Cаse Vignette: “Mаrissа”Marissa is a 29-year-оld wоman referred tо an outpatient behavioral health clinic by her primary care provider after presenting with increased anxiety, sleep disturbance, and difficulty concentrating over the last three weeks. During the intake, Marissa states, “I feel like I haven’t been myself since everything happened.”Marissa works full time as an office manager for a regional construction company and lives with her partner of four years. She describes herself as previously dependable, social, and highly engaged in both work and family activities. Over the past several weeks, however, Marissa reports significant changes in mood, daily functioning, and alcohol consumption.Approximately 18 days ago, Marissa was involved in a serious motor vehicle accident while driving home from work. She reports being hit on the driver’s side by another vehicle that ran a red light. Marissa recalls hearing “metal crushing” and being unable to open her car door immediately after the collision. Emergency responders arrived on scene, and Marissa was transported to the hospital for evaluation of minor injuries, including bruising and a shoulder strain. No loss of consciousness or major physical injuries were reported.Although medically cleared the same day, Marissa states she has felt “constantly on edge” since the accident. She reports difficulty falling asleep and describes frequent nighttime waking after vivid dreams involving the accident or similar crash scenarios. On several occasions, she has awakened sweating and disoriented.Marissa reports that during the day, unexpected sounds such as screeching tires, honking, or sirens cause her to become startled and physically tense. She notes increased irritability with coworkers and her partner, stating, “I snap at people over little things now.”Marissa has not driven since the accident and has been relying on rides from her partner or coworkers. She reports feeling intense anxiety when approaching intersections or riding in vehicles, often scanning the road and gripping the seat.In addition, Marissa describes moments where images of the accident “pop into my head out of nowhere,” especially while trying to focus at work. During these moments, she reports feeling briefly disconnected from her surroundings and states, “It almost feels like I’m back there for a second.”Marissa notes increased difficulty concentrating on routine tasks, resulting in several work mistakes over the past two weeks. Her supervisor recently commented that she seems distracted and less engaged.When asked how she has been managing these symptoms, Marissa reports drinking alcohol more frequently in the evenings. Prior to the accident, she describes consuming alcohol socially “maybe once or twice a week.” Since the accident, she reports drinking 3–4 glasses of wine most nights, stating that alcohol helps her “shut my brain off enough to sleep.”Marissa acknowledges concern about this change, stating, “I know this isn’t a great solution, but it’s the only thing that helps me relax.”Marissa denies any prior psychiatric diagnoses or treatment history. She denies prior problematic alcohol use, legal issues related to substances, or history of trauma exposure. She denies suicidal ideation, homicidal ideation, hallucinations, or delusional thinking.During the clinical interview, Marissa is alert and oriented x4. She appears fatigued and somewhat guarded but cooperative. Speech is normal in rate and tone. Mood is described as “anxious and exhausted.” Affect is constricted but congruent with discussion topics. Thought process is logical and goal-directed.Marissa states her primary reason for seeking help is: “I need to get back to normal because this is affecting every part of my life.”
Which оf the fоllоwing would be аppropriаte for аn officer who has been flagged by an early intervention system for citizen complaints about racist attitudes?