This is a treatment path overview for public health nursing and primary care providers to address symptoms of PTSD in health care settings.

1. The Path to Healing Trauma
STEP 1 - Assess for Symptoms of PTSD
☐ Use the PC-PTSD – PC-PTSD is a well normed and validated measure of PTSD.
If there are three or more symptoms identified the patient is highly likely to have
PTSD. If there are two or more present there is a possibility of PTSD.
☐ DREAMS Questions – Use the dreams questionnaire to assess further symptoms
if unclear about presence of PTSD or to give a more full picture of treatment
needs to patient and treatment team.
STEP 2 - Provide Education About PTSD
Provide Information About PTSD – Often people feel out of control, scared and like
they can not even trust their experience. Information can change the trajectory of a
patient’s life. Since PTSD relates with many other health conditions supporting this
process can be a vital move towards health.
Normalize Symptoms of PTSD – Trauma is a normal reaction to an abnormal life event.
We can let our patient’s know that the feelings, thoughts and bodily reactions are normal
for individuals who had been a life threatening event. When people know the symptoms
are normal they can begin to accept them and fight them less. This allows for their innate
capacity for health to be re-established.
Join with Patient – Joining is the process of entering into another’s world. We don’t need
to fix. We can walk with our patients to health. If people feel heard, understood and safe
with you it maybe the first time they have had that experience in years. This type of
connection allows people to enter treatment.
STEP 3 - Review Treatment Options PTSD Treatment Requires a Team
☐ PTSD Skills Groups – Help individuals develop the skills validated
scientifically to heal the trauma.
☐ Healing Through Arts – Healing PTSD can be found through connecting self-
expression to inner vitality. Using art as a tool for self-exploration and
transformation can help patients move from overwhelm to capacity.
☐
Brief Behavioral Health Interventions – A short-term skills based individual
treatment that supports individuals to develop skills, understand PTSD and
increase healthy coping based on evidenced based and validated treatment
protocols.

2. ☐ Cognitive Behavioral Therapy (CBT) – Is an evidenced based treatment for
PTSD that supports individuals in a collaborative manor to reconnect to their
strength, resilience and vitality.
☐ EMDR – One of the gold standards in PTSD treatment. This protocol works with
an individuals innate health to reduce triggers, stress reaction, have increased
relaxation, peace and comfort in their life.
☐ Public Health Nursing – Connect with patient. Build a supportive relationship
that allows patient to connect with care. Offer appropriate referral. Coordinate
care with multiple members of treatment team. Support patient to develop
treatment team.
☐ Social Work Services – Many individuals with PTSD also have brain injury and
PTSD alone can make it overwhelming to follow up on appointments, fill out
forms and people can feel and act out of control. Social Workers can support
patients to maintain their treatment protocol, manage the stress reaction to
treatment and deal with traumatic triggers when they are impacting treatment
relationships.
☐ Medications PCP – Primary Care Providers can offer many treatments that can
help. However current research indicates that these treatments are a part but not
sufficient to treat PTSD. See article on treatment of PTSD in primary care.
Patients can bring article to their provider.
☐ Medications Psychiatry – Psychiatrist can provide medications that support
reduction of symptoms. Some targets of treatment are mood stability, anxiety
reduction (careful about benzodiazipines), improved sleep, and nightmare
reduction. See article on treatment of PTSD in primary care.
STEP 4 - Offer Brief Skills and Support
☐ Offer coping skills ☐ Support increased self-care
☐ Use Self-Care Check List ☐ Support patient to increase resilience
☐ Re-Connect to Religion ☐ Achievement/Self-regard – Small Steps
☐ Re-Connect to Spirituality ☐ Move from out of control to in control
☐ Thought Skills strategies ☐ Make safe coping plan (three skills to use)
☐ Increased positive emotions ☐ Increased social support
☐ Emotional regulation ☐ Connect to supportive family members
☐ Dogs, Cats, Animals ☐ Exercise
☐ Eating regularly ☐ Recognizing stress and use relaxation skills