The document provides guidance for presenting on PTSD and Military Veterans to police officers. It recommends keeping the template intact but allowing for customization. Supplemental slides on PTSD details can be integrated if warranted. Additional multimedia content may also be added. The presentation objectives are to educate officers on PTSD among Veterans, interacting with Veterans in crisis, de-escalation techniques, and self-care.
question 1The goal of the Six Sigma program is to achieve a leve.docxIRESH3
question 1
The goal of the Six Sigma program is to achieve a level of quality that is as close to perfection as possible. Sigma is actually a statistical term used to gauge how far a process deviates from perfection. Explain how the disciplines within Six Sigma can improve hospital efficiency and hospital profitability?
question 2
What is your personal definition of continuous quality improvement? How would you relate this definition to operations in a health care organization? How do we try to build new methods of practicing based on profound knowledge, most of which already is tacit in the organization, as well as the new knowledge that the CQI process generates?
question 3
What is the value of supply chain management? How does supply chain management impact the financial position of an organization?
question 4
Why would an organization need to measure the capacity (throughput) of the various resources (x-ray equipment, exam rooms, length of stay, etc.)? How does capacity management support decision-making?
Assignment 1
For this assignment, you are required to write a research paper (4-6 pages) on methods of quality measurement. Your paper must include the following:
1) Detailed summary of at least two different methods of quality measurement.
2) Examples of how the methods may be used to improve organizational effectiveness.
3) Evaluation of the methods.
4) At least four references.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
Assignment 2
For this assignment, you are required to write a reflection and self-evaluation of your understanding of health care business analyses. Your assignment should include a discussion of the following:
1) A summary of your understanding of health care business analyses: In your own words, why is it important? What does it entail?
2) What was the most significant concept you learned during the course? How did the course assignments assist in your understanding of this concept?
3) What questions do you still have about health care business analyses? Was there anything else you were expecting to learn that the course did not cover?
4) How would you rate your overall understanding of health care business analyses? What steps do you plan on taking to increase your knowledge and understanding?
PTSD
Post-traumatic stress disorder (PTSD) is a biopsychological condition associated with very stressful or life-threatening events such as abuse, rape, violence, military combat, severe accidents, and natural disasters. Symptoms include having intrusive thoughts about or reliving the event(s), withdrawing from others, and experiencing anxiety or hyperarousal for weeks or months following the event(s). People with PTSD may turn to drugs or alcohol to help them cope, they may exhibit signs of depression, their relationships may deteriorate, and they may manifest physical symptoms.
PTSD has been studied intensiv ...
Combatting Stigma: Encouraging Help Seeking in Soldiers | Solh WellnessSolh Wellness
Solh Wellness is breaking the stigma surrounding mental health, and promoting the importance of seeking help among soldiers. Read Help Seeking Practical Steps.
PTSD and the 911 Call Taker: A PowerPhone WebinarPowerPhone
This document discusses a webinar on recognizing and dealing with critical incident stress and PTSD in call handlers. It begins with introductions and provides an overview of critical incident stress, PTSD, and factors that can contribute to call handler burnout. Research is presented that examined the relationship between traumatic call exposure, distress levels, and PTSD symptoms in call handlers. The webinar concludes with a discussion of newly discovered treatments for resolving stress and PTSD.
This document discusses stress and suicide among Indian soldiers. It provides statistics showing high suicide rates in the Indian army compared to combat deaths. It then lists and describes numerous stress factors for soldiers, including operational stress, family problems, lack of leave, shortage of mental health resources, and social stigma regarding mental health issues. The document also outlines physical, mental, behavioral, and emotional symptoms of stress, as well as stress management techniques like changes in thinking, behavior, lifestyle, and social support.
Police and correctional officers face tremendous stress from their jobs, including vicarious, occupational, and professional stress. Prolonged exposure to trauma can lead to conditions like PTSD. The police culture impacts how officers deal with stress, sometimes in unhealthy ways like alcohol abuse. After traumatic incidents, departments use strategies like critical incident stress debriefing to help officers process their emotions in a safe environment and avoid long-term negative consequences of job stress.
Police and correctional officers face tremendous stress from their jobs, including vicarious, occupational, and professional stress. The police culture impacts how officers deal with stress, sometimes preventing healthy processing of trauma and even encouraging unhealthy coping like alcohol abuse. Prolonged exposure to trauma can result in PTSD or Police Trauma Syndrome, which progresses through stages from initial repression of emotions to burnout. Critical incident stress debriefings provide a confidential space after traumatic events for officers to externalize their emotions before unhealthy defense mechanisms set in.
primary care management of the returning veteran with PTSDgreytigyr
This document provides an overview and objectives for a presentation on primary care management of returning veterans with PTSD. It discusses the scope of PTSD among veterans, the pathophysiology and diagnostic criteria, and how PTSD can impact common medical problems and family relationships. It outlines the role of osteopathic and adjunctive interventions, as well as resources for managing PTSD. Maps and images are included to depict areas of conflict and lifestyle impacts. The presentation aims to help primary care providers better recognize, understand, and treat PTSD among veteran patients.
question 1The goal of the Six Sigma program is to achieve a leve.docxIRESH3
question 1
The goal of the Six Sigma program is to achieve a level of quality that is as close to perfection as possible. Sigma is actually a statistical term used to gauge how far a process deviates from perfection. Explain how the disciplines within Six Sigma can improve hospital efficiency and hospital profitability?
question 2
What is your personal definition of continuous quality improvement? How would you relate this definition to operations in a health care organization? How do we try to build new methods of practicing based on profound knowledge, most of which already is tacit in the organization, as well as the new knowledge that the CQI process generates?
question 3
What is the value of supply chain management? How does supply chain management impact the financial position of an organization?
question 4
Why would an organization need to measure the capacity (throughput) of the various resources (x-ray equipment, exam rooms, length of stay, etc.)? How does capacity management support decision-making?
Assignment 1
For this assignment, you are required to write a research paper (4-6 pages) on methods of quality measurement. Your paper must include the following:
1) Detailed summary of at least two different methods of quality measurement.
2) Examples of how the methods may be used to improve organizational effectiveness.
3) Evaluation of the methods.
4) At least four references.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
Assignment 2
For this assignment, you are required to write a reflection and self-evaluation of your understanding of health care business analyses. Your assignment should include a discussion of the following:
1) A summary of your understanding of health care business analyses: In your own words, why is it important? What does it entail?
2) What was the most significant concept you learned during the course? How did the course assignments assist in your understanding of this concept?
3) What questions do you still have about health care business analyses? Was there anything else you were expecting to learn that the course did not cover?
4) How would you rate your overall understanding of health care business analyses? What steps do you plan on taking to increase your knowledge and understanding?
PTSD
Post-traumatic stress disorder (PTSD) is a biopsychological condition associated with very stressful or life-threatening events such as abuse, rape, violence, military combat, severe accidents, and natural disasters. Symptoms include having intrusive thoughts about or reliving the event(s), withdrawing from others, and experiencing anxiety or hyperarousal for weeks or months following the event(s). People with PTSD may turn to drugs or alcohol to help them cope, they may exhibit signs of depression, their relationships may deteriorate, and they may manifest physical symptoms.
PTSD has been studied intensiv ...
Combatting Stigma: Encouraging Help Seeking in Soldiers | Solh WellnessSolh Wellness
Solh Wellness is breaking the stigma surrounding mental health, and promoting the importance of seeking help among soldiers. Read Help Seeking Practical Steps.
PTSD and the 911 Call Taker: A PowerPhone WebinarPowerPhone
This document discusses a webinar on recognizing and dealing with critical incident stress and PTSD in call handlers. It begins with introductions and provides an overview of critical incident stress, PTSD, and factors that can contribute to call handler burnout. Research is presented that examined the relationship between traumatic call exposure, distress levels, and PTSD symptoms in call handlers. The webinar concludes with a discussion of newly discovered treatments for resolving stress and PTSD.
This document discusses stress and suicide among Indian soldiers. It provides statistics showing high suicide rates in the Indian army compared to combat deaths. It then lists and describes numerous stress factors for soldiers, including operational stress, family problems, lack of leave, shortage of mental health resources, and social stigma regarding mental health issues. The document also outlines physical, mental, behavioral, and emotional symptoms of stress, as well as stress management techniques like changes in thinking, behavior, lifestyle, and social support.
Police and correctional officers face tremendous stress from their jobs, including vicarious, occupational, and professional stress. Prolonged exposure to trauma can lead to conditions like PTSD. The police culture impacts how officers deal with stress, sometimes in unhealthy ways like alcohol abuse. After traumatic incidents, departments use strategies like critical incident stress debriefing to help officers process their emotions in a safe environment and avoid long-term negative consequences of job stress.
