Treating Trauma From an Integrated Approach A Collaborative Approach to Care June 1, 2019 * Tex-CHIP Training Series

Counseling for Trauma

Understanding Provider Role in Treating Client Who is my client? Mandatory? Who do I have informed consent for? Leadership relationship? FAP JAG/Veterans Court Will there be a referral for VA Mental Health? Why VA Primary Care facility? (Component?) Rapport/stabilization vs treatment Length of treatment Veterans Court? (victim must approve of program participation) 3G (aggravated assault?) in TX

Considerations when Interacting with Client Stabilization of medical Stabilization of RISK Atypical Legal is a risk factor for increased suicidality Tommy is active duty Additional issues will stem from incarceration DV Discharge Security clearance Financial MST/SA or Combat? Agitation symptom of PTSD. Not exusal Transitioning Issues

Our Treatment Plan (a) RISK (b) Medical (c) Agitation Healthcare Domain: Behavioral Health Provider: Counseling Provider Objective: Decrease in symptoms as indicated by client report of: (a) RISK (b) Medical (c) Agitation (d) Mood stabilization (e) Transition issues (f) Trauma   Goals:  Assess. Continue to assess. Reduce risk. “Battle buddy” or leadership involvement? b) Rule out medical issue. Increase basic care c.) Normalization of agitation d)  Decrease symptoms of depression and anxiety e) Develop plan for effective transition F.) Assess. Develop rapport/Trust. MI Interventions: assess for access to firearms (both personally and professionally). Utilize CAMs if necessary.  b) Create goals for hot meal (DFAC?), sleep hygiene and hydration. Medical monitoring. IOP? c) Peer to peer & Validation, leverage accountability, increase sense of personal control, psychoeducation, CBT (changing maladaptive thoughts from a destructive view to constructive) d) Discuss medication evaluation. Grounding. Increase healthy social activities. Resiliency/ Strengths focused e) Refer to TAPS. Work on strengths. Discuss identity and of perceived challenges. f.) Psychoeducation on EBP. Rational .

Measuring Outcomes/Success Risk? CAMS Decreased Anxiety/Depression. Mood stabilization. Basic needs increased. Medication evaluation. Sleep Decreased Agitation. Regulated self control? Peer to peer involvement Family Reintegration? Plan of action for transition? Plan of action to treat trauma. Better assessment for PTSD? Type? Moral Injury? EBP- When appropriate (timing)

Communication Needed from Other Providers All of them!!! Particularly AD cannot be silo’d