Dr.

Jennifer Lauren Rusli

Wales Medical Centre
277/279 Forest Rd.
Hurstville, NSW 2220
Fax: 02 9585 9013 September 23, 2019

Dear Dr. Rusli,

Patricia Miller DOB 17/03/1964

Thank you for providing Patricia Miller a Mental Health Care Plan to seek PSS sessions with me. Patricia
has completed one of six sessions on September 17th and has a follow up appointment with me on October
1st. Patricia saw my colleague, Julieanne Lowe, three times while I was on maternity leave and gave
permission for me to get an update from Julieanne on those sessions. During Patricia’s session on
September 17th she reported a decrease in depressive symptoms and denied recent suicidal ideation.
Patricia reported having recent episodes where she cried “uncontrollably at church”, which were due to
current financial and relationship stressors. She states her main target goal is to work on her resentment in
relationships and behaviour (yelling on phone, rumination) that follows. In the past Patricia has stated
loneliness is a contributing factor to her depression and has started to attend church, which seems to be
helping build connections.

Patricia will now be attending the full Radically Open Dialectical Behavioural Therapy (RO DBT)
program which includes a skills class, fortnightly individual sessions and phone coaching after hours. The
class will commence on October 14th. RO DBT is new to Australia and is a highly effective treatment for
disorders of overcontrol, such as maladaptive perfectionism, chronic anxiety and chronic depression. The
main target for RO DBT is loneliness and noticing social signalling deficits that inhibit social connection.
Patricia identifies as overcontrolled and reports family members also lean overcontrolled. In Patricia’s
case, RO DBT will teach her ruled behaviour for herself and others that leads to resentment and
loneliness. Patricia will work to understand emotional expression (smiling while tearing up), increase
flexibility in how she responds to others when they haven’t followed what she feels is correct and increase
compassion towards herself when she feels like she hasn’t preformed “correctly”. She has committed to
also continue psychiatry appointments for medication management.

If you have any questions or concerns, please do not hesitate to call at 0434221654 or email me at
rebeccaciattolcsw@gmail.com. I look forward to collaborating with you on Patricia’s case.

Kind Regards,

Rebecca Ciatto, DBT-LBC TM

Accredited Mental Health Social Worker

CC: Dr. Anna Farrar

Wesley Hospital Kogarah Consulting Rooms
20 English St.
Kogarah, NSW 2217
Fax: 02 9588 4138