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J Loss Trauma. 2016;21(2):147-159. Epub 2015 Sep 25.

Trauma-Informed Medical Care: Patient Response to a Primary Care Provider Communication Training.

Author information

1
Department of Psychiatry, Georgetown University Medical School, Washington, DC, USA.
2
Department of Psychiatry, Georgetown University Medical School, Washington, DC, USA ; Department of Neurology, Georgetown University Medical School, Washington, DC, USA.
3
EPower & Associates, Nashville, Tennessee, USA.
4
University of Pittsburgh Medical School, Pittsburgh, Pennsylvania, USA.
5
Sidran Institute, Baltimore, Maryland, USA.
6
Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
7
Department of Oncology, Georgetown University Medical School, Washington, DC, USA.
8
Department of Psychiatry, MedStar Health Research Institute, Hyattsville, Maryland, USA.

Abstract

Trauma exposure predicts mental disorders and health outcomes; yet there is little training of primary care providers about trauma's effects, and how to better interact with trauma survivors. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), to evaluate its feasibility and preliminary efficacy. We randomized four primary care sites to training or wait-list conditions; PCPs at wait-list sites were trained after reassessment. Primary care providers (PCPs) were Family Medicine residents (n = 17; 2 sites) or community physicians (n = 13; 2 sites). Outcomes reported here comprised a survey of 400 actual patients seen by the PCPs in the study. Patients, mostly minority, completed surveys before or after their provider received training. Patients rated PCPs significantly higher after training on a scale encompassing partnership issues. Breakdowns showed lower partnership scores for those with trauma or posttraumatic stress symptoms. Future studies will need to include more specific trauma-related outcomes. Nevertheless, this training is a promising initial approach to teaching trauma-informed communication skills to PCPs.

KEYWORDS:

Communication; continuing medical education; patient-centeredness; primary care; trauma

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