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National Center for PTSD

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National Center for PTSD
Shared by: HC111124214820
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11/24/2011
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7
DEPARTMENT OF VETERANS AFFAIRS

Trauma Recovery Program

Palo Alto Health Care System

795 Willow Road

Menlo Park, CA 94025







In reply refer to:



Dear Colleague:





Thank you for your interest in the Trauma Recovery Program, the PTSD residential rehabilitation treatment

program at the VA Palo Alto Health Care System. Enclosed, please find the referral packet for admission

of men and women to our residential treatment programs.



The Trauma Recovery Program, located at the Menlo Park Division of the VA Palo Alto Health Care

System, provides state-of-the-art diagnostic assessment and evaluation of male and female veterans and

active duty personnel experiencing war zone related stress, sexual trauma while serving in the military, or

other traumatic events experienced during military service. The Women’s Trauma Recovery Program is a

10 bed facility opened in 1992 to provide women an opportunity for gender specific residential treatment for

PTSD located in a building designated specifically for the treatment of women. The Men’s Trauma

Recovery Program is a 40 bed facility originally opened in 1978 for the treatment of men with military

related PTSD. All individuals are admitted for a period of approximately 60 to 90 days; this timeframe can

be adjusted based on the individual’s clinical or personal needs. All admissions are scheduled on a rolling

basis.



The mission of the Trauma Recovery Program is to restore individuals with military-related post traumatic

stress disorder (PTSD) to their highest level of functioning and to promote their reintegration into their

communities and reconnection with their families and loved ones. This mission is accomplished through

cognitive behavioral therapy in the context of a therapeutic milieu with adherence to clinical practice

guidelines and utilization of evidenced-based treatments to the fullest extent possible. Residents spend 5-8

hours a day in group therapy learning skills in such areas as anger management, affect tolerance,

communication, health issues, and harm reduction. Participation in a Cognitive Processing Therