Amara is a 27-year-old woman who is a trained Accountant. She was involved in a road traffic accident in which her car collided with another vehicle on a busy dual carriageway. Amara was absent from work for several weeks, having been hospitalised for a number of weeks due to multiple physical injuries, including various fractures. When she attempted to return to work, this was unsuccessful.

Amara could not concentrate and was easily distractible, she was snappy with colleagues and was suffering from frequent panic attacks. Since that time, she was placed on sick leave, was unable to return to work and eventually, her contract of employment was terminated. The Court is concerned with understanding the nature and extent of Amara’s psychological injuries, how much they are attributable to the road traffic accident, whether there is evidence of a brain injury, the prognosis for recovery and treatment options.

The assessment process involved reviewing the Court documents and Amara’s GP and hospital records. Amara was interviewed and a full history was taken, including any pre-existing mental health problems, an account of the accident and an analysis of the difficulties she had experienced since that time. Amara was also administered psychometric tests, comprising neuropsychological, mental health and personality measures.

The findings of the assessment were that Amara had one short episode of mild anxiety in the past following the breakup of a long term relationship. This was considered as a pre-existing vulnerability that only had a small bearing upon Amara’s psychological response to the road traffic accident, given that otherwise her previous psychological functioning was assessed as having been healthy. Amara’s account and the psychometric assessment suggested that she was likely to be suffering from Post Traumatic Stress Disorder with high levels of avoidance of reminders and also frequent intrusive memories of the moments when she awoke in the ambulance and felt overwhelming physical pain. There was also evidence of some mild to moderate impairment in her central executive functioning, which was likely underpinning the difficulties in her concentration at work. Amara’s irritability was considered to be a traumatic response but also complicated by the changes in her cognitive functioning, which were both frustrating and a reminder of the trauma.

It was considered that whilst some further spontaneous neuropsychological recovery was possible, Amara’s recovery in this area was likely to have plateaued. Recommendations were made for Amara to receive some neurorehabilitation to help her learn ways to adapt her work in order to accommodate some of these limitations. Recommendations were also made for psychological treatment of the PTSD, which was considered treatable. With some adaptations to her working environment and routine, plus the neurorehabilitation and psychological treatment, Amara was offered a reasonably good prognosis.