Art of Awareness,Inc.

813 Broadway South Portland, Maine 04106 Phone: 207-799-1331 Fax: 207-799-1350 April 17, 2009 To Whom It May Concern: Please advise that as of 4/9109, Lori Handrahan successfully completed a DBT informed assessment and treatment recommendations with Ida O'Donnell, LCSW and Leslie Connolly, LCSW. Lori engaged in seven sessions of individual DBT informed therapy at Art of Awareness between 2/16/09 and 4/9109. She demonstrated good willingness and was well engaged in this course of treatment, which was recommended by her daughter's GAL. Lori was able to focus on specific behavior change related to self-care and monitor her wellness needs and her ability to address these needs. Lori discovered the many barriers to her wellness during her course of treatment. Such barriers included living a substantial distance to her support network which is located in Washington, DC. Due to her isolation from friends and colleagues, Lori has struggled to seek significant interpersonal connection, which has caused her emotional distress. Additionally, Lori reports that she has been living in a hostile environment due to incessant emailingandharassingbyherex-husband.Igor.This behavior by her exhusband appears to have resulted in Lori's emotional distress and has had a detrimental impact on her wellbeing, functioning and occupational performance. Lori is especially concerned that she may be at risk for losing her current job due to a court order mandating that she reside in the State of Maine, therefore sacrificing her ability to financially provide for her daughter, Mila. Relocation is required by Lori's employer. Losing her job would likely be harmful to Lori's sense of self and identity, which could further compromise her wellbeing. DBT informed treatment is not necessary at this time for Lori. DBT is indicated for individuals who demonstrate problematic behaviors due to emotional dysregulation. Due to the fact that Lori has not struggled with emotion regulation, it is recommended that she continue individual therapy with her current therapist Allie Knowlton, LCSW for further trauma treatment and emotional support. Trauma treatment will be possible when Lori feels safe. Furthermore, Lori will likely benefit most and experience relief when she is able to connect regularly with her natural support system in Washington, DC.

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ART OF AWARENESS, INC. INITIAL ASSESSMENT Date: 2/16/09 Client: Lori Handrahan Address: 28 Franklin Terrace South Portland, ME 04106 Phone: 207-211-7706 DOB: 5-30-1969 IDENTIFYING INFORMATION: Age: 39 Gender: female Employment/Means of Support:

Relationship Status: divorced

Care International

Misc. (sexual orientation,

cultural identity, religion, education, military status/history)

Client is a Caucasian woman, recently divorced and is the mother of a 2 year old daughter. She has PhD in Sociology. Her work has given her the opportunity to travel widely around the world. MENTAL STATUS: Client presented oriented to person, place, and time. She denied any suicidal or homicidal ideation. There was no evidence of psychotic processes. She was well groomed, very articulate, cooperative, and appeared quite intelligent. PRESENTINGPROBLEM: Client was referred for Dialectical Behavior Therapy (DBT) by District Court. The court is overseeing parental custody arrangements for her child. Client did not identify or present with any issues or behaviors that would typically be addressed in DBT. She described having good coping skills and a good support network in the Washington DC area. However, she does not want to be in contempt of court and she is open to strengthening and fine tuning her coping skills is needed. HISTORYOF THE PROBLEM: Client reports that she met her now ex-husband while living and working overseas. They eventually moved to the USA, married and had a daughter. Client reports that her husband has a history of having "rage attacks" and has been violent toward her. She eventually separated from him, then filed and received a protection from abuse order that lasted for 8 months. They are now divorced and have recently been given shared custody. Client is concerned that her daughter may not be safe when with her ex-husband. She also is at risk of losing her job if she doesn't relocated to Washington DC. However, she does not want to be in contempt of the court order so she plans to engage in DBT therapy and will stay in Maine, unless she can convince the court to allow her to move.

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ART OF AWARENESS, INC. INITIAL ASSESSMENT Page 2 BIOPSYCHOSOCIAl STRESSORS:Client reports that the stressors in her life are related to feeling unsafe around her ex-husband. She doesn't feel that her daughter is safe while in her ex-husband's care. And she is concerned that she may lose her job, if she doesn't relocate. FAMILY & SIGNIFICANT DEVelOPMENTAL HISTORY: Client reports that her biological father was very physically and emotionally abusive to her, her sister and her mother. Her parents divorced when she was a child and her mother eventually remarried. Client has no contact with her biological father and very limited contact with her mother and step-father. She has contact with her 35 year old sister. Client was married and divorced to another man before this most recent divorce. She reports that her first marriage ended because she wanted to have children and he didn't. She states that they are still friends. Client denies any symptoms of Post Traumatic Stress Disorder related to her relationship with her father or her ex-husband, such as nightmares, intrusive memories or images, and hypervigilance. Client denies any history of substance abuse, eating disorders, depression, or anxiety. She did appear to be extremely worried about the immediate stressors in her life and admitted to needing to remind herself to eat, due to decreased appetite.

MEDICAL HISTORY &STATUS: (Including medications) Client reports no medical symptoms or conditions. Client is not on any medications. CLIENT '5 STRENGTHS: Client is very intelligent, articulate and cooperative. She reports using meditation and time with her friends to manage stress. She enjoys her work and benefits from working out of her home in order to spend more time with her daughter.

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CLINICAL FORMULATION: Client is under much stress related to sharing custody of her daughter with her ex-husband and pressure from her employer to relocate. She seems to have a history of healthy coping skills and resources. Due to the fact that she doesn't trust or feel safe around her ex-husband, she presents a bit hyper-vigilant and extremely protective. This seems to be a appropriate response given her situation. The treatment she receives at Art of Awareness, Inc. will be a DBT informed skills training and Cognitive Behavior Therapy as a means to strengthen existing skills and teach her new skills as needed.

DIAGNOSIS: AXIS 1: V61.10 Partner Relational Problem Rule out Adjustment disorder AXIS 11: No Diagnosis AXIS 111: None reported AXIS 1V: Divorce, Custody Disputes AVIS V: GAF 75

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