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

2. Case Management for Trauma

3. Understanding Provider Role in Treating Tommy
From a Case Manager Perspective:
Compliance is key. Maintaining appointments with Veterans Treatment Court, Probation, Primary Care Team, and adhering to the medication regimen.
From a Counselor’s Perspective:
Forming the therapeutic alliance is paramount, understanding he feels isolated. He went from being in charge and having people conform to him, to having trouble adjusting to civilian life and not fitting in.
Allowing a safe space for him to process the trauma of his combat tours, identifying and modifying his unproductive beliefs and the behaviors that go with them.

4. Considerations when Interacting with Tommy
Combat Veteran, multiple tours over the last 10 years. Spent final year as a Drill Instructor
Showing signs of possible PTSD, Adjustment Disorder, Mood Disorder
Negligible Self-Care behaviors
Post-modernistic approaches might be key in shaping the early sessions. Reframing, externalizing, and awareness exercises could be useful.
Having him identify and re-position his different systems, from the military then to his family life

5. Our Treatment Plan Healthcare Domain: Behavioral Health
Provider: Case Manager
Objective:
Decrease in symptoms as indicated by client report of:
(a) Depression
(b) Anxiety
(c) Possible Treatment non-compliance
(d) 
Goals:
a)  To experience less depression by learning ways to manage it
b) I want to lower my anxiety
c)  I want to learn about my medication and take it as prescribed
Interventions:
a)  I will engage in light physical activity, no less than 30 minutes daily, as evidenced through self report.
b)  I will learn how to improve my reaction to stress by practicing relaxation exercises daily. My therapist will assist during session in identifying which relaxation exercises to use and progress will be measured by daily log submitted each week.
 c) I will engage in education about my medication and its’ side effects. My therapist will train me on the use of a medication log and review it with me weekly.

6. Measuring Outcomes/Success
In the treatment plan, we discussed reviewing the weekly medication log and a daily journal of what stress management techniques were utilized and what their effectiveness was. Those can be reviewed at the beginning of each weekly session as a check-in for the last week.
Success could be something as big as no reported anxiety episodes throughout the week or simply not missing a medication for the week.

7. Communication Needed
Has veteran began eating/drinking within normal limits again?
Has veteran attended all scheduled medical/mental health provider appointments?
Has veteran been officially diagnosed with a MH disorder and a medication regimen established?
Is veteran actively engaged with Veterans Treatment Court?
How has veteran’s family visitations gone?