Police and correctional officers face tremendous stress from their jobs, including vicarious, occupational, and professional stress. The police culture impacts how officers deal with stress, sometimes preventing healthy processing of trauma and even encouraging unhealthy coping like alcohol abuse. Prolonged exposure to trauma can result in PTSD or Police Trauma Syndrome, which progresses through stages from initial repression of emotions to burnout. Critical incident stress debriefings provide a confidential space after traumatic events for officers to externalize their emotions before unhealthy defense mechanisms set in.
primary care management of the returning veteran with PTSDgreytigyr
This document provides an overview and objectives for a presentation on primary care management of returning veterans with PTSD. It discusses the scope of PTSD among veterans, the pathophysiology and diagnostic criteria, and how PTSD can impact common medical problems and family relationships. It outlines the role of osteopathic and adjunctive interventions, as well as resources for managing PTSD. Maps and images are included to depict areas of conflict and lifestyle impacts. The presentation aims to help primary care providers better recognize, understand, and treat PTSD among veteran patients.
Post-traumatic stress disorder (PTSD) arises as a delayed response to an exceptionally stressful event like war, disaster, or assault. Symptoms include re-experiencing the event through flashbacks or nightmares, avoidance of reminders, and increased anxiety and arousal. Risk factors include previous trauma, lack of social support, and genetics. Diagnosis involves assessing symptoms of re-experiencing, avoidance, changes in mood and arousal. Treatment options include antidepressants, anti-anxiety medication, and cognitive behavioral therapy (CBT) which exposes patients to traumatic memories and teaches coping skills.
Tai Chi Therapy Veterans Ptsd Treatment Nursing Research.pdfsdfghj21
Tai Chi therapy is being researched as a potential treatment for veterans experiencing PTSD. The techniques used in Tai Chi therapy aim to reduce stress, anxiety, and anger through slow, controlled movements and deep breathing. Healthcare workers can apply these techniques to help patients manage PTSD symptoms. Nurses are well-positioned to screen veterans for PTSD using tools like the PTSD Toolkit for Nurses, which provides guidance on assessment, intervention, and referral for treatment.
Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that can develop after exposure to a traumatic or dangerous event. Symptoms include re-experiencing the event through flashbacks or nightmares, avoidance of trauma-related stimuli, and increased arousal and stress. Effective treatments include psychotherapy such as cognitive behavioral therapy and medications. Researchers are studying risk factors for PTSD and testing new treatment methods such as Internet-based therapy to improve detection and treatment.
Stress and its management in Indian soldiersRobin Victor
Stress and suicide are significant issues for Indian soldiers due to the demanding environment of the military. Statistics show high suicide rates among Indian soldiers compared to combat deaths. Many factors can cause stress, including operational stress, family problems, lack of leave, humiliation from superiors, and social apathy. Symptoms of stress and suicide in soldiers include depression, changes in behavior, and talking about death. Prevention of suicide in the military requires awareness of warning signs, immediate intervention, ensuring soldiers are not left alone, and seeking help from medical professionals. Overall the document stresses the need to address soldier well-being and treat them with dignity.
Self-harm, especially repetitive self-harm, is strongly associated with suicide and should not be considered merely "attention seeking". A rapid initial assessment should be performed to establish urgency, mental capacity, distress levels, and presence of mental illness. Risk of further self-harm is greatest for those with repeated previous episodes, drug or alcohol dependence, a history of criminal behavior or psychiatric issues. All self-harm patients, especially children, should be offered psychosocial assessment and consideration for admission to address underlying issues and safeguard their well-being.
Self-harm, especially repetitive self-harm, is strongly associated with suicide and should always be taken seriously. A thorough assessment should be performed to evaluate physical injuries, mental state, risk factors for further self-harm or suicide, and safeguarding needs. Psychosocial assessment by an appropriately trained individual and follow-up with mental health services is recommended. Challenges include ensuring assessment and care when a patient wants to leave or has diminished capacity, but their safety must be the top priority.
Mrs. S confides in you that she is terrified of her husband. She rep.pdfarpitcomputronics
Mrs. S confides in you that she is terrified of her husband. She reports that at times, he is so kind,
and then later he is angry and has become physically abusive at times. She also reports that he
frequently wakes up at night screaming and trying to crawl under the bed.
1.) What does the nurse suspect?
Additional questioning reveals that Mr. S has just returned to the United States following a 3-
year deployment in the military. You strongly recommend that Mr. S see a health care provider
as soon as possible.
1.) What questions might be helpful in identifying the cause of these manifestations?
2.) What other manifestations would make the nurse suspect PTSD?
3.) What three criteria must be met to confirm the diagnosis of PTSD?
4.) Other than combat, what are some other causes of PTSD?
Solution
Ans:
1.) What does the nurse suspect?
In the above case, Since Mr. S was in the military and might have undergone life threatening
events. Based on his reactions and his wife statements, nurse suspect that, Mr. S is under
depression ie., Posttraumatic Stress Disorder (PSTD).
PSTD: Is a psychiatric disorder that can occur following the experience or witnessing of a life-
threatening events such as military combat, natural disasters, terrorist incidents, serious
accidents, or physical or sexual assault in adult or childhood.
It\'s natural to experience fear in dangerous situations. But people with PTSD may behave as
though they are under attack when there is no real imminent threat.
A person who suffers PTSD typically re-experiences the trauma through flashbacks and
nightmares, experiences that can seem as real as the actual trauma. The person often feels
intensely that the trauma could happen again at any time.
Thoughts and feelings can trigger symptoms, but so can words, situations or objects that remind
the person of a traumatic situation.
2).What questions might be helpful in identifying the cause of these manifestations?
The first step in diagnosing trauma is making an appointment with a doctor, preferably someone
trained in mental health disorders. The doctor will talk with the patient to determine their state of
mind. The practitioner will have to determine whether the prerequisite symptoms for PTSD are
present before deciding how to proceed. For a diagnosis of PTSD, the patient must have
experienced the following for at least one month:
· 3). What other manifestation would make the nurse suspect PTSD?
Since Mr. S was in the military and might have undergone life threatening events. Based on his
reactions and his wife statements, nurse suspect that, Mr. S is under depression ie., Posttraumatic
Stress Disorder (PSTD).
4).What three criteria must be met to confirm the diagnosis of PTSD?
Currently, diagnosis of PTSD is based on 8 criteria
1) The first criterion has 4 components, as follows:
2) The second criterion involves the persistent re experiencing of the event in 1 of several ways:
Unlike adults, children reexperience the event through repetiti.
The document discusses the importance of reality-based training for emergency response teams. It provides 10 steps for successful reality-based training, including having support from leadership, qualified instructors, crisis management simulations, teamwork exercises, and debriefing sessions. It also discusses accommodations employers should consider for returning veterans, such as allowing flexible schedules, providing a quiet work environment, and ensuring employee assistance programs are prepared to address common issues like PTSD and depression.
Mental Health in Fact-checking and Journalism: Dealing with Stress and Trauma211 Check
Mental Health in Fact-checking and Journalism: Dealing with Stress and Trauma is a presentation by Jibi Moses Daniel Associate Editor and Associate Coordinator for the 211 Check Project at Defyhatenow. He made the presentation for an audience of about 25 attendees via Zoom and YouTube Livestream with support from the International Fact-checking Netwotk (IFCN) through the BUILD Grant
Please refer to the links below for the videos mentioned above :
LADY GAGA - https://youtu.be/tMnkQB4J3hY
UN Speech by BTS - https://youtu.be/oTe4f-bBEKg
Posttraumatic stress disorder (PTSD) is a psychiatric disorder that may occur after experiencing or witnessing a traumatic event. Common symptoms include intrusive memories, nightmares, avoidance of trauma-related stimuli, negative changes in mood and cognition, and increased arousal and reactivity. Risk factors include prior trauma, lower socioeconomic status, childhood adversity, and female gender. Treatment involves trauma-focused psychotherapy such as cognitive behavioral therapy (CBT) with exposure therapy or cognitive processing therapy. Selective serotonin reuptake inhibitors (SSRIs) or venlafaxine may also be used as a second-line treatment.
This document provides information on building resilience in students through understanding trauma and mental health issues. It discusses how trauma like sexual assault can lead to conditions like post-traumatic stress disorder (PTSD) and discusses common myths about PTSD. It provides information on understanding trauma, PTSD symptoms, and how colleges can help students by educating them on these topics and promoting help-seeking behaviors and peer support. The document advocates for creating compassionate campuses where students feel empowered and supported regarding their mental health.
