ABSTRACT
Marla is 17 years old. Her parents own a local tourist company, and the family trains horses for carriage rides. Marla helps train the horses after school and on the weekends. Her career goals include going to college, becoming a veterinarian’s assistant, and returning to help run the family business. Last year, she was training a new horse that became frightened and suddenly bolted, severely injuring Marla. In addition to ongoing physical sequelae (headaches, blackouts, and stuttering), she has a high level of general arousal, sleep disturbance, startle reactions whenever she sees a horse or enters the training area, and intrusive thoughts and nightmares regarding the accident. In addition, she has withdrawn socially and refuses to go back to training the horses.
