Integrated Care For The Traumatized

Integrated Care for the Traumatized puts forth a model for the future of behavioral health focused on health care integration and the importance of the Whole Person Approach (WPA) in guiding the integration.

This comprehensive reflective resource explores the values, principles and practical applications of trauma-informed and -infused health care. Trauma-Informed Health Care introduces the different types of trauma - including medical and health trauma - and the impact of adversities, social inequalities and stressors. It explores their effects on health and the body, and on people's relationships with health providers. Key issues addressed include the importance of cultural humility, the effects of secondary and vicarious trauma, burnout and moral injury. It also covers the critical issue of organizational trauma: how to avoid practice which has potential to traumatize or retraumatize, and the role of cultural understanding, language, leadership, staff wellbeing and the physical environment. Drawing substantially on the experiences of people who use services and active practitioners, this book spans diverse settings -- from doctor's surgeries to hospitals and allied health services. It reveals how "every interaction can be an intervention" and provides you with practical examples, graphics and reflective exercises to support you to bring about positive change.

This handbook is a comprehensive, authoritative and up-to-date source on prevention technologies specifically for integrated care settings. It covers general issues related to prevention including the practical issues of financing, and staffing, and a general introduction to the advantages of prevention efforts. It covers a range of behavioral health disorders using an approach that is most relevant to the practitioner: it provides basic definitions, and describes the specific roles of both the primary care provider (PCP) and the behavioral care provider (BCP) as well as specific resources presented in a stepped care model. Stepped care has been used sucessfully in medical settings. Adapted to behavioral health settings, It allows the clinician and the patient to choose treatments that are tailored to specific levels of intensity. This handbook is an interdisciplinary resource useful for classes in integrated care as well as for clinicians employed in in these settings.

Advances in trauma care have accelerated over the past decade, spurred by the significant burden of injury from the wars in Afghanistan and Iraq. Between 2005 and 2013, the case fatality rate for United States service members injured in Afghanistan decreased by nearly 50 percent, despite an increase in the severity of injury among U.S. troops during the same period of time. But as the war in Afghanistan ends, knowledge and advances in trauma care developed by the Department of Defense (DoD) over the past decade from experiences in Afghanistan and Iraq may be lost. This would have implications for the quality of trauma care both within the DoD and in the civilian setting, where adoption of military advances in trauma care has become increasingly common and necessary to improve the response to multiple civilian casualty events. Intentional steps to codify and harvest the lessons learned within the military's trauma system are needed to ensure a ready military medical force for future combat and to prevent death from survivable injuries in both military and civilian systems. This will require partnership across military and civilian sectors and a sustained commitment from trauma system leaders at all levels to assure that the necessary knowledge and tools are not lost. A National Trauma Care System defines the components of a learning health system necessary to enable continued improvement in trauma care in both the civilian and the military sectors. This report provides recommendations to ensure that lessons learned over the past decade from the military's experiences in Afghanistan and Iraq are sustained and built upon for future combat operations and translated into the U.S. civilian system.

Interpersonal trauma is ubiquitous and its impact on health has long been understood. Recently, however, the critical importance of this issue has been magnified in the public eye. A burgeoning literature has demonstrated the impact of traumatic experiences on mental and physical health, and many potential interventions have been proposed. This volume serves as a detailed, practical guide to trauma-informed care. Chapters provide guidance to both healthcare providers and organizations on strategies for adopting, implementing and sustaining principles of trauma-informed care. The first section maps out the scope of the problem and defines specific types of interpersonal trauma. The authors then turn to discussion of adaptations to care for special populations, including sexual and gender minority persons, immigrants, male survivors and Veterans as these groups often require more nuanced approaches. Caring for trauma-exposed patients can place a strain on clinicians, and approaches for fostering resilience and promoting wellness among staff are presented next. Finally, the book covers concrete trauma-informed clinical strategies in adult and pediatric primary care, and women’s health/maternity care settings. Using a case-based approach, the expert authors provide real-world front line examples of the impact trauma-informed clinical approaches have on patients’ quality of life, sense of comfort, and trust. Case examples are discussed along with evidence based approaches that demonstrate improved health outcomes. Written by experts in the field, Trauma-Informed Healthcare Approaches is the definitive resource for improving quality care for patients who have experienced trauma.

This timely volume provides the practitioner with evidence based treatments for many of the clinical problems encountered in integrated care. It applies the core concepts of stepped care to integrating brief mental health interventions as a way to address ongoing problems in the modern healthcare landscape. It sets out in depth the state of the healthcare crisis in terms of costs, staffing and training issues, integration logistics and management, system culture, and a variety of clinical considerations. Central to the book is a best-practice template for providing behavioral stepped care in medical settings, including screening and assessment, levels of intervention and treatment, referrals, and collaboration with primary care and other specialties. Using this format, contributors detail specific challenges of and science-based interventions for a diverse range of common conditions and issues, including: Depression. Anxiety disorders. Adherence to chronic obstructive pulmonary disorder management. Alcohol and other substance misuse. Attention deficit hyperactivity disorder. Chronic pain. Neurocognitive disorders. Paraphilias: problematic sexual interests.[WU3] Sexual abuse and PTSD in children. A solid roadmap for widescale reform, Principle-Based Stepped Care and Brief Psychotherapy for Integrated Care Settings is deeply informative reading for health psychologists, social workers, psychiatrists, and clinical psychologists. It also clarifies the research agenda for those seeking improvements in healthcare quality and delivery and patient satisfaction.

Grounded in research and accumulated clinical wisdom, this book describes a range of ways to integrate mindfulness and other contemplative practices into clinical work with trauma survivors. The volume showcases treatment approaches that can be tailored to this population's needs, such as mindfulness-based stress reduction (MBSR), acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), mindfulness-based cognitive therapy (MBCT), and mindful self-compassion (MSC), among others. Featuring vivid case material, the book explores which elements of contemplative traditions support recovery and how to apply them safely. Neurobiological foundations of mindfulness-oriented work are examined. Treatment applications are illustrated for specific trauma populations, such as clients with chronic pain, military veterans, and children and adolescents.

Presenting an integrative model for treating traumatized children, this book combines play, art, and other expressive therapies with ideas and strategies drawn from cognitive-behavioral and family therapy. Eliana Gil demonstrates how to tailor treatment to the needs of each child by using both directive and nondirective approaches. Throughout, practical clinical examples illustrate ways to target trauma-related symptomatology while also helping children process painful feelings and memories that are difficult to verbalize. The book concludes with four in-depth cases that bring to life the unique situation of each child and family, the decision-making process of the therapist, and the applications of developmentally informed, creative, and flexible interventions.