Four student veterans spoke to faculty about their transition from military to student life. They found it difficult to adjust to the lack of structure and camaraderie of the military. Student veterans miss having clear tasks and appreciate accommodations from faculty for their unique needs, such as from training conflicts or PTSD triggers like alarms. The presentation provided information on PTSD, its symptoms, and supports available through the Vet Center.
This document provides information for Employee Assistance Program (EAP) providers on supporting veterans in the workplace. It discusses common challenges veterans face, how to screen for military service and PTSD, referral options, and tools to help veterans excel at their jobs. A survey found most EAP providers want more education on issues like PTSD, military culture, and referral resources. The document promotes the Veterans Employment Toolkit and other online tools and resources for EAP providers to better assist veterans.
Polyvagal Theory- How Trauma affects your bodySaba Kazi
Understanding trauma and PTSD
Understanding the dance of attack and withdrawal in relationships
Understanding how extreme stress leads to dissociation or shutting down
Understanding how to read body language
This document outlines a training session for healthcare workers on setting healthy boundaries to reduce work-related stress. The goals are to describe sources of stress, define stress and its effects, and explain strategies for handling stress, including setting boundaries between work and personal life. Topics discussed include what constitutes job stress, how stress affects the body and behavior, tips for speaking up about workplace issues, and strategies for managing stress through self-care. Resources on home healthcare safety and hazards are also provided.
Posttraumatic stress disorder (PTSD) is a mental health condition that develops after exposure to a traumatic event. Symptoms include re-experiencing the trauma through flashbacks or nightmares, avoidance of trauma-related stimuli, increased arousal and negative changes in mood and cognition. Risk factors include a history of childhood trauma, lack of social support, and severity of the traumatic event. Effective treatments include trauma-focused cognitive behavioral therapy and medications like SSRIs.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Post-traumatic stress disorder (PTSD) arises as a delayed response to an exceptionally stressful event like war, disaster, or assault. Symptoms include re-experiencing the event through flashbacks or nightmares, avoidance of reminders, and increased anxiety and arousal. Risk factors include previous trauma, lack of social support, and genetics. Diagnosis involves assessing symptoms of re-experiencing, avoidance, changes in mood and arousal. Treatment options include antidepressants, anti-anxiety medication, and cognitive behavioral therapy (CBT) which exposes patients to traumatic memories and teaches coping skills.
Tai Chi Therapy Veterans Ptsd Treatment Nursing Research.pdfsdfghj21
Tai Chi therapy is being researched as a potential treatment for veterans experiencing PTSD. The techniques used in Tai Chi therapy aim to reduce stress, anxiety, and anger through slow, controlled movements and deep breathing. Healthcare workers can apply these techniques to help patients manage PTSD symptoms. Nurses are well-positioned to screen veterans for PTSD using tools like the PTSD Toolkit for Nurses, which provides guidance on assessment, intervention, and referral for treatment.
Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that can develop after exposure to a traumatic or dangerous event. Symptoms include re-experiencing the event through flashbacks or nightmares, avoidance of trauma-related stimuli, and increased arousal and stress. Effective treatments include psychotherapy such as cognitive behavioral therapy and medications. Researchers are studying risk factors for PTSD and testing new treatment methods such as Internet-based therapy to improve detection and treatment.
Stress and its management in Indian soldiersRobin Victor
Stress and suicide are significant issues for Indian soldiers due to the demanding environment of the military. Statistics show high suicide rates among Indian soldiers compared to combat deaths. Many factors can cause stress, including operational stress, family problems, lack of leave, humiliation from superiors, and social apathy. Symptoms of stress and suicide in soldiers include depression, changes in behavior, and talking about death. Prevention of suicide in the military requires awareness of warning signs, immediate intervention, ensuring soldiers are not left alone, and seeking help from medical professionals. Overall the document stresses the need to address soldier well-being and treat them with dignity.
Self-harm, especially repetitive self-harm, is strongly associated with suicide and should not be considered merely "attention seeking". A rapid initial assessment should be performed to establish urgency, mental capacity, distress levels, and presence of mental illness. Risk of further self-harm is greatest for those with repeated previous episodes, drug or alcohol dependence, a history of criminal behavior or psychiatric issues. All self-harm patients, especially children, should be offered psychosocial assessment and consideration for admission to address underlying issues and safeguard their well-being.
Self-harm, especially repetitive self-harm, is strongly associated with suicide and should always be taken seriously. A thorough assessment should be performed to evaluate physical injuries, mental state, risk factors for further self-harm or suicide, and safeguarding needs. Psychosocial assessment by an appropriately trained individual and follow-up with mental health services is recommended. Challenges include ensuring assessment and care when a patient wants to leave or has diminished capacity, but their safety must be the top priority.
Mrs. S confides in you that she is terrified of her husband. She rep.pdfarpitcomputronics
Mrs. S confides in you that she is terrified of her husband. She reports that at times, he is so kind,
and then later he is angry and has become physically abusive at times. She also reports that he
frequently wakes up at night screaming and trying to crawl under the bed.
1.) What does the nurse suspect?
Additional questioning reveals that Mr. S has just returned to the United States following a 3-
year deployment in the military. You strongly recommend that Mr. S see a health care provider
as soon as possible.
1.) What questions might be helpful in identifying the cause of these manifestations?
2.) What other manifestations would make the nurse suspect PTSD?
3.) What three criteria must be met to confirm the diagnosis of PTSD?
4.) Other than combat, what are some other causes of PTSD?
Solution
Ans:
1.) What does the nurse suspect?
In the above case, Since Mr. S was in the military and might have undergone life threatening
events. Based on his reactions and his wife statements, nurse suspect that, Mr. S is under
depression ie., Posttraumatic Stress Disorder (PSTD).
PSTD: Is a psychiatric disorder that can occur following the experience or witnessing of a life-
threatening events such as military combat, natural disasters, terrorist incidents, serious
accidents, or physical or sexual assault in adult or childhood.
It\'s natural to experience fear in dangerous situations. But people with PTSD may behave as
though they are under attack when there is no real imminent threat.
A person who suffers PTSD typically re-experiences the trauma through flashbacks and
nightmares, experiences that can seem as real as the actual trauma. The person often feels
intensely that the trauma could happen again at any time.
Thoughts and feelings can trigger symptoms, but so can words, situations or objects that remind
the person of a traumatic situation.
2).What questions might be helpful in identifying the cause of these manifestations?
The first step in diagnosing trauma is making an appointment with a doctor, preferably someone
trained in mental health disorders. The doctor will talk with the patient to determine their state of
mind. The practitioner will have to determine whether the prerequisite symptoms for PTSD are
present before deciding how to proceed. For a diagnosis of PTSD, the patient must have
experienced the following for at least one month:
· 3). What other manifestation would make the nurse suspect PTSD?
Since Mr. S was in the military and might have undergone life threatening events. Based on his
reactions and his wife statements, nurse suspect that, Mr. S is under depression ie., Posttraumatic
Stress Disorder (PSTD).
4).What three criteria must be met to confirm the diagnosis of PTSD?
Currently, diagnosis of PTSD is based on 8 criteria
1) The first criterion has 4 components, as follows:
2) The second criterion involves the persistent re experiencing of the event in 1 of several ways:
Unlike adults, children reexperience the event through repetiti.
The document discusses the importance of reality-based training for emergency response teams. It provides 10 steps for successful reality-based training, including having support from leadership, qualified instructors, crisis management simulations, teamwork exercises, and debriefing sessions. It also discusses accommodations employers should consider for returning veterans, such as allowing flexible schedules, providing a quiet work environment, and ensuring employee assistance programs are prepared to address common issues like PTSD and depression.
Mental Health in Fact-checking and Journalism: Dealing with Stress and Trauma211 Check
Mental Health in Fact-checking and Journalism: Dealing with Stress and Trauma is a presentation by Jibi Moses Daniel Associate Editor and Associate Coordinator for the 211 Check Project at Defyhatenow. He made the presentation for an audience of about 25 attendees via Zoom and YouTube Livestream with support from the International Fact-checking Netwotk (IFCN) through the BUILD Grant
Please refer to the links below for the videos mentioned above :
LADY GAGA - https://youtu.be/tMnkQB4J3hY
UN Speech by BTS - https://youtu.be/oTe4f-bBEKg
Posttraumatic stress disorder (PTSD) is a psychiatric disorder that may occur after experiencing or witnessing a traumatic event. Common symptoms include intrusive memories, nightmares, avoidance of trauma-related stimuli, negative changes in mood and cognition, and increased arousal and reactivity. Risk factors include prior trauma, lower socioeconomic status, childhood adversity, and female gender. Treatment involves trauma-focused psychotherapy such as cognitive behavioral therapy (CBT) with exposure therapy or cognitive processing therapy. Selective serotonin reuptake inhibitors (SSRIs) or venlafaxine may also be used as a second-line treatment.
