CBI Health is using virtual care/telehealth to continue delivering effective treatment to clients in the wake of the pandemic. This ‘Connected Care Story’ describes how our team used exposure specialized therapy and other types of treatment (not sure what this means) to support *Noah, a client with posttraumatic stress disorder (PTSD)who was experiencing distress and anxiety following a traumatic event. (Best practice for PTSD.

I was in a tuturial.

Noah was a healthy young man in his late twenties who worked for four years as a courier throughout the Greater Toronto Area. He was about halfway through his route deliveries one day, when he was held up at gunpoint in his courier truck. The incident traumatized him and left him with distressing psychological symptoms symptoms of PTSD. He was unable to sleep or conduct normal activities, and his relationship with his family became strained. His mental distress left him feeling anxious, his energy was dissipated, and he had to take a leave of absence from work. (These are not enough to diagnose PTSD, not sure who diagnosed him.

Maybe “distressing psychological symptoms” instead ) Noah was always sociable and actively involved with his church and his family. After the traumatic event occurred, he withdrew from his faith and community. He also developed a fear of driving, which not only affected his employment, but his family life. He no longer felt comfortable or safe driving his daughter to and from daycare, which he had always looked forward to doing. Noah was referred to an occupational therapist at CBI Health who and the team began treatment with him in person before the pandemic began. (was there anyone else involved in care, like a psychologist in the community?). She assessed his heart rate, breathing and other PTSD symptoms including nightmares, upset stomach, and tightness in his chest and back. (many of these are not “assessment” for PTSD and the sentence doesn’t really look at trauma symptoms). Can we remove it? Prior to the pandemic, she the team spent months (that’s a LONG time) doing exposure therapy (as an adjunct to any other care? This is not best practice for PTSD, but again his symptoms don’t sound like PTSD. They sound like driving anxiety.) to help Noah navigate his triggers, which included guns, his uniform, and the vehicle involved in the incident. Noah and his therapist They went to a car dealership to see the model of vehicle from the incident.

They went to a hunting store for exposure to guns in display cases. They also worked with his employer who permitted access to the courier truck. They practiced getting inside the truck, driving it around the parking lot, and then eventually driving the exact delivery route Noah took when the incident occurred. (Great examples of exposure!) When the pandemic hit, Noah’s therapist healthcare team transitioned his treatment sessions to phone calls. She They continued to track his progress and goals, which addressed the importance he places on his faith, repairing his familial relationship, and returning to work. Throughout the entire process, Noah was very trusting and put forth a strong effort to work through his challenging experiences. He began managing his triggers and made tremendous progress in his recovery journey . As he worked through the trauma (not sure what this is referring to, but sounds like processing, which is not the same as exposure therapy), his nightmares started to subside. Noah became a family man again and supported his wife, who is now expecting another child. He reconnected with his church community virtually. Noah also participated in a return-to-work program (was this not part of the trauma program?) , which he has since completed to resume working as a courier. His therapist says Noah demonstrated resiliency and personal growth throughout the process, and he is now back on the road and working full-time as a courier again. We need to ensure it does not appear we have OTs assessing or diagnosing PTSD.

Also I believe in many of these cases in ONT we are not treating trauma in isolation but as a collaboration with a psychologist in the community. We don’t want to appear to be taking credit if there was other work being done. The symptoms identified do not correspond to a PTSD diagnosis and her “assessment” was predominantly physical symptoms with minimal mention of any psychological symptoms. Great if the focus is simply driving anxiety, not reflective of PTSD. Lastly, not sure how many courier trucks get held up in the GTA but from the article tells us the following demographics in addition to being held up (and only states the name is changed) he works for a courier company which wears a uniform, male, married with at least one daughter. Lives in the GTA, expecting another child and involved with his church…. That may be a bit much. Even if we just remove the location and stuff. Even if we have his permission, we should be keeping his identity confidential. I deleted some other stuff. Thanks E