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

2. Counseling for Trauma

3. 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

4. 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

5. 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 .

6. 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)

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