This document provides information on building resilience in students through understanding trauma and mental health issues. It discusses how trauma like sexual assault can lead to conditions like post-traumatic stress disorder (PTSD) and discusses common myths about PTSD. It provides information on understanding trauma, PTSD symptoms, and how colleges can help students by educating them on these topics and promoting help-seeking behaviors and peer support. The document advocates for creating compassionate campuses where students feel empowered and supported regarding their mental health.
Four student veterans spoke to faculty about their transition from military to student life. They found it difficult to adjust to the lack of structure and camaraderie of the military. Student veterans miss having clear tasks and appreciate accommodations from faculty for their unique needs, such as from training conflicts or PTSD triggers like alarms. The presentation provided information on PTSD, its symptoms, and supports available through the Vet Center.
This document provides information for Employee Assistance Program (EAP) providers on supporting veterans in the workplace. It discusses common challenges veterans face, how to screen for military service and PTSD, referral options, and tools to help veterans excel at their jobs. A survey found most EAP providers want more education on issues like PTSD, military culture, and referral resources. The document promotes the Veterans Employment Toolkit and other online tools and resources for EAP providers to better assist veterans.
Polyvagal Theory- How Trauma affects your bodySaba Kazi
Understanding trauma and PTSD
Understanding the dance of attack and withdrawal in relationships
Understanding how extreme stress leads to dissociation or shutting down
Understanding how to read body language
This document outlines a training session for healthcare workers on setting healthy boundaries to reduce work-related stress. The goals are to describe sources of stress, define stress and its effects, and explain strategies for handling stress, including setting boundaries between work and personal life. Topics discussed include what constitutes job stress, how stress affects the body and behavior, tips for speaking up about workplace issues, and strategies for managing stress through self-care. Resources on home healthcare safety and hazards are also provided.
Posttraumatic stress disorder (PTSD) is a mental health condition that develops after exposure to a traumatic event. Symptoms include re-experiencing the trauma through flashbacks or nightmares, avoidance of trauma-related stimuli, increased arousal and negative changes in mood and cognition. Risk factors include a history of childhood trauma, lack of social support, and severity of the traumatic event. Effective treatments include trauma-focused cognitive behavioral therapy and medications like SSRIs.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Are you looking for a long-lasting solution to your missing tooth?
Dental implants are the most common type of method for replacing the missing tooth. Unlike dentures or bridges, implants are surgically placed in the jawbone. In layman’s terms, a dental implant is similar to the natural root of the tooth. It offers a stable foundation for the artificial tooth giving it the look, feel, and function similar to the natural tooth.
Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, prepared useful Practice Aids pertaining to Alzheimer’s disease for this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.
Lecture 6 -- Memory 2015.pptlearning occurs when a stimulus (unconditioned st...AyushGadhvi1
learning occurs when a stimulus (unconditioned stimulus) eliciting a response (unconditioned response) • is paired with another stimulus (conditioned stimulus)
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
Histololgy of Female Reproductive System.pptxAyeshaZaid1
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Police_Toolkit_Slides.pptx
1. Delete this slide before use.
Tips and Information: Thank you for choosing to share PTSD and
Military Veterans: Police Officer Training slides. This slide deck was
developed in conjunction with the Police Officer Toolkit: PTSD and
Military Veterans.
We ask that you recognize NCPTSD as the content source and keep the
NCPTSD template intact during your presentation. However, the
individual slides may be amended (e.g. add or remove slides) to best
serve your audience. For example, consider length of time available for
your presentation, local resources to include, and be sure to add local
contact information for attendees.
Notes are included for most slides. Feel free to revise the notes – these
are offered as a guide to included slides. Citations are not included in
the slide deck, but can be found in the Police Officer Toolkit.
Be sure to amend the title slide with your presenter information and
include a final slide that offers contact information for those
attending to follow up with you if necessary. 0
2. Delete this slide before use.
Supplemental Module: At the end of the slide deck, there are a
series of slides in a Supplemental Module. This content is not
intended to be discussed at the end of your presentation, but to be
integrated at an earlier point in the slides if you feel more detail is
warranted.
For example, the Supplemental Module includes more detailed
information about traumatic experiences, PTSD symptoms, effective
treatments, and co-occurring conditions. This information may be
useful to include depending on your time constraints and audience.
If you’d like to include more basic information about PTSD and
effective treatments, we recommend our PTSD 101: PTSD Overview
course. You are welcome to use screen shots of PTSD Overview or
other NCPTSD courses or materials to amend this PPT.
1
3. Delete this slide before use.
Additional Content: You might consider adding multimedia
content to the PPT, which we did not do to maintain file size of this
PPT. In particular:
• Download AboutFace Previews: compilation of Veteran
responses to key questions which overview symptoms and
treatment experiences
• Download Whiteboard Videos (Public): series of 5
animated whiteboard videos on PTSD and effective
treatments
If you have questions or need more in-depth information for your
presentation, contact: ncptsd@va.gov
2
4. Posttraumatic Stress Disorder and Military
Veterans: Police Officer Training
[Insert Your Presenter Details]
September 20, 2016
5. VETERANS HEALTH ADMINISTRATION
Course Objectives
The focus of this training is to educate officers about:
1. PTSD issues among Veterans
2. How to interact with Veterans in crisis
3. De-escalation techniques to improve interactions
with Veterans in crisis
4. Self-care and peer support actions to reduce stress
amongst police officers
4
7. VETERANS HEALTH ADMINISTRATION
PTSD and Police Work
• The events that police respond to are likely upsetting
situations that may serve to trigger symptoms for
those who have PTSD.
• In most cases the person with PTSD shares the
immediate goal of increasing personal safety.
• The ability to recognize PTSD can assist an officer to
respond more effectively in cases where someone has
PTSD.
6
8. VETERANS HEALTH ADMINISTRATION
What Is PTSD?
• During a potentially traumatizing event, our brains take a
snapshot of that situation and remember the circumstances.
• In similar circumstances, our bodies react with a "fight or
flight" response in preparation to deal with the threat again,
which may be adaptive in life threatening situations.
• PTSD leads a person to over-generalize the fight or flight
response to threats - even benign events (e.g., a car backfire)
signal danger.
• People with PTSD may continue to respond to triggers (or
reminders of the life-threatening event) as if their life is in
danger even when it is not.
7
9. VETERANS HEALTH ADMINISTRATION
PTSD Basics
• PTSD occurs after direct exposure to or witnessing of a
traumatic event, learning about the accidental or violent
death of a close relative or friend, or through repeated or
extreme exposure to aversive details of traumatic events.
• To receive a PTSD diagnosis, a person must have symptoms in
the following four clusters for at least a month, with noted
decreases in functioning:
– Intrusion symptoms
– Avoidance symptoms
– Negative alterations in cognitions and mood
– Alterations in arousal and reactivity
8
10. VETERANS HEALTH ADMINISTRATION
Why Recognizing PTSD Matters
1. To recognize that there may be something more taking
place. One PTSD symptom might help you look for, or ask
about, other common accompanying symptoms that may
be impacting behavior.
2. To identify when some other problem may be happening
that is not usually part of PTSD, such as a person hearing
voices.
3. To help the person with PTSD get connected with services.
9
11. VETERANS HEALTH ADMINISTRATION
PTSD and Veterans
• Anyone can be exposed to a traumatic event, and anyone
exposed to a traumatic event can go on to have PTSD
symptoms.
• Military Veterans are unique - they are more likely to have
experienced multiple traumatic events than the general
population.
• Veterans are also likely to have strengths and values based on
their experiences in the military, and to have completed
specialized training in tactics, weapons, and use of deadly
force in urban environments.
10
12. VETERANS HEALTH ADMINISTRATION
How Common Is PTSD in Veterans?
• 6-7% of Americans will experience PTSD during their lifetime.
• 18-35% of military Veterans will experience PTSD during their lifetime.
• Different sub-populations of Veterans are more likely to have higher
rates, including those with higher combat exposure.
• Little is known about the prevalence of PTSD among those who are the
focus of police calls, but the numbers can be expected to be higher
than those in the general population.
• The prevalence of those with PTSD whom you come into contact
during your law enforcement duties may be much higher.
• Veterans involved in your calls are also more likely to have other
mental health problems, such as drug or alcohol abuse.
