studies. While her parents were financially very supportive, she felt obligated to follow their career suggestions for her. She returned to therapy after a 12-month break, having had help with her ability to speak up on her own behalf in the family household. Initially, her mother was present during the sessions by after a few weeks the client attended by herself and made her own appointments. Therapy at this stage was CBT and Schema Therapy. Her mood improved and she felt confident enough to discontinue treatment.

The Presenting Problem

Client self-referred for further help when low mood returned. Client wanted to stop crying whenever her father appeared to be disappointed in her, to alleviate her constant “not feeling good enough”, and always, always, feeling guilty. Since her last therapy, the client had commenced volunteer work with at risk children in remote communities. Client had heard about TRTP and wondered whether this process could help her.


DASS prior to session 1 placed client in moderate range on all dimensions of depression, anxiety and stress. She had hormonal imbalance being ruled out by Gynaecologist. This report was provided for my perusal by the specialist who diagnosed mild anxiety and depression. Client stated that she was horrified by the stories of abuse to children and could not forget the injuries sustained by one little girl. I suspected that the client under-reported her symptoms.


The only intervention was The Richards Trauma Process (TRTP). This was provided over four sessions. The first three were a week apart and the final session was two weeks later. Prior to the first face-to-face session, the client completed the homework exercise, outlining the most stressful events in her life, and a list of desired outcomes.

The client’s homework revealed a repeated pattern of authoritarian, dominating parenting by father, lack of support by her peacemaking mother, and her brothers “disappearing” when she was in trouble. “Being in trouble“could be just scraping a chair on the floor or dropping something. During session 1, client was provided with some psycho education, suggested readings, and validation of feelings. During sessions 2 to 4, hypnosis as per classic TRTP.

Outcomes of Treatment

After session 1, the client reported feeling more confident and was able to hold her own at home. By the completion of the process, she had changed her University, University Course, and had a clear plan on what she wanted to achieve in the longer term. She viewed her volunteer work experiences as being the impetus for her future career choice. She also felt an equal at home and noticed that her family treated her with more respect.

At completion of treatment the DASS showed normal on all dimensions. Client rang after three months to say she was thriving and had never felt better. She referred a friend for TRTP.


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