Welcome to Scribd, the world's digital library. Read, publish, and share books and documents. See more
Download
Standard view
Full view
of .
Look up keyword
Like this
1Activity
0 of .
Results for:
No results containing your search query
P. 1
CREW v. U.S. Department of the Army: Regarding PTSD Diagnoses: 5/24/2011 - Release Part 3

CREW v. U.S. Department of the Army: Regarding PTSD Diagnoses: 5/24/2011 - Release Part 3

Ratings: (0)|Views: 7 |Likes:
Published by CREW
On April 17, 2009 Citizens for Responsibility and Ethics in Washington (CREW) filed a Freedom of Information Act (FOIA) request with the Department of the Army, seeking records related to guidance given to army staff and contractors regarding the diagnosis of post traumatic stress disorder (PTSD). CREW seeks these records to raise public awareness about the process behind the diagnosis of PTSD and the pressure being placed on doctors to diagnose related anxiety disorders as a cost-cutting measure. The request was filed after Salon.com obtained a June 2008 taped conversation between an Army staff sergeant and an Army psychologist, in which the psychologist revealed he had been pressured not to diagnose PTSD. On July 31, 2009, CREW filed a lawsuit against the Army, CREW v. Dep't of the Army, challenging the Army's failure to produce records in response to CREW's FOIA request seeking documentation of Army guidance that discourages diagnoses of post traumatic stress disorder (PTSD). The Veterans Affairs has issued similar guidance that CREW also is seeking to document through a FOIA request that is also the subject of pending litigation.
On April 17, 2009 Citizens for Responsibility and Ethics in Washington (CREW) filed a Freedom of Information Act (FOIA) request with the Department of the Army, seeking records related to guidance given to army staff and contractors regarding the diagnosis of post traumatic stress disorder (PTSD). CREW seeks these records to raise public awareness about the process behind the diagnosis of PTSD and the pressure being placed on doctors to diagnose related anxiety disorders as a cost-cutting measure. The request was filed after Salon.com obtained a June 2008 taped conversation between an Army staff sergeant and an Army psychologist, in which the psychologist revealed he had been pressured not to diagnose PTSD. On July 31, 2009, CREW filed a lawsuit against the Army, CREW v. Dep't of the Army, challenging the Army's failure to produce records in response to CREW's FOIA request seeking documentation of Army guidance that discourages diagnoses of post traumatic stress disorder (PTSD). The Veterans Affairs has issued similar guidance that CREW also is seeking to document through a FOIA request that is also the subject of pending litigation.

More info:

Published by: CREW on May 25, 2011
Copyright:Public Domain

Availability:

Read on Scribd mobile: iPhone, iPad and Android.
This book can be read on up to 6 mobile devices.
download as PDF, TXT or read online from Scribd
See more
See less

01/01/2014

pdf

text

original

 
PatientEngagement
Educatingpatientsaboutdepressionandtreatmentoptionsoftenhasalreadystartedpatientsbecomingpartnersintheircareprocess.Thenextstepisprovision
of
morespecificengagementaroundagreedtreatment.
ProvideKeyEducationalMessages
Forpatientsstartingantidepressantmedication
(availableasapatienteducationhandout):
Table7:AdvicetoPatientsCommencingAntidepressantTherapy
Antidepressantsonlywork
if
takeneveryday.Antidepressantsarenotaddictive.Benefitsfrommedicationappearslowly.Continueantidepressantsevenafteryoufeelbetter.Mildsideeffectsarecommon,andusuallyimprovewithtime.
If
youarethinkingaboutstoppingthemedication,callmefirst.Thegoal
of
treatmentiscompleteremission;sometimesittakesafewtries.Forpatientsstartingpsychologicalcounseling:Counselingtakesalittlelongerbeforeyouwillfeelanyimprovements.Keepyourappointmentswiththetherapist.Behonestandopen,andaskquestions.Workcooperativelywiththetherapist(e.g.completetasksassignedtoyouaspart
of
thetherapy).
If
youhaveproblemsorarenotsatisfiedwithyourtherapist,callusand
we'll
helpyou.Tellallpatients:
If
youarefeelingworse,
don't
waituntilyournextappointment.Callmyofficerightaway!
EncourageaSelf-ManagementPlan
Encouragethepatienttoselectasmall,achievablegoaltoworkoneachweekforthenextseveralweeks.Selectingaself-managementplanisanactivity
to
reinforcepositivecopingandhelpalleviatesomesymptomswhilewaitingfortheeffects
of
medication.
In
addition,self-managementcanpromotethepatient'sconfidenceandactivationboth
of
whichareassociatedwithimprovedmentalhealthoutcomesGoalsshouldbesimplewithsmallincrementstobeginwithandcanincludephysicalactivity,pleasurableactivities,spendingtimewithsupportivepeople,orrelaxingactivities.Thefollowingformcanbeusedasahelpfulreminderandreinforcement.
 