11
13. VETERANS HEALTH ADMINISTRATION
Military Training
• Police and Veterans both:
– Share a desire for public and personal safety
– Are trained to adhere to rules, structure, and command
– Share commitment to public service and self-sacrifice
– Are experienced in controlling themselves in difficult situations
• While there are differences in police and military training, the
urban nature of current conflicts requires the ability to operate
in similar environments.
• Consider Veterans as at least your equal in terms of training on
tactics, weapons, and use of deadly force.
• Depending on deployment type, Veterans may have significant
experience in using these techniques.
12
15. VETERANS HEALTH ADMINISTRATION
Intrusion Symptoms
Intrusion symptoms often involve internal thoughts or feelings
that will not be obvious. Instead, you might notice:
• A person seems distracted, defensive, and inattentive to what
you are asking. He or she is not necessarily being disrespectful
or lying, but may be re-experiencing memories of a past
traumatic event.
• A person is overly reactive, such as jerking away or cowering
when touched, not because he or she is being resistant or
aggressive, but because he or she is having a flashback. The
person is experiencing all the cues events of a prior traumatic
event, as if it is happening again at that moment.
14
16. VETERANS HEALTH ADMINISTRATION
Avoidance Symptoms
Avoidance symptoms may directly interfere with your duties. A
person with PTSD may try to avoid people, situations, places, or
internal states that remind them of traumatic events because
remembering a traumatic event is so distressing. For example:
• A Veteran who was involved in a violent attack on his or her
division's motorcade may resist getting into a patrol car.
• A person who has experienced an attack in a heavily-populated
urban area may become agitated when inadvertently caught in
a protesting crowd.
• A person who was assaulted by someone in uniform avoids or
refuses to talk or make eye contact with you because you are in
uniform.
15
17. VETERANS HEALTH ADMINISTRATION
Negative Alterations in Cognitions and Mood
These symptoms take the form of emotional numbing or having
difficulty feeling emotions, problems with memory, estrangement
from others, or negative views of oneself and the world. Negative
changes in thoughts or feelings may not be observable but can still
interfere in police duties. For example:
• A person with PTSD who is feeling alienated from others does
not trust you enough to cooperate with your questions or
commands.
• A person with PTSD who feels numb and detached (or even
hopeless) may fail to provide you with information about the
event to which you are responding.
16
18. VETERANS HEALTH ADMINISTRATION
Alterations in Arousal and Reactivity
These types of PTSD symptoms are probably the most likely
symptoms police will encounter. A person with PTSD may be overly
alert, hyper-reactive, and on edge. For example:
• A person with PTSD constantly scans the environment for potential
danger and may feel extremely threatened by anyone approaching him
or her. This is especially threatening if being approached from behind, as
is sometimes the case with a second officer.
• A person with PTSD may feel easily threatened and become aggressive or
violent when you try to direct or restrain him or her.
• A person with PTSD (especially a Veteran) may carry a weapon because
he or she feels unsafe. Someone with PTSD may be more likely to use
that weapon because he or she may misinterpret neutral cues as signs of
danger.
17
19. VETERANS HEALTH ADMINISTRATION
Symptoms Without a Full Diagnosis
• PTSD may not always be the reason for negative reactions.
• Veterans may have many of the symptoms of PTSD without a
full diagnosis of PTSD.
• Veterans may have negative reactions for reasons other than
PTSD, such as:
– Having difficulty sleeping because of chronic pain
– Being angry because they feel civilians do not have that same service
orientation as Servicemembers and Veterans.
• Any assumption on your part that a person is acting in a certain
way because he or she has PTSD may result in the person
feeling misunderstood or angry.
18
22. VETERANS HEALTH ADMINISTRATION
Introduction: PTSD Symptoms in Others
You are encouraged to practice the skills included here and to use
your own judgment as to when these techniques may be most
useful.
Keep the following in mind:
• Safety: When Veterans experiencing PTSD symptoms are
agitated and/or in crisis situations, their primary concern at
that point is for personal safety.
• Sensitivity: Veterans in crisis situations are particularly attuned
to things going on in their immediate environment. If anything
happens for which the rationale is ambiguous, a Veteran in
crisis may default to a negative interpretation.
21
23. VETERANS HEALTH ADMINISTRATION
Introduction: PTSD Symptoms in Others
Keep the following in mind:
• Training: Veterans have been taught how to use physical
aggression as a tool in dangerous situations, but they may also be
in better control of their own use of aggression. This gives officers
an opportunity to "team up" with the Veteran to reduce the need
for anyone to make use of aggression.
• Experience: Veterans with tactical military training are aware of
tactics and techniques that police officers will employ in a crisis
situation. When left to make their own interpretation of police
officer behavior, Veterans in crisis may default to seeing the
officers as hostile and aggressive.
22
24. VETERANS HEALTH ADMINISTRATION
Increasing Understanding of Police Actions:
Tactical Transparency
• Tactical transparency means explaining actions before
making a move so that the person with whom you are
dealing knows what to expect.
• It may be particularly helpful for working with Veterans
who are prone to making negative interpretations when
things going on in their immediate environment are
ambiguous to them.
• The purpose is to provide Veterans with a more clear
interpretation of your behavior as a police officer, and to
convey your mutual interest in assuring the safety of all
involved.
23
25. VETERANS HEALTH ADMINISTRATION
Adjusting Non-Verbal Communication
Adjusting your non-verbal communication can make a difference in
the way those with PTSD interpret your intent. Non-verbal
communication can be at least as important as the actual words
that are spoken.
Non-verbal behaviors fall into three categories:
• Friendly/helpful: Communicating safety, respect, a desire to help, or
gestures that build a connection with someone (e.g., handshake and smile).
• Aggressive/hostile: Communicating a distance from or even a danger to
another individual (e.g., having one hand on your firearm).
• Ambiguous: Behaviors that are left up to interpretation may be interpreted
as aggressive by individuals in crisis situations (e.g., facing someone with
one shoulder angled away).
24
26. VETERANS HEALTH ADMINISTRATION
Non-Verbal Communication Actions
Consider reducing or changing non-verbal communication
actions, or at least know that you may be challenged to
convince the person in crisis that you are not intending to use
physical aggression.
When attending to your non-verbal communication, take care
to note the following body language behaviors:
• Posture
• Hand Gestures
• Facial Cues
25
27. VETERANS HEALTH ADMINISTRATION
Non-Verbal Communication: Posture
Potentially Misperceived Posture:
– Keeping physical distance from the person in crisis
– Placing your feet in a position to be able to move away
quickly
– Orienting your body to one side to reduce your size as a
target and keep weapons at a maximum distance
– Moving to close off exit routes
Consider changing one or more of these behaviors to reduce your
communication of aggression, or at least know that you may be
fighting an uphill battle to convince the Veteran that you are not
intending to use physical aggression.
26
28. VETERANS HEALTH ADMINISTRATION
Non-Verbal Communication: Hands
Potentially Misperceived Movements with Hands or Arms:
– Pointing or holding a flat palm up to someone
– Moving hands quickly or in an ambiguous way
– Folding arms (you are closed off and no longer open to
helping)
Communicating a willingness to help (open arms, hands low
with palms open and facing upward), may take place while
maintaining safe body postures. You might be able to employ
neutral or positive hand gestures as a way to offset an
aggressive body stance while still maximizing your safety and
readiness to respond.
27
29. VETERANS HEALTH ADMINISTRATION
Non-Verbal Communication: Facial Cues
Challenges with Facial Cues:
– Facial cues are the most difficult to alter
– Facial cues are easily misinterpreted
– Facial cues are largely out of our direct control
One important distinction facial cues convey is that between
honesty and insincerity.
Choose only verbal statements (e.g., "I appreciate your
service to our military") that you actually believe. If you
genuinely believe these statements, your sincerity will show
in your facial cues.
28
30. VETERANS HEALTH ADMINISTRATION
Verbal Communication Actions
When attending to your verbal communication, make
every effort to describe and explain your action. Try to
convey respect, ask and give information in a calming way,
and give directions that will distract and focus behavior in
the person in crisis.
