A 25-year-old female college student presents 18 days after being assaulted in a parking garage. She reports flashbacks of the attack, nightmares, avoidance of parking structures and being alone at night, hypervigilance, and an exaggerated startle response. She also describes a persistent inability to feel happiness and a sense of detachment from her own body during stressful moments. She has missed two weeks of classes and is unable to concentrate on coursework.