Jam Lentejas, Ph.

D
Licensed Psychologist

THE WRITER
I am Ms. Lentejas . I am a Licensed Clinical Psychologist. My specialist field is psychological
trauma an area within which I have worked over the past seven years. Full details of my
qualifications entitling me to give expert opinion and evidence are available upon request.

INSTRUCTIONS
The case concerns a motor vehicle accident dated December 04, 2016 in which the claimant
allegedly suffered personal injury. I have been consulted by the family relatives through referral
of the hospital where the victim was confined. I have been provided with the claimants general
practice notes and records.

INVESTIGATION

INTERVIEW
DATE OF INJURY : December 4, 2016
INITIAL INTERVIEW : December 22, 2016
NAME OF PATIENT : JOHN DEFANTE
BIRTHDATE : December 14, 1989
CASE# : 123456
CASE : Personal Injury/Motor Vehicle accident

ON EXAMINATION
Mr. Defante presented entirely appropriately and gave a clear and consistent account of the
accident and its impact upon him. He was clearly distressed by his level of anxiety in relation to
the driving incident.

THE INCIDENT AND SUBSEQUENT DEVELOPMENTS

On December 04, 2016, Mr. Defante was on his way home from visiting our aunts house in
Greenfields Subdivision, Novaliches, Quezon City. He was sitting on the passenger side while
his brother was driving. They were traversing Mindanao Avenue, along the C-5 Road, Mindanao
Avenue, Quezon City.

While on the moving vehicle, he noticed that a Land Cruiser negotiated a Left-turn at a No Left-
turn spot. While they were on the opposite ascending road of the said area heading towards the
direction of Trinoma, on their proper lane on the left side of the road, the Land Cruiser driven by
swiftly descended the same lane from the opposite direction. His brother was surprised so he
blew the Wigos horn to signal the Land Cruisers driver that what he did was wrong since there
was, in fact, a clear and visible No Left-Turn sign on that part of the road. Then, since the
Land Cruiser was driving very fast at about 80-100 kph, and to avoid the impending impact, his
brother tried to swerve to the right, but the Land Cruiser, swerved on the same direction as them,
making the the collision imminent. The patient recalls waking up in the hospital bed with great
pain.
 Jam Lentejas, Ph.D
Licensed Psychologist
Mr. Defante has been able to avoid driving since the accident, had already been a passenger but
generally endures this situation with dread. He was usually calmer when riding cars in the past,
but after the incident, he became severely anxious especially when he see street corners and/or
U-turn signs along the road. He feels like grasping for air and is fidgety whenever he was about
to ride any vehicle.

As a result of his driving anxiety his social life has been considerably curtailed. Whereas he used
to drive to see friends and go to work, he now no longer does so. He generally prefers to remain
at home and whilst he will occasionally go out to if necessary, he will avoid doing so if at all
possible. He is exceedingly wary of other vehicles on the road, particularly those travelling in
front of him.

He is also very anxious as a passenger, reflecting that at times he will scream out, and on one
occasion even tried to get out of the car. He does not feel in control and feels that the driver
tends to go too fast for him.

Mr. Defante did describe dwelling on the accident and has spontaneous intrusive imagery of
such. He is reminded of the accident whilst travelling in a car and is always conscious of vehicles
travelling behind. The main psychological impact of the accident would appear to be his
shattered belief in his sense of safety whilst travelling in a car and that there is nothing he can do
to protect himself. This is in marked contrast to his former confidence driving, where he was able
to undertake long distances in the car and had even driven on his own to work or out of town.

PREVIOUS PERSONAL HISTORY

Mr. Defante was born in Quezon City where he grew up. He has 1 brother. He has good
memories of her childhood. He is close to his parents and maintains a close relationship with
them as well as with his family relatives.
He graduated at the age of 21 and became a Certified Public accountant at the age of 22. He is a
Certified Public accountant for 6 years now.

PREVIOUS MEDICAL HISTORY

Mr. Defante described his medical history noting that he had generally been fit and well. He did
not note any previous psychological problems and history of such in his family. Since the
accident, he has seen a counsellor, but did not find this of any help, reflecting that generally the
counsellor just let him talk about his feelings and thoughts associated with the accident.

DISCUSSION AND OPINION

Following a road traffic accident in December 04, 2016 Mr. Defante has suffered a marked
psychological reaction.

He would at any time have qualified for a diagnosis of Post Traumatic Stress Disorder. He
described significant symptoms of traumatization and Paranoia. The accident appeared to shatter
his belief that he could travel safely in a car and left his with a marked sense of vulnerability
 Jam Lentejas, Ph.D
Licensed Psychologist
which underlies his anxiety in relation to car travel.

Mr. Defante clearly suffers from a Specific Phobia in relation to driving/ car travel. Whilst he has
continued to drive and ride motor vehicles, he experiences great distress when he does so and
generally endures this situation with dread. The extent of her anxiety has had a marked impact
upon the quality of his life, as he, has to work from home and his social life and interests have
been restricted. Despite counselling there has been no improvement in the intensity of his
psychological reaction over time. He will need continuous inducement of anti-anxiety
medications to help him sleep and survive the night.

CONCLUSIONS

SUMMARY OF DIAGNOSIS
Mr. Defante is a candidate patient of Post Traumatic Stress Disorder and shall be in continuous
observation and counselling for at least a year.

Mr. Defante has suffered a Specific Phobia to driving/car travel of moderate intensity, which has
persisted without improvement over the past months.

CAUSATION
His symptoms of anxiety related to driving and car travel can be entirely attributed to the
accident in question

PROGNOSIS
There has been little improvement to date in Mr. Defantes symptomatology despite being
referred for counselling. However, this form of therapy is rarely appropriate in such anxiety
cases and can conversely make the situation worse. He requires cognitive behavioural therapy
and medication with appropriate intervention there should be good recovery for atleast 1 year
from the commencement of such.

TREATMENT REQUIRED
Mr. Defante currently requires cognitive behavioural therapy with a therapist such as a chartered
clinical psychologist or cognitive behavioural therapist. This should be sought and the cost of
therapy should be budgeted at between 5,000 per session. Some 12 sessions should suffice.
Continuous anti-anxiety medications are required for the duration of the treatment.