Workshop: Prevention &
Response to Mass Trauma &
Disaster
Francis R. Abueg, Ph.D.
TraumaResource
Clinical & Forensic Psychology
Sunnyvale, California
drfrancis@traumaresource.com
Overview of Presentation
• Trauma organization websites
• Provider education
• Patient education
• Thank you to Josef Ruzek, Ph.D. of the National
Center for PTSD and colleagues for presentation
content.
Some Challenges in Resource
Access





Explosion of resources
Challenge of centralizing resources
Challenge of simplifying resource location
Do resources affect practice?
Resource validation/accuracy
Accuracy of Information
 Bremner, Quinn, Quinn, and Veledar (2006)
 Review of 80 Internet websites
 42% of sites had inaccurate information
 82% did not provide a source of content
 41% did not use a mental-health professional in the
development of the content
 Websites providing information about traumatic stress
are often not useful, and can sometimes provide
inaccurate and potentially harmful information to
consumers
NCPTSD Website
www.ptsd.va.gov
• Resources to support
patients and public
• Resources to support
research and practice
▫
▫
▫
▫
▫
▫
▫
PILOTS database
Iraq War Clinician Guide
PTSD 101
Psychological First Aid Manual
CTU-Online
PTSD Research Quarterly
Videos
Trauma Organizations
• International Society for Traumatic Stress Studies (ISTSS)
▫ www.istss.org
• Center for the Study of Traumatic Stress
▫ http://www.centerforthestudyoftraumaticstress.org /index.php
▫ Includes resource listing, includes service members, families, and
children
• Defense Centers of Excellence for Psychological Health and
Traumatic Brain Injury
▫ http://www.dcoe.health.mil/
Trauma Organizations
• National Child Traumatic Stress Network
▫ http://www.nctsn.org/
▫ National Child Traumatic Stress Network is a
comprehensive resource for the public, consumers,
and professionals
• APA Division 56
▫ http://www.apatraumadivision.org/resources.php
▫ Doctoral and internship training resources
▫ Division 56 Research Wiki
• David Baldwin’s Trauma Pages
▫ http://www.trauma-pages.com/
Clinical Practice Guidelines
• International Society for Traumatic Stress Studies
▫ http://www.istss.org/Content/NavigationMenu/ISTSSTreatment
Guidelines/PTSDTreatmentGuidelines/default.htm
• National Institute for Clinical Excellence (UK)
▫ http://guidance.nice.org.uk/CG26/NICEGuidance/pdf/English
• VA-DOD
▫ https://www.qmo.amedd.army.mil/ptsd/CompleteGuideline.pdf
• Australian Center for Posttraumatic Mental Health
▫ http://www.acpmh.unimelb.edu.au/resources/resourceasdptsd_guidelines.html
PILOTS : Published International
Literature on Traumatic Stress
• 35,000 citations of articles
on traumatic stress
• Includes reports and
foreign-language materials
• Trauma-specific thesaurus
• CSA platform (like
PsycInfo)
• Links to online sources
• Articles by NCPTSD
authors provided as PDFs
CTU-Online: Clinician’s Trauma Update
• Summarizes clinically
relevant articles on treating
Veterans & military personnel
• Summaries presented in brief
format with links to the full
article
• Emailed every 2 months
• Subscribe at:
http://www.ptsd.va.gov/profes
sional/newsletters/ctuonline.asp
Assessment Tools Online
• PTSD Checklist-Civilian Version (PCL-C)
 http://www.pdhealth.mil/guidelines/appendix3.asp
• PTSD Checklist-Military Version (PCL-M)
 http://www.pdhealth.mil/guidelines/appendix3.asp
• PTSD Checklist– Stressor Specific Version (PCL-S)
 http://www.pdhealth.mil/guidelines/appendix5.asp
• NCPTSD provides information about a variety of trauma-specific
and more general assessment tools
▫ http://www.ptsd.va.gov/professional/pages/assessments/assess
ment.asp
• ISTSS
▫ http://www.istss.org/AM/Template.cfm?Section=ResourcesforCl
inicians&Template=/CM/ContentDisplay.cfm&ContentID=1549
Online Courses for Providers: PTSD 101
▫
▫
Background and
Assessment

