BR presented as a 22-year-old single, university student and an endurance runner. She had competed successfully at middle and long distance events since the age of 14. Since transitioning to university, B had increased her training load considerably with the hope of competing at national level and eventual selection for international competition. However, over the past year she had suffered two stress fractures that had not been given appropriate time to heal. Initially, she had presented to her primary health care physician (GP) several times including for ongoing pain management which she was attempting to treat herself by way of over-the-counter medications. During one of these GP consultations, she revealed how stressed and anxious she was and the effect this had on her athletic performance. She was then referred to a sports psychiatrist, based on the perceived longevity of untreated mental health symptoms and her wish to return to competitive sport as soon as possible. The report from this consultation and assessment is below.