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    Capella 4050 Assessment 1

    Capella 4050 Assessment 1 Preliminary Care Coordination Plan

    Student Name

    Capella University

    NURS-FPX 4050 Coord Patient-Centered Care

    Prof. Name


    Preliminary Care Coordination Plan

    Preliminary care coordination plans holistically organize patient information to provide effective care practices that meet patient’s needs and preferences. This assessment is based on developing a care coordination plan for patients with PTSD at Psyclarity Mental Health Facility- San Diego. The goal is to develop a preliminary care plan for PTSD, including physical, psychosocial, and cultural considerations, and to highlight the available community resources for the continuity of care. 

    Health Concerns and Associated Practices for Health Improvement

    Post-Traumatic Stress Disorder (PTSD) is a complex mental health disorder developed due to witnessing or experiencing a traumatic event such as abuse, a natural disaster, an accident, or losing a loved one. According to the American Psychological Association (2022), PTSD is characterized by intrusive thoughts, flashbacks, severe anxiety, and nightmares. It can lead to physiological and psychological effects such as avoidance of reminders of traumatic events, emotional numbing, altered mood and cognition, and arousal. The evidence-based practices that can be utilized in the effective management of PTSD are: 

    • Cognitive processing therapy helps individuals confront and repress traumatic memories and manage symptoms. The primary goal is to alter the individual’s perception regarding the situation and assist the patient in reinterpreting the tragic incident to reduce the detrimental consequences (Prajjwal et al., 2022).
    • Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based therapy for post-traumatic stress disorder involving eye movement to process distress memories and reduce PTSD symptoms. EMDR uses imaginal trauma exposure and saccadic eye movement to help people reprocess their trauma in a positive way (Susanty et al., 2020).
    • Medication such as Selective Serotonin Reuptake Inhibitors (SSRIS) helps alleviate anxiety, depression and intrusive thoughts. SSRIs are often recommended as the best treatment option for PTSD (Prajjwal et al., 2022).
    • Trauma-informed care involves recognizing the widespread impact of trauma, understanding its effect and integrating trauma-sensitive practices in support and healthcare services. It emphasizes physical, emotional and psychological safety for patients to help individuals rebuild a sense of control (Greenwald et al., 2023). 

    Assumptions and Uncertainties 

    It is important to understand the individual differences in the therapy option, as not all individuals respond to the treatment in the same manner. Variability in trauma history and comorbidity also influences treatment outcomes. Similarly, access to care varies depending on socioeconomic and environmental factors such as income, gender, culture, stigma and language differences, which significantly impact the ability to seek help. Thus, having an integrated and holistic approach to treatment may significantly improve clinical outcomes. 

    Goals to Address the Healthcare Issue 

    For the recovery from PTSD, it is important to design an intervention plan that improves the overall well-being, manages symptoms and enhances the quality of life. It is imperative to have SMART goals that are specific, measurable and attainable for individuals with PTSD. The patient will benefit from the below mentioned examples in their goal completion; 

    • Goal 1- Increasing trauma literacy among the patients: Educate the patient to actively engage and understand their own trauma experience through educational and awareness programs that educate individuals regarding PTSD, its course of action, the efficacy of treatment and medication adherence, lifestyle changes, stigma, and a culture of mental well-being (Al Jowf et al., 2022). One year training program was held to empower patients to actively engage with and understand their own trauma experiences and to foster a supportive environment for healing, which aim is to increase trauma-related literacy and encourage open dialogue regarding PTSD, treatment, and mental well-being. 

    Capella 4050 Assessment 1

    • Goal 2- Enhancing social support for healthy coping and emotional regulation among patients: Train the patient to create community support through first aid training of professionals (Chalmer et al., 2020). The goal is to educate the patient to create a support system of friends and family and develop mental health services to help individuals on coping strategies and emotional regulation to manage anxiety and distress. The number of participants and improvement in social functioning can be measured through patient and community worker feedback. One year training program can help in increasing acceptance and emotional regulation among patients through social support and assist the patient to manage anxiety.
    • Goal 3- Improving the crisis intervention services: Inform the patient to engage with professionals and improve the crisis intervention services by developing and maintaining a crisis team that responds to distressed individuals immediately. The goal is to improve crisis intervention services by 60% through a trained team of professionals such as psychologists, nurses, social workers and law enforcers. This 60% improvement will be relative to baseline data, which will be established by evaluating the current state of crisis intervention, particularly focusing on metrics like response time and success rates. Progress will be gauged by juxtaposing these baseline metrics with results after the plan’s execution. One year implementation program was developed to help the patient to receive effective care through a crisis intervention team that focuses on response time and the success rate of intervention.

