Module C: Management of ASD/PTSD in Mental Health Specialty
Patient presenting to mental health with suspected PTSD (positive screen for trauma exposure and PTSD symptoms) [A]
Assess risk of harm to self or others. Seek collateral information about stressors, service member's function, medical history, and absence or impairment on operation or mission [B]
Meet DSM IV criteria for ASD/PTSD? [C] Stabilize and/or arrange treatment for: Medical condition, psychosocial deficits (housing etc), acute mental health symptoms PTSD with Comorbid Symptoms (addiction, SUD, phychosis, bipolar)
Treat non-PTSD disorder in appropriate setting Educate patient and family about PTSD and treatment options. Develop collaborative interdesciplinary treatment plan [K]
Initiate therapy for PTSD: Educate about medication, initiate pharmacotherapy to willing patients [see Pharmacotherapy], initiate one of the psychotherapy methods [see Psychotherapy], provide adjunctive psychosocial therapy as appropriate, provide support
Reassess PTSD symptoms, diagnotic status, functional status, quality of life; additional treatment needs; patient preferences [G]
Is patient improving? [H] Patient demonstrate full remission? [H] Discontinue treatment. Educate patient about indications for and route of access to additional treatment
Improved symptoms and functioning but requires maintenance treatment? [H]
Continue therapy at intensified dose/frequency, change to a different treatment modality, apply adjunctive therapies [H, I] Allow sufficient time for full response: Continue therapy, intensify dose/frequency, change treatment modality, apply adjunctive therapies, increase level of care Continue current course of treatment: Consider stepping down frequency/dose, transition from intensive psychotherapy to case management, transition from individual to group treatment modalities