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Adam is a 32 year old builder who presents to the GP with a 4 month history of nightmares about a violent burglary in his home earlier in the year. His family are all safe and his wife has insisted he presents given he continues to be angry about what happened and refuses to mention it entirely. He has become increasingly absorbed in his work and Adam admits his marriage is in difficulty. Adam is very reluctant to be referred to a specialist or for ‘talking treatment’.

Based on the most likely diagnosis, what is the most appropriate initial step in management?

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