Assessment

What is PTSD?
Treatment

Cognitive-Behavioral
Interventions

Cross-Cultural
Considerations (CE)

Group Therapy (CE)

Increasing Effectiveness of
PTSD Treatments

Overcoming Barriers (CE)

Pharmacotherapy

Smoking Cessation

Substance Abuse

VA/DoD Clinical Practice
Guideline (CE)
PTSD 101 (Cont)
• Specific Trauma
▫ Combat Stress Injuries (CE)
▫ Military Sexual Trauma
▫ Traumatic Brain Injury
• Special Populations
▫ African-American Veterans (CE)
▫ Asian American & Pacific Islander Veterans (CE)
▫ Hispanic Veterans (CE)
▫ Military Culture
▫ Older Veterans (CE)
• General Healthcare
▫ Physical Health Effects (CE)
Center for Deployment Psychology
www.deploymentpsych.org
Health Care Toolbox
• Guidance for
pediatric health care
providers
• http://www.healthc
aretoolbox.org/
Medical University of South Carolina
TF-CBTWeb
• Free web-based training course for learning Trauma-Focused
Cognitive-Behavioral Therapy
• Developed and tested by Drs. Esther Deblinger, Judy Cohen, and
Anthony Mannarino
• Found in multiple research studies to be an effective treatment for
children with trauma-related problems and their families
• Provides 10 hours of CE training that teaches the procedures of TFCBT
• Includes streaming video demonstrations, clinical scripts, cultural
considerations, clinical challenges and many other learning
resources
http://tfcbt.musc.edu/
Cognitive Processing Therapy:
Evidence-Based PTSD Treatment for Adults
Coming Soon to NCPTSD
• Online training in Prolonged Exposure
treatment
• Online training in STAIR (Skills Training in
Affect and Interpersonal Regulation)
• Online training in CBT skills
▫ Goal-setting
▫ Motivation enhancement
▫ Behavioral task assignment (homework)
Afterdeployment.org
• ????
Provider Portal Content
• Overview of afterdeployment.org (tour)
• Using afterdeployment.org with your patients
• Continuing education for providers
▫ DoD and VA CEU courses
• Connecting with other providers
• Self-help for providers
▫ Burnout
Online CEUs
• International Society for Traumatic Stress Studies: Sessions from
the organization’s annual meeting, including master clinician
sessions
▫ http://www.istss.org/RecordedSessions/2297.htm
• The Center for Deployment Psychology has interactive online
courses designed for clinicians caring for military service members,
veterans and family members
▫ Working with Service Members and Veterans with PTSD
 http://www.essentiallearning.net/student/content/sections/le
ctora/VeteransPTSD/index.html
Online CEUs (Cont)
• Prolonged Exposure for the Treatment of PTSD
 http://www.essentiallearning.net/student/content/s
ections/lectora/ProlongedExposureTherapyVets/ind
ex.html
▫ Cognitive Processing Therapy for PTSD in Veterans
and Military Personnel
 http://www.essentiallearning.net/Student/content/
sections/Lectora/CognitiveProcessingTherapyforPT
SDinVeteransandMilitaryPersonnel/index.html
Online CEUs
• Learning Center of the National Child Traumatic Stress
Network: Online catalog developed for mental health
professionals, parents and caregivers, policymakers, and
others
▫ http://learn.nctsn.org/course/category.php?id=3
• The Anxiety Disorders Association of America provides a
free podcast on treatment of PTSD
▫ http://www.adaa.org/resourcesprofessionals/podcasts/treatment-ptsd
Information for Survivors/Patients:
Fact Sheets
• David Baldwin’s Trauma Information Pages
▫ http://www.trauma-pages.com/support.php
• National Child Traumatic Stress Network
• NIMH fact sheets
▫
▫
▫
▫
▫
▫
▫
▫
▫
▫
▫
What is PTSD?
Who gets PTSD?
What are the symptoms of PTSD?
Do children react differently than adults?
How is PTSD detected?
Why do some people get PTSD and others do not?
How is PTSD treated?
What efforts are under way to improve detection and treatment of PTSD?
How can you help a friend or relative with PTSD?
Where can one go for help?
http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorderptsd/complete-index.shtm
Fact Sheets
• NCPTSD
▫ Research on Women, Trauma, and PTSD
 http://www.ptsd.va.gov/professional/pages/women-trauma-ptsd.asp