Approach:
• Demonstrate respect
• Ask for and use names whenever possible
• Expect and, when possible, accommodate strong
emotional responses
29
31. VETERANS HEALTH ADMINISTRATION
Verbal Communication Actions
Giving and Requesting Information:
• Ask about immediate concerns
• Collect information in a way that is calming
− Encourage the person to answer a series of simple and direct questions
to focus attention
− Ask questions in the order of what happened to organize thinking
− If talking about the situation increases distress, ask unrelated questions
to distract the person from his or her reactions
− Use reflective, clarifying or summarizing statements to communicate
that you understand
− Convey that you are there to help and to keep the person safe
− Let the individual know that stress reactions are understandable
30
32. VETERANS HEALTH ADMINISTRATION
Verbal Communication Actions
Giving Direction:
• Ensure that the person is moved to a safe location, if warranted
• Protect the person from unnecessary exposure to distressing
circumstances
• Provide direction that is clear and positive, directing people in
what to do, rather than what not to do
• Give the person something to do that distracts him or her
• If you have to act firmly or abruptly, moderate the impact at
your first opportunity
• Reinforce compliance by promptly and positive acknowledging
actions that follow your instructions
31
33. VETERANS HEALTH ADMINISTRATION
Case Example: Minimal Transparency
Officers Jones and Wilkins respond to a call from a reception staff member
near the front lobby of a busy local hospital. Upon arrival, they witness a man
in his mid to late 50's, yelling and waving his arms at hospital staff.
Officer Jones asks the man to calm down and tell him what happened. While
the man explains the situation to Officer Jones, Officer Wilkins begins
gradually working his way around the side of the scene to check the man's
back pockets for signs of weapons.
Seeing Officer Wilkins' maneuver, the man moves to keep Officer Wilkins
from getting behind him. He seems clearly agitated by the move and loses
rapport with Officer Jones. The officers both begin asking the man to stand
still, but the man gets increasingly agitated to the point that the officers
become concerned for the safety of staff and other hospital visitors in the
area.
32
34. VETERANS HEALTH ADMINISTRATION
Case Example: Tactical Transparency
Officers Jones and Wilkins respond to a call from a reception staff member near
the front lobby of a busy local hospital. Upon arrival, they witness a man in his
mid to late 50's, yelling and waving his arms at hospital staff.
Officer Jones asks the man to calm down and tell him what happened. Officer
Jones recognizes a military tattoo on the man's forearm and recognizes that this
man may be acutely aware of police training and tactics. Officer Jones knows
that his partner will begin gradually working around the side of the scene to
check the man's back pockets for signs of weapons. Knowing that any advantage
to keeping the maneuver covert may not exist, he tells the man "My partner
here is just walking around to see if you have any weapons on you, so that we
can make sure everybody here stays safe."
The man replies, "I saw what you're doing. I don't want you sneaking around
behind me, and anyway I don't have any weapons on me." He turns and shows
Officer Wilkins the back of his pants, and the conversation continues between
the man and Officer Jones.
33
35. VETERANS HEALTH ADMINISTRATION
Increasing Situational Awareness: The
Grounding Technique
• The grounding technique may be useful in addressing intrusive
thoughts and flashbacks related to a prior traumatic event.
• The goal is to help an agitated person to focus on the current
situation with the police officer, rather than thinking about and
responding to events in his or her own head.
• This technique can be used in many situations in which
individuals would benefit from an increased attention to
current circumstances. For example, you may use it to help an
acutely suicidal person who is experiencing extreme
hopelessness.
• At any sign that this grounding is further frustrating the person,
stop and give something else a try.
34
36. VETERANS HEALTH ADMINISTRATION
The Grounding Technique Actions
This technique works best when kept simple. It has 3 basic elements:
1. Assessment: Assess if there are deviations from typical
communication, such as:
– Maintaining eye contact less than 80% of the time
– Answering questions in a way that does not directly addresses the question
– Pausing to think in a way that does not appear to be linked to the question
at hand
2. Introduction to the technique: This should suit your style. An
introduction may be as simple as breaking into the conversation
with a statement such as, “You seem upset. I'm going to ask you
a few very simple questions just to check in with you.”
35
37. VETERANS HEALTH ADMINISTRATION
The Grounding Technique Actions
3. Questioning: Proceed through progressively more difficult
questions that require the individual to attend to sensory
stimuli in the immediate environment:
Phase 1:
– Tell me something you see here right now.
– Tell me something you hear right now.
– Tell me something you can touch/feel right now.
Phase 2: If you are uncertain the person is sufficiently oriented to the
present, increase the difficulty of questions:
– Tell me two new things that you see here right now.
– Tell me two new things that you hear right now.
– Tell me two new things that you can touch/feel right now.
Phase 3: Adjust the Questioning step as needed.
36
38. VETERANS HEALTH ADMINISTRATION
Case Example: Grounding Technique
Officers respond to a disturbance call in a public parking lot. A disheveled
man is pacing in the lot and he approaches officers when they arrive.
The man answers some questions that officers ask, but not all. He
appears to be thinking about things unrelated to his conversation with
the officers, but begins to describe a situation where some "kids" threw
a cup of ice at him in the parking lot. As he tells his story, he becomes
increasingly agitated beyond what is reasonable for the events described.
The primary officers attempt the grounding technique, stating "I'm going
to ask you a few simple questions just to check in with you, ok?" The
man is pacing back and forth and grabbing at his hair, but says "yeah" to
the officer's inquiry.
37
39. VETERANS HEALTH ADMINISTRATION
Case Example: Grounding Technique
"Tell me something you can see right here in the parking lot."
Pacing back and forth the man does not respond. "Just tell me
one thing you see right here in the parking lot," repeats the
officer. "I see you," says the man. Seeing the improvement, the
officer moves on, "Great, now tell me something you can hear
right now," to which the man replies "I hear the traffic going by."
The officer continues to ask questions of increasing difficulty
(e.g. "Now tell me two new things…"), and finally asks the man,
"Are you doing ok enough that we can talk about what
happened again?" The man affirms, and is able to continue with
some questioning without increased agitation.
38
40. VETERANS HEALTH ADMINISTRATION
Making a Referral to Treatment
Depending on the policy of your department, you may be able to provide
Veterans with information about treatment resources available in the local
area. Resources available differ by geographic region.
Many different Veteran-specific treatment options exist:
• Most communities have access to Department of Veterans Affairs (VA) health care
facility. Since 2009, every VA medical center has had a Veterans Justice Outreach
(VJO) Coordinator to spearhead local efforts directed toward Veterans who come
into contact with the legal system.
• Other types of sites may include those specifically for women Veterans, for
Veterans who served in combat, or for Veterans needing acute substance
detoxification.
• While some agencies are funded and run as government entities (state, county),
many other excellent options exist in the form of non-profit treatment and
advocacy agencies specifically dedicated to improving the lives of America's
Veterans.
39
41. VETERANS HEALTH ADMINISTRATION
CIT Training: Advanced Skills in De-Escalation
• The Crisis Intervention Team (CIT) model (a.k.a. the
"Memphis model") is widely accepted as the gold
standard of police training in crisis intervention.
• While the CIT model includes additional detailed training
in mental health issues and de-escalation techniques, it is
also a model for integrating police and other community
resources to increase officer and public safety and
improve the lives of all.
• The CIT model is highly regarded and recommended by
the mental health advocacy group, National Alliance on
Mental Illness (NAMI).
40
43. VETERANS HEALTH ADMINISTRATION
Stress First Aid (SFA) Model
The Stress First Aid (SFA) model is
a self-care and peer support
model developed for those in
high-risk occupations like military,
fire and rescue, and law
enforcement.
It includes seven actions that will
help you to identify and address
early signs of stress reactions in
yourself and others in an ongoing
way (not just after “critical
incidents”).
42
44. VETERANS HEALTH ADMINISTRATION
When Is SFA Needed?