Figure6:Self-ManagementWorksheet
SELF-MANAGEMENTWORKSHEET
Thereare
a
number
of
thingsyou
can
doto
helpyourselffeel
betterwhenyou'renot
at
your
best.
We
suggest
you
selectoneactivity
here
that
you
can
staft
on.
Remember
to
take
itslowlyat
fint
andaddnew
things
asyoubegin
to
feel
Everyday
next
week,Iwill
spend
atleastminutes(makeiteasy,reasonable)doing:
I
Everydaynextweek,Iwill
practice
physical
relaxation
atleast
__
times,
for
atleast
minutes
eachtime(makeiteasy,reasonable).
4.
Practice
relaxing.F
Q[
manypeople,the
changesthat
come
withdepressioncanleadtoanxiety.SincephysicaltelaxaOon
can
leadtomental
relaxation,
ptactidng
relazing
is
another
wayto
help
yoocselE
Try
deep
bteathing,
or
takeaWatmbath,
or
justfindaguiet,comfortable,peacefulplace
and
say
comforting
things
to
yoocself(like
"It's
okay.").
5.
Simple
goal.
and
.maD
.rep
••
It's
easytofeel
overwhelmed
whenyoo'te
depressed,
Some
pmblemsand
decisionscanbedelayed,
but
otherscannot.
It
can
be
hard
todealwith
themwhenyou're
feelingsad,havelittleenergy
and
are
not
thinkingasclearlyasusual.
Try
breakingthings
downinto
smallsteps.
Giveyoorself
credit
for
each
step
youaccomplish.
Thepmblem
is:_
My
goal
is:_
Step
1:_
Step
2:_
Step
3:
6.
Eat
ftOtritiODO,
balanced
meat.
aod
avoidalcohol
Alcoholisadepressant
and
can
add
tofeeling
downand
alone.It
can
also
interfere
with
thehelpyoomayreceivefrom
antidepressant
medication.
1.
Remain
physicaDyactive.
Makesureyoumaketime
to
address
YOUt
basicphysiealneeds,forexample,walkingforacertain
amount
oftime
each
day.
2.
Make
time
fOr
pleuorable
activitie..
Eventhough
you
rrYRf
not
feelasmotivated,
Q[
getthe
same
amount
of
pleasureasyou
used
to,
commit
to
scheduling
some
funactivityeachday
rrYRfbe
a
fsvorite
hobby.Everydaynextweek,Iwill
spend
atleast
minutes
(makeiteasy,
reasonable)
doing:
J.
Speod
time
with
peoplewho
can
.opport
yoo.
It's
easy
to
avoid
contactwith
people
whenyou'tedown
Q[
not
at
YOOt
best,
but
you
need
the
support
of
friends
and
family.Explainto
themwhat
youate
experiencing,
if
you
can,
If
you
can't
talk
about
it,
that's
okay.
Just
asking
them
tobe
with
yoo,maybe
dutingone
of
YOUt
activities,isa
good6rst
step.
During
the
next
week,Iwillmake
contact
for
atleast_minutes(makeiteasy,
reasonable)
with(name)
doing!
talkingabout:
During
thenextweek,Iwill
improve
my
diet
by:(example,drinking
watet
at
soda
instead
of
alcohol).
 
Explain
and
Recommend
Care
Management
Explainrole
of
thecaremanagerasasystematicextension
of
theclinician'sabilitytomonitortreatmentresponseandsideeffectsaswellastoassistthepatientinmaintainingoradjustingself-managementgoals.Thecaremanagercallsinoneweektobesuretreatmenthasstartedortohelpsolveproblems
if
ithasnot.Thecaremanagergenerallycallsatsubsequent4-weekintervalstore-administerthePHQ-9toassesseffects
of
treatment.Verifyingthebestavailablephonenumberforthepatientwillfacilitateaneasyinitialcontactbythecaremanager.Lettingthepatientknowtypicalcaremanagercontactintervalsandfollow-upofficevisitappointmentswillhelpintreatment.ThencompleteandtransmitaReferraltothecaremanagerviaCHCSII/AHLTAincludingrelevantdetailsasdemonstratedinFigure7.
Figure7:ReferraltoCareManagement
(CHCSII/AHLTA)View
Referral
Patient:Jones,JohnPatSSN:xxxxxxxxReasonforReferral:
RESPECTID
#
0001FMP/SSN:xxxxxxxxSex/DOB/Age:22y22yomalescreenedpositivefordepression
withPHQ9
results
of
6symptoms
and
score
of
16.Pt.electedtostartatluoxetine20mgandwillbereturningtoclinicinImonth.
Pt.
selectsswimmingasaself
management
goal
and
will
startat
1x
per
week.
Pt.agreesto
care
management/requests
call.
Homephone
#
preferredand
verified.

You're Reading a Free Preview

Download