▫ Sexual Trauma: Information for Women's Medical Providers
 http://www.ptsd.va.gov/professional/pages/ptsd-womens-providers.asp
▫ Effects of Disaster on People with Severe Mental Illness
 http://www.ptsd.va.gov/professional/pages/effects-disaster-mentalillness.asp
▫ PTSD in Children and Adolescents
 http://www.ptsd.va.gov/professional/pages/ptsd_in_children_and_adolescen
ts_overview_for_professionals.asp
▫ PTSD in Refugees
 http://www.ptsd.va.gov/professional/pages/ptsd-refugees.asp
▫ Trauma, PTSD, and Attachment in Infants and Young Children
 http://www.ptsd.va.gov/professional/pages/trauma_ptsd_attachment.asp
Fact Sheets: Disaster
• Centers for Disease Control: Issues related to emergency
preparedness and response
▫ http://www.bt.cdc.gov/masscasualties/copingpub.asp
▫ http://www.bt.cdc.gov/masscasualties/copingpro.asp
• American Psychiatric Association: Information about
disaster psychiatry
▫ http://www.psych.org/Resources/DisasterPsychiatry.
aspx
Disaster
• Psychological First Aid Manual (phone app
coming!)
▫ http://www.ptsd.va.gov/professional/manuals/psych-first-aid.asp
• Includes handouts for survivors…
▫
▫
▫
▫
▫
▫
▫
▫
▫
▫
Connecting with Others: Seeking Social Support
Connecting with Others: Giving Social Support’
When Terrible Things Happen
Tips for Helping Infants and Toddlers’
Tips for Helping Preschool-Age Children
Tips for Helping School-Age Children
Tips for Helping Adolescents
Tips for Adults
Basic Relaxation Techniques
Alcohol and Drug Use after Disasters
Self-Help Reading for Adults
• Courage after fire: Coping strategies for returning soldiers and their
families. (2005). K. Armstrong, S.Best, & P. Domenici. Ulysses Press.
• Down range: To Iraq and back. (2005). B. Cantrell & C. Dean. Washington:
WordSmith Books.
• I Can't Get Over It: a handbook for trauma survivors (1992). by Aphrodite
Matsakis, PhD. New Harbinger Publications.
• Back from the brink: A family guide to overcoming traumatic stress.
(1992). D. Catherall. Bantam Books.
• Trust after trauma: A guide to relationships for survivors and those who
love them. (1988). A. Matsakis. Oakland, CA: New Harbinger.
• Recovering after the war. (1990). P. Mason. New York: Penguin Books.
• Vietnam wives: Facing the challenges of life with veterans suffering from
post-traumatic stress disorder. (2nd ed.) (1998). A. Matsakis. Sidran Press.
Self-Help Reading for Teenagers
• Finding my way: A teen’s guide to living with a parent
who has experienced trauma. (2005). M. D. Sherman &
D.M. Sherman. Edina, MN: Beaver’s Pond Press.
• I’m not alone: A teen’s guide to living with a parent who
has a mental illness. (2006). M. D. Sherman & D.M.
Sherman. Edina, MN: Beaver’s Pond Press.
Online Patient Education:
www.ptsd.va.gov
• Fact sheets, handouts,
videos
• War-zone Guides
• Links to other relevant
websites
▫ MyHealtheVet
▫ afterdeployment.org
▫ Nationalresourcedirector
y.gov
Self-Guided Change Programs
• Common features
▫
▫
▫
▫
Multiple sessions/workshops
Multiple components
Stand alone components
Can also be used as an adjunct to face-to-face
therapy.
 Assign on-line homework assignments
 Track patient progress
 Clinician contact time
Self-Guided
Therapist check-in
Fully integrated
http://www.beatingtheblues.co.uk/
Considering Professional Help
• https://www.myhealth.va.gov/mhv-portalweb/anonymous.portal?_nfpb=true&_pageLabel=mentalHealth&_
nfls=false
• 30 minute interactive course consisting of:
▫ 5 Sections:
 Do I Need Help? (includes a brief self-assessment)
 What is Stopping Me?
 What Can I Expect
 Who Can Help Me?
 Where Can I Find Help?
▫ Videos of veterans who have had to overcome concerns and
challenges before seeking help
 Transcripts were made of real veterans and then presented by
actors with similar features
Considering Professional Help
Considering Professional Help
Realwarrriors.net
• The Real Warriors Campaign is an initiative launched by
the Defense Centers of Excellence for Psychological
Health and Traumatic Brain Injury (DCoE)
▫ Build resilience, facilitate recovery, support reintegration
▫ Decrease stigma to seeking psychological care through