While stress reactions may be relatively common in law
enforcement jobs, SFA has been developed to be used
when functioning is impaired or there is significant
distress involved, such as:
• No longer feeling like your normal self
• Loss of control of emotions or behavior
• Excessive guilt, shame or blame
• Panic, rage or depression
43
45. VETERANS HEALTH ADMINISTRATION
Stress Continuum Model
READY
(Green)
REACTING
(Yellow)
INJURED
(Orange)
ILL
(Red)
DEFINITION
Optimal functioning
Adaptive growth
Wellness
FEATURES
At one’s best
Well-trained and prepared
In control
Physically, mentally and
spiritually fit
Mission-focused
Motivated
Calm and steady
Having fun
Behaving ethically
DEFINITION
Mild and transient
distress or impairment
Always goes away
Low risk
FEATURES
Feeling irritable, anxious or
down
Loss of motivation
Loss of focus
Difficulty sleeping
Muscle tension or other
physical changes
Not having fun
CAUSES
Any stressor
DEFINITION
More severe and
persistent distress or
impairment
Leaves a scar
Higher risk
FEATURES
Loss of control
Panic, rage or depression
No longer feeling like
normal self
Excessive guilt, shame or
blame
CAUSES
Life threat
Loss
Inner conflict
Wear and tear
DEFINITION
Clinical mental disorder
Unhealed stress injury
causing life impairment
FEATURES
Symptoms persist and
worsen over time
Severe distress or social or
occupational impairment
TYPES
PTSD
Depression
Anxiety
Substance abuse
44
46. VETERANS HEALTH ADMINISTRATION
Four Types of Exposures
Intense or Prolonged Stress
Life Threat
A traumatic injury
Due to an
experience of
threat to life of self
or others, including
a “near miss” or
“close call”
Loss
A grief injury
Due to the loss
of cherished
people, things or
parts of oneself
Inner
Conflict
A moral injury
Due to behaviors
or the witnessing
of behaviors that
violate morals or
values
Wear &
Tear
A fatigue injury
Due to the
accumulation of
stress from all
sources over time
without sufficient
rest and recovery
45
48. VETERANS HEALTH ADMINISTRATION
Check
Check Actions:
Observe
Look
Listen
Keep Track
Stressors
Distress
Changes in
functioning
Response to
interventions
Examine
One-to-one
interactions
Collateral
information
Decide
Dangerousness
Stress Zone
Needs
47
49. VETERANS HEALTH ADMINISTRATION
Coordinate
Coordinate Actions:
Collaborate
To promote
recovery
To ensure
safety
To get more
information
Inform
Chain of
command
Family
Peers
Refer
Recommend
resources
Consultation
Direct hand-off
48
50. VETERANS HEALTH ADMINISTRATION
Cover
Cover Actions:
Stand By
Ready to assist
Watch and
listen
Hold attention
Make Safe
Authoritative
presence
Warn
Protect
Assist
Make
Others Safe
Protect
Warn
Encourage
Perception
of Safety
Caring
presence
Reduce chaos
Reduce danger
Listen and
communicate
49
51. VETERANS HEALTH ADMINISTRATION
Cover: Personal Example
Two officers respond to a shooting. The man who answers the
door has a gun in his hand and starts shooting as he is opening the
door.
The inexperienced officer runs back to safety behind a wall. The
senior officer walks backwards as the man is shooting, providing
cover to the younger officer until they both reach safety. The
younger officer says he feels guilty for running.
The senior officer says, “I’m glad you ran away – that was your only
opportunity to get safe. If you had reacted by shooting it would
have put us both in more danger, and by you getting yourself safe, I
didn’t have to worry about you and could keep a calm head until I
got to you.”
50
52. VETERANS HEALTH ADMINISTRATION
Calm
Calm Actions:
Quiet
Stop physical
exertion
Reduce hyper-
alertness
Slow down
heart rate
Relax
Compose
Draw attention
outwards
Distract
Re-focus
Foster Rest
Recuperate
Sleep
Time out
Soothe
Listen
empathetically
Reduce
emotional
intensity
51
53. VETERANS HEALTH ADMINISTRATION
Calm: Personal Example
After a motor vehicle crash involving a child, a senior
officer told his team, “You have to stay in the moment.
Only think of what you need to do right now.”
He gave them things to do, and tried to put people in
place where they were competent at that moment. He
was calm himself, didn’t look at the body, and gave a
young trooper whose wife was pregnant another job
away from the scene.
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54. VETERANS HEALTH ADMINISTRATION
Connect
Connect Actions:
Be With
Maintain
presence
Keep eye
contact
Listen
Empathize
Accept
Promote
Connection
Find trusted
others
Foster contact
with others
Encourage
contact with
others
Reduce
Isolation
Improve
understanding
Correct
misconceptions
Restore trust
Invite and
include
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55. VETERANS HEALTH ADMINISTRATION
Connect: Personal Example
A department was involved in a civilian being shot by an officer.
Officers were concerned that they couldn’t speak about the incident
amongst themselves until after a grand jury investigation.
The Critical Incident Response Team (CIRT) was called in because its
members could maintain confidentiality. Because the CIRT members
were trained in the SFA model, they were able to discuss with
officers how the incident had impacted sense of safety, sense of
calm, relationships, and sense of competence and confidence
without discussing the details of the event.
In the meantime, the superintendent in charge of internal affairs
made the rapid completion of the investigation a high priority.
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56. VETERANS HEALTH ADMINISTRATION
Competence
Competence Actions:
Social Skills
Develop family
relationships
Develop peer
relationships
Seek mentoring
Occupational
Skills
Brief
operational
pause
Mentor back to
duty
Retrain
Reassign
Well-Being
Problem-solving
skills
Health and
fitness
Managing
trauma and loss
reminders
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57. VETERANS HEALTH ADMINISTRATION
Competence: Personal Example
A commanding officer makes sure to mentor his crew when they are
showing signs of Orange zone stress, by giving them respite, training, or
advice. If things get worse, he is not afraid to tell them that if they keep
going without getting some help, they’re going to lose their job, family, or
life.
He sent one officer to inpatient mental health treatment for suicidality,
and got another help for a painkiller habit she developed after shoulder
surgery.
He also has someone in the department screen and interview local
mental health professionals, so he is confident that when he refers his
officers to treatment, they are getting names of providers who are well
trained and who understand the law enforcement culture.
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58. VETERANS HEALTH ADMINISTRATION
Confidence
Confidence Actions:
Trust
Trust in:
Peers
Equipment
Leaders
Mission
Hope
Forgiveness of
self
Forgiveness of
others
Imagining the
future
Self-Worth
Belief in self
Accurate self-
concept
Self-respect
Meaning
Making sense
Purpose
Faith
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59. VETERANS HEALTH ADMINISTRATION
Confidence: Personal Example
A number of agencies were involved in an active shooter
situation. At the conclusion of the incident, a lot of the junior
officers who were involved were concerned about what they
could have done differently.
A senior officer established an after-action review using senior
peers, because he knew that only respected senior peers
would be able to guide the younger officers away from
blaming themselves for things. The senior peers were in the
best position to let the junior officers know that everyone goes
through similar situations and the right approach is to learn
from all calls rather than blaming or second-guessing oneself.
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60. VETERANS HEALTH ADMINISTRATION
Group / Educational Format I
In certain circumstances, SFA actions can be used to structure a
group following a stressful event. In this case, there are important
differences between SFA group format and a debriefing model:
• No one is required to attend if they don’t want to attend, and the
group doesn’t need to occur within any specific window of time
following the event. Those involved should determine the best time
for the group.
• The stressful event is not revisited or described in detail.
• The discussion is focused on how the event is impacting individuals in
the present moment, and into the future, within the SFA frame of
five essential human needs (the needs for cover, calm,
connectedness, competence, and confidence).
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61. VETERANS HEALTH ADMINISTRATION
Group / Educational Format II
Essential
Need
Question
Cover • How has the incident (event) affected your sense of safety?
Calm
• What changes have occurred regarding sleep, feelings of being on edge, or
ability to keep calm? What helps?
Connection
• Has there been an impact on how you talk with each other, work morale, or
connecting with family and friends?
• Is there someone you feel comfortable talking with about this?
• Has anyone you know done or said something that really helped?
Competence
• Any concerns about being able to handle what’s going on in your life, deal
with your stress reactions, or do your work? Listen for cues that may suggest
other challenges to coping.
• What are some things that you have done to cope that have been helpful in
the past, or have been helpful since this event / incident?
Confidence
• Any change in your confidence in your ability to do your job in the same way
as before the event, or in leadership?
• Does this incident (event) hold special meaning or connect with other
experiences in any way?
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62. VETERANS HEALTH ADMINISTRATION
Group / Educational Format III
After the discussion prompted by the questions, you can include
a short discussion about the importance of being particularly
disciplined in self-care and looking out for one another for a
period of time, including:
• Participating in more healthy forms of coping
• Being diligent about getting enough sleep by reducing any
distractions that one can control
• Minimizing negative coping (such as isolation, using alcohol or
substances to sleep)
• Making use of available resources.
Finally, ask if there is any other support they need.
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63. VETERANS HEALTH ADMINISTRATION
SFA: Take Home Messages
• SFA actions are to be used as needed for
yourself or with coworkers who are
experiencing either significant distress or
decrements in functioning.
• SFA actions should be incorporated into
duties in a natural, seamless way, and
implemented only when needed.
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65. VETERANS HEALTH ADMINISTRATION
PTSD Is Not a Broken Brain
• PTSD is the brain's mechanism for registering life-threatening
events.
• When presented with similar circumstances, our bodies react
with a "fight or flight" response.
• The "fight or flight" response could keep us safe if the threat is
real.
• For an individual with PTSD, the brain can over-generalize and
register regular events as life threatening as well, such as:
– Car backfire
– An argument with a spouse
– Being cut off on the freeway
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66. VETERANS HEALTH ADMINISTRATION
PTSD Is Not a Broken Brain
• The immediate goal for someone with PTSD is to
increase personal safety.
