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Implementing Trauma-Informed Care in Primary Medical Settings: Evidence-Based Rationale and Approaches
Authors:L Kevin Hamberger  Courtney Barry  Zeno Franco
Institution:1. Department of Family and Community Medicine, Medical College of Wisconsin, Milwuakee, WI, USAkevinh@mcw.edu;3. Department of Family and Community Medicine, Medical College of Wisconsin, Milwuakee, WI, USA
Abstract:ABSTRACT

Chronic stress stemming from trauma exposure and posttraumatic stress disorder (PTSD) leads to many health problems that are typically seen by primary care providers. Unfortunately, providers rarely identify trauma as the root cause of patient difficulties. The present paper provides an evidence-based rationale for implementing trauma-informed care principles and processes into medical primary care systems. Beginning with a review of prevalence of trauma exposure and PTSD in primary care clinics, this article elucidates relationships between trauma exposure and behavioral and medical health problems, as well as clinical and physiological pathways that lead from trauma exposure to illness. The article concludes with exposition of trauma-informed interventions that can be implemented in primary care clinics, and discussion of future directions.
Keywords:Trauma-informed care  trauma  primary care  PTSD  trauma and health  healthcare utilization  trauma interventions  chronic stress
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