Media outreach
Print materials
Interactive web site
Social media
▫ Website features stories of real service members who have
sought treatment and are continuing to maintain successful
military or civilian careers
http://www.realwarriors.net
VA OEF/OIF Page
• www.OEFOIF.va.gov
• OEF/OIF webpage on VA mental health
• Overview of benefits available to recent
returnees
• Descriptions of different venues where returnees
and families may seek help
• Social Media
▫ Blogs
http://www.OEFOIF.va.gov
MilitaryOneSource.com
• Target audience: Service members from all branches,
family members, service providers
▫ Web resources
▫ Supplements existing installation services
▫ Provides free help and information, by phone with a
professionally trained consultant, or online
▫ Wide range of issues from budgeting and investing to
relationships and deployment
▫ Available 24 hours a day, 365 days a year
▫ Free counseling services (up to 12 sessions per person, per issue),
face-to-face in the local community, by telephone, and online
http://www.militaryonesource.com/
DCoE Outreach Center
Call
Chat
• Provides an authoritative source of
information and resources on
psychological health (PH) & traumatic
brain injury (TBI) issues
• Helps service members, veterans, and
their families by connecting them with the
resources they need to promote their
resilience, recovery, and reintegration
• Assists service members, veterans,
families, leaders, healthcare providers
navigate the system of care
• Responds to information requests about
the DCoE
• Serves:
▫ Service Members, Veterans, Families,
Military Leaders, Clinicians, Researchers,
Educators, Support personnel, Chaplains
• Capability/Availability:
Or e-mail resources@dcoeoutreach.org
▫ 24/7 availability of Health Resource
Consultants (most have masters or
doctoral level degrees and healthcare
experience)
▫ Respond by phone, email, instant
messaging, chat, fax
▫ Respond to specific research requests
45
http://www.mentalhealth.va.gov/C
ollege/
Student Veterans of America
www.studentveterans.org
Three primary missions:
•Develop student veteran groups on
college and university campuses and
coordinate by region between existing
groups.
•Connect student groups with
resources.
•Advocate on behalf of student veterans
at the state and national level.
Online Toolkits Coming
VA PTSD PRO
(Practitioner Resources Online)
• One-stop shopping for busy clinician
• All materials selected for relevance to clinical
care
• Personal shopping basket function
• Search function by kind of resource (e.g., fact
sheets, videos, articles)
PTSD Coach Overview
PTSD Coach is a mobile phone application
for people with PTSD and those
interested in learning more about PTSD
This application provides:
 Education about PTSD
 A self-assessment tool
 Portable skills to address acute
symptoms
 Direct connection to crisis support and
 Information about treatment aimed at
guiding those who could benefit into
care
Used to augment face-to-face care or as a
stand-alone education and symptom
management tool
• From the home screen (seen
here), users can choose from
the four main actions of the
application
Home Screen
• Users may also use “Setup” to
personalize the app with media
from their own phone. Users are
guided through this process
automatically on their first time
through the app
• The “About” button provides
users with information about the
application and access to the team
that built it.
Coming Phone Apps
•
•
•
•
•
•
•
•
•
•
•
•
•
PTSD Family Coach
Mindfulness
PE Coach
CPT Coach
Behavioral Activation
Acceptance and Commitment Therapy
Cognitive Behavioral Therapy for Insomnia
Psychological First Aid
TBI
Safety Plan
Problem-Solving
Parenting
Skills for Psychological Recovery
Improving Resources?
• Organizing and vetting resources for specific
audiences?
• Proactive outreach to audiences?
• More interactive resources?
• Evidence-based resources?
• Supplementing training resources with
consultation?
Questions and Comments?
• drfrancis@traumaresource.com