• Having symptoms of PTSD is an adaptive response
to a threatening environment that is now being
employed too frequently.
• Because these reactions often go unrecognized
until a crisis situation arises, police officers may
have the first opportunity to steer someone with
PTSD toward getting the help they need.
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67. VETERANS HEALTH ADMINISTRATION
The Traumatic Event
• PTSD follows an event which is considered traumatic when
a person is confronted with death or serious injury or the
threat of death or serious injury, via:
– Direct exposure
– Witnessing, in person
– Indirectly, by learning that a close relative or close
friend was exposed to trauma
– Repeated or extreme indirect exposure to aversive
details of the event(s), usually in the course of
professional duties
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68. VETERANS HEALTH ADMINISTRATION
The Resulting Symptoms
• For police officers, it may be useful to recognize that PTSD
symptoms fall into two types:
– Symptoms that are of immediate interest to police officers
(e.g., quick escalation to anger)
– Symptoms that are not immediately obvious, but that
operate "behind the scenes" to undermine the ability of
someone to respond appropriately (e.g., extreme lack of
sleep)
• The experience of someone with PTSD can be more
complicated than is immediately evident from more
obvious symptoms.
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69. VETERANS HEALTH ADMINISTRATION
PTSD Symptom Categories
Alterations in
Arousal and
Reactivity
Negative
Alterations in
Cognitions
and Mood
PTSD
Avoidance
Intrusion
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70. VETERANS HEALTH ADMINISTRATION
Intrusion Symptoms
Bad memories of the traumatic event can come back at any time. When
active, these symptoms move the person toward a "fight or flight" response,
negatively impacting the safety of the situation. These can include:
• Intrusive thoughts, which can be agitating and anxiety-provoking.
• Emotional and physical reactivity to reminders, which can commonly cause
emotional and/or physical reactions that can be confused for other things, such as
lying or fear of getting caught doing something illegal.
• Flashbacks, which can cause a person to feel as though they are actually back at
the time and place of the traumatic event, re-experiencing the sights, sounds, and
smells of the traumatic event, which can cause behaviors that may be
misinterpreted as aggression or resistance.
• Nightmares related to the event, which may cause the person to avoid falling
asleep for fear of reliving the event. They may reduce an individual's ability to cope
with stresses and crisis situations appropriately.
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71. VETERANS HEALTH ADMINISTRATION
Avoidance Symptoms
• Because remembering a traumatic event is distressing, the
individual with PTSD may try to avoid people, places, and things that
remind him or her of it, or try to avoid talking about or thinking
about the event.
• Avoidance may not be so obvious. For example, someone assaulted
by another person in uniform may avoid contact with anyone in
uniform.
• Those with PTSD may attempt to avoid life in general, becoming very
isolated, keeping to themselves in their homes, and avoiding all
social contact with the outside world.
• The support of family and friends can erode or disappear
completely, leading to chronic distress and poor functioning.
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72. VETERANS HEALTH ADMINISTRATION
Negative Alterations in Cognitions and Mood
Those suffering from PTSD may find it hard to express or even
feel emotion. These symptoms may include:
• Being unable to recall key features of the traumatic event
• Persistent (and often distorted) negative beliefs and expectations, such as
"I am bad," or "The world is completely dangerous”
• Exaggerated blame of self or others for causing the traumatic event or for
resulting consequences
• Persistent negative trauma-related emotions such as fear, horror, anger,
guilt, or shame
• Markedly diminished interest in (pre-traumatic) significant activities
• Feeling isolated from others
• Difficulty experiencing positive emotions
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73. VETERANS HEALTH ADMINISTRATION
Alterations in Arousal and Reactivity
As a result of living through a traumatic event that was
unpredicted, the individual with PTSD may respond by being
overly alert at all times. Even non-threatening things can be
misperceived as dangerous or threatening. These symptoms
may include:
• Irritability or aggression
• Risky or destructive behavior
• Hypervigilance, feeling “jittery” or “keyed up”
• Heightened startle reaction
• Difficulty concentrating
• Difficulty sleeping
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74. VETERANS HEALTH ADMINISTRATION
Course of Symptoms and Triggers
• When confronted with a traumatic event, the vast
majority of us will experience at least some symptoms of
PTSD.
• For many, the symptoms fade away over the coming
weeks and months. For some, the symptoms may linger,
even for years. Only in very severe circumstances,
however, are the symptoms constantly "turned on.”
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75. VETERANS HEALTH ADMINISTRATION
Course of Symptoms and Triggers
• Most often, PTSD symptoms will come and go, and are often brought
on by some sort of stressor or reminder of the traumatic event, known
as "triggers." Some examples include:
– Hearing a car backfire for someone who was traumatized in the presence
of gun fire
– Seeing a car accident, which can remind a crash survivor of his or her own
accident
– Seeing a news report of a sexual assault, which may bring back memories
of an assault
• However, a trigger may not always be obvious. It can be anything that
reminds someone of a traumatic event. Typically, these are stimuli that
were present at the time that the traumatic event occurred (i.e.,
similar circumstances, same time of year, smells, sounds, feelings).
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76. VETERANS HEALTH ADMINISTRATION
Substance Use Commonly Co-Occurs with PTSD
• For people with PTSD, the two most common co-occurring problems
are substance abuse and depression.
• PTSD usually precedes the substance use and substances are used as
a symptom management strategy (i.e., “numbing the pain”).
• Substance withdrawal symptoms may trigger and exacerbate PTSD
symptoms, initiating a cycle that precipitates poorer addiction
outcomes.
• In one study, 28% of women and 52% of men with PTSD also had a
Substance Use Disorder (SUD).
• Combined SUD and trauma-focused treatment for PTSD is
recommended.
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77. VETERANS HEALTH ADMINISTRATION
Depression Commonly Co-Occurs with PTSD
• Depression is nearly 3 to 5 times more likely among those
with PTSD than those without PTSD.
• Painful memories, feelings of guilt or regret, loss or reduced
trust in other people – all of which can be symptoms of PTSD
- can lead to depression.
• Both depression and PTSD include negative thoughts and
beliefs, greater irritability, trouble sleeping, difficulty keeping
one’s mind focused, loss of pleasure or interest in things one
used to enjoy, or isolation.
• Cognitive behavioral therapy (CBT) and use of some
antidepressants have proven effective for both problems.
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78. VETERANS HEALTH ADMINISTRATION
Why Understand Treatment Options?
• PTSD treatments are among the most effective available for any
mental health problems.
• Knowing that PTSD has effective treatments may be helpful in cases
where you have the opportunity to refer those with PTSD to
treatment.
• The two main types of PTSD treatment include specific
psychotherapies, sometimes called “counseling” or “talk therapy,”
and certain types of medication, like antidepressants. Sometimes
people combine psychotherapy and medication to best manage
PTSD.
• For a full description of treatment options and help on how to find
a treatment provider, visit the National Center for PTSD website:
http://www.ptsd.va.gov
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79. VETERANS HEALTH ADMINISTRATION
Case Example 1: Aggressive Driving
Mary is a recently returned Veteran. While deployed, she drove in several convoys
that were twice attacked by IED's (Improvised Explosive Devices) planted
alongside the road.
Since being home, she has felt quite agitated while driving because where she
lives, the cars drive closely together and it reminds her of time spent driving in
convoys. When she drives to work, she is on a busy high-speed section of freeway.
One afternoon, a car in the lane beside her suddenly moved into her lane, cutting
her off. She avoided slamming into the car, but immediately got very angry at the
other driver. Perceiving this car as a threat, Mary accelerated and passed the car
by using the breakdown lane. She then merged directly in front of it and gave a
sharp tap on the brake to threaten the driver behind her.
Observing this from farther back, a third driver called 911 and reported Mary's
license plate and vehicle description. By this point, Mary is extremely agitated and
angry. A state trooper pulls in behind her car and turns on the lights.
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80. VETERANS HEALTH ADMINISTRATION
Case Example 2: Domestic Disturbance
Steve is between deployments with the National Guard. During his last
deployment, his barracks was attacked with mortar and machine gun
fire while he was sleeping.
Since then, Steve has felt safer sleeping with his sidearm by the bed.
His wife is very upset with this, and she finally expresses her concerns.
Rather than talking in a rational manner about his wife's feelings, Steve
reacts with anger. He feels the need to defend his behavior because
this is what makes him feel safe at night. The argument escalates and
Steve recognizes that both he and his wife have been yelling at each
other.
Outside, a police car pulls up. A neighbor has apparently called the
police again.
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