NeuroFlow strives to meet our users where they are and accommodate the unique and diverse needs of the people using our platform. We are constantly improving our solutions to achieve that goal. As a member of the clinical operations team at NeuroFlow, I’m focused on developing a platform experience that provides tailored support and takes into account the diverse backgrounds of our users. To that end, NeuroFlow has incorporated the tenets of trauma-informed care, an approach that recognizes the impact of trauma on individuals’ physical and mental well-being and incorporates those insights into their care.
More providers and health plans are recognizing the impact of trauma on health and are making trauma-informed care a top priority. Robert Block, former president of the American Academy of Pediatrics, has been widely quoted as saying, “Adverse childhood experiences are the single greatest unaddressed public health threat facing our nation today.” Before diving into how NeuroFlow supports those who have experienced trauma, it’s important to understand what trauma-informed care is and why it’s important.
A Quick Primer on Trauma-Informed Care
Providing trauma-informed care is essential in delivering effective physical and behavioral healthcare. The approach was established in in-person care settings, but the emergence of virtual care calls for technology to embrace trauma-informed practices through both design and content delivery.
Most of the early research into the impact of trauma on the body and the brain was in response to symptoms seen in military service members after combat. Our understanding of the widespread impact of trauma and how it affects physical and mental health grew with the 1997 CDC study on Adverse Childhood Experiences, known as ACES, which showed a strong correlation between childhood trauma and poor health outcomes in later life.
Types of Childhood Trauma
Source: Centers for Disease Control and Prevention
Credit: Robert Wood Johnson Foundation
Increased Health Risk Due to Trauma
Source: Centers for Disease Control and Prevention
Credit: Robert Wood Johnson Foundation
When preparing to treat individuals who have experienced trauma, it’s important for providers to consider both trauma-specific treatment and trauma-informed care. Trauma-specific services are clinical interventions, whereas trauma-informed care addresses organizational culture and practice. Trauma-specific treatment is provided by specially trained clinicians and may be appropriate to treat PTSD in some patients. But trauma-informed care can be provided by any healthcare provider and can be used to support all individuals who have experienced trauma.
According to SAMHSA, trauma-informed care is defined by the “Four Rs”. To be trauma-informed an organization must realize the widespread impact of trauma and understand potential paths for recovery, recognize the signs and symptoms of trauma in clients, families, and staff, respond by fully integrating knowledge about trauma into policies, procedures, and practices, and actively resist re-traumatization.
How NeuroFlow Supports Trauma-Specific Treatment
In order to identify trauma and measure treatment progress, providers and payors need validated assessments that are readily available for individuals. Healthcare organizations using NeuroFlow can assign their patients the PC-PTSD-5, a five-item screening tool designed to identify individuals with probable PTSD and the PCL-5, a longer screening used to make provisional PTSD diagnosis and monitor symptoms during treatment. Providing these assessments via NeuroFlow allows individuals the opportunity to answer sensitive questions whenever they feel most comfortable while also enabling their provider or health plan to have information they need to provide trauma-specific treatment.
For individuals who do screen positively for trauma, NeuroFlow offers PTSD-focused digital health journeys for both population health and integrated care settings to provide relevant education to help individuals manage their symptoms. As a self-service tool, NeuroFlow gives individuals with trauma access to resources and support 24/7, to continue learning and practicing outside of their trauma treatment sessions, and to build resilience and self-efficacy.
How NeuroFlow Deploys Trauma-Informed Technology And Support
As behavioral healthcare providers increasingly use technology to support and enhance their work with patients, it’s important to ensure that the commitment to being trauma-informed extends to technology as well. For example, in-person providers can cultivate trauma-informed environments by making spaces that are safe, welcoming and relaxing using plants, paint colors, and appropriate signage. Similarly, behavioral health technology can be more respectful and supportive in its design and function.
At NeuroFlow we recognize the impact that trauma can have on the individuals that we support as well as the ways that individuals can experience re-traumatization. Our Response Services team reaches out to individuals who have been identified as at risk for self-harm and suicide with the goal of completing screenings and connecting them to the right level of care. In this outreach we often speak to individuals who have experienced trauma including the loss of a loved one, serious illness and injury, or experiences with military combat.
Our Response Services Coordinators are trained in trauma-informed care and respond with empathy and understanding in how we screen and refer individuals with trauma. We recently supported an individual who was the victim of a physical assault that affected his ability to communicate and at the end of the call he thanked our team for being patient and spending extra time on the call with him to accommodate his needs.
Sometimes our Response Services outreach requires us to connect individuals with emergency services or mobile crisis teams when they are at high risk for suicide. When signing up for NeuroFlow, individuals have the option to enter their address and emergency contact information so we are equipped to support them. NeuroFlow’s product and design team took a thoughtful approach to designing these requests for personal information with trauma-informed principles, recognizing that contact with the police and crisis services can in itself be a traumatic experience, particularly for marginalized individuals. They designed these in-app requests to give users an understanding of how their information may be used before providing it, upholding one of SAMHSA’s key principles for a trauma-informed approach: Trustworthiness and Transparency.
At NeuroFlow, our mission is to create a happier and healthier world. Recognizing the impact of trauma and equipping ourselves and our partners to better support and treat individuals with trauma is an ongoing process and a critical part of that mission. We look forward to building upon the foundation we’ve established to help facilitate trauma-informed care while also identifying more ways to support those who have experienced trauma.
Faith Best, LCSW is the Clinical Services Senior Manager at NeuroFlow.
Helpful Resources:
https://www.ptsd.va.gov/professional/assessment/screens/pc-ptsd.asp
https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp
https://www.ptsd.va.gov/understand/what/history_ptsd.asp
https://www.cdc.gov/violenceprevention/aces/about.html
https://ncsacw.acf.hhs.gov/userfiles/files/SAMHSA_Trauma.pdf
https://dl.acm.org/doi/abs/10.1145/3491102.3517475
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