her job, but has been having some interpersonal issues with her co-workers recently. She has been promoted to the position of lead medical assistant, and supervises four other medical assistants in the office. She has noted that she feels more overwhelmed in her work, more often feeling irritable and short with her coworkers. She feels that she must go behind the other workers to check they have done their work, although this has not been a significant issue. Recently she had an argument with a co-worker over a small matter she reports would not have caused her significant concern in the past. She is not in any trouble with her supervisor at work, but wants to seek treatment before any such problem occurs.
             Review of Mariah's family of origin brings on some significant issues. She was the youngest of 4 children, born to an alcoholic father and a co-dependent mother. Her mother and father frequently had loud verbal arguments, and once Mariah stepped between her mother and father to try to stop them from fighting. She was slapped by her father across the face accidentally on that occasion. She was sexually abused by an uncle from age 6 to age 10. This abuse consisted mostly of fondling but Mariah does not remember much it, and believes she may have blocked it out. She has never spoken about this in depth to her husband or anyone else. She reports "I just want to put it behind me." She never told her mother about the abuse, primarily because she felt her mother was overwhelmed with the care and management of her alcoholic father. Mariah describes herself primarily as a "caretaker". She feels this is what brought her in to the medical field in the first place. She had planned to go to nursing school but does not see that as a reasonable option in the near future due to the care her children require. She does report that she sometimes has flashbacks to the episodes of abuse, especially when she w...