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PTSD: National Center for PTSD

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Managing PTSD Primary Care


Rural Provider PTSD Toolkit

Managing PTSD in Primary Care
After screening and diagnosis, the next step is connecting patients to effective treatment. Unfortunately, there is a great deal of variation in availability, particularly in rural areas where there is often a lack of mental health providers, especially providers with training and expertise in PTSD treatments.
Veteran and provider talking
Regardless of availability of treatment providers, many patients decline referral to mental health care and prefer treatment with their primary care providers (PCP). Others drop out of specialized treatment and return to the care of their PCP. Primary care providers can play a powerful role in helping patients engage in treatment for PTSD by talking with them about their experiences, reassuring them that treatment works and explaining that successful treatment will improve overall health and well-being.
Tips for Primary Care: Encouraging Trauma-Focused Psychotherapy

  • Explain that untreated PTSD can negatively impact health and enjoyment of life
  • Point out that with no treatment, symptoms are unlikely to get better and may get worse
  • Acknowledge there are many treatments for PTSD, but that research shows some treatments work better than others and these evidence-based treatments offer the best chance for improvement
  • Be a myth-buster: Trauma-focused psychotherapy for PTSD is not lying on a couch, won't go on indefinitely, and is not the same as talking to a support group
  • Explore why a patient is declining a referral - listening to concerns validates the patient and allows you to clarify misconceptions and understand logistical barriers
  • Know the recommended treatments, not just for PTSD but also for the common symptoms that you treat - like insomnia
  • Acknowledge that there are side effects to psychotherapy; it is hard work and symptoms may worsen initially
Although psychotherapy is more effective than medication, there are reasons that some patients might prefer medications. In some cases medication may be the only available intervention. For more information about clinical guidelines for the treatment of PTSD, please visit the PTSD Guideline Overview page.

PTSD Information Voice Mail: (802) 296-6300
Also see: VA Mental Health