    Community Resources for Safe and Effective Continuum of Care

    A comprehensive continuum of care for PTSD in a community relies on utilizing the resources designed to provide a holistic framework for awareness, treatment, support and prevention. Resources such as community centers, support groups, mental health clinics, helplines and school-based counseling significantly enhance community health through utilizing evidence-based practices. Organizations such as the Gift from Within (n.d.), a non-profitable organization working with patients with PTSD to provide peer-support, and the PTSD Alliance (n.d.), which provides support for PTSD patients through psychological services, support groups, and awareness resources, both of these organizations offer assistance to people who are suffering from the condition. 

    Mental health clinics offer therapeutic and counseling services that help patients work on their traumas and underlying aspects, such as unresolved childhood conflict and relationships, and improve their overall functionality. The community health centers provide primary care, such as screening and assessment for patients with PTSD. Research-based on comparing the collaborative care program-based clinic and co-located services and an on-site therapist highlighted improved symptoms of PTSD while favoring collaborative care-based clinics (Kaltman et al., 2019).

    Support groups like NAMI (n.d.) promote a culture of support, belonging, and emotional healing, while crisis helplines like San Diego Access and Crisis Helpline (Health and Human Agency, n.d.) assist with immediate situations and emergencies pertaining to behavioral health. Moreover, school-based counseling provides an opportunity for early assessment and intervention. 


    The current assessment was based on developing a preliminary care coordination plan for the patient with PTSD. The plan advocates improving trauma-related literacy, community support and crisis intervention services while utilizing community services such as mental health clinics, community centers, support groups, crisis helplines and school-based counseling programs. The aim is to improve the quality of care by involving community support groups. 


    Al Jowf, G. I., Ahmed, Z. T., An, N., Reijnders, R. A., Ambrosino, E., Rutten, B. P. F., de Nijs, L., & Eijssen, L. M. T. (2022). A public health perspective of post-traumatic stress disorder. International Journal of Environmental Research and Public Health, 19(11), 6474.

    American Psychological Association. (2022, November). Post-traumatic stress disorder (PTSD).

    Chalmers, K. J., Jorm, A. F., Kelly, C. M., Reavley, N. J., Bond, K. S., Cottrill, F. A., & Wright, J. (2020). Offering mental health first aid to a person after a potentially traumatic event: A Delphi study to redevelop the 2008 guidelines. BMC Psychology, 8, 105.

    Gift From Within (n.d.). Post traumatic stress disorder information & healing (Ptsd). 

    Greenwald, A., Kelly, A., Mathew, T., & Thomas, L. (2023). Trauma-informed care in the emergency department: Concepts and recommendations for integrating practices into emergency medicine. Medical Education Online, 28(1), 2178366.

    Health and Human Service Agency (n.d.). County of San Deigo,and%20Crisis%20Lifeline%2C%20call%20988

    Kaltman, S., Watson, M. R., Campoli, M., Serrano, A., Talisman, N., Kirkpatrick, L., Mete, M., & Green, B. L. (2019). Treatment of depression and PTSD in primary care clinics serving uninsured low-income mostly Latina/o immigrants: A naturalistic prospective evaluation. Cultural Diversity & Ethnic Minority Psychology, 25(4), 579–589.

    NAMI San Diego (n.d.). Support groups.

    PTSD Alliance (n.d.). Ptsd & posttraumatic stress disorder.

    Prajjwal, P., Inban, P., Natarajan, B., Mitra, S., Tango, T., Ahmed, A., Bansode, S., & Almushawah, A. A. (2022). Current treatments of post-traumatic stress disorder and amygdala ablation as a potential cutting-edge therapy in its refractory cases. Cureus, 14(11), e31943.

    Susanty, E., Sijbrandij, M., Srisayekti, W., Suparman, Y., & Huizink, A. C. (2022). The effectiveness of eye movement desensitization for post-traumatic stress disorder in Indonesia: A randomized controlled trial. Frontiers in Psychology, 13.

    Capella 4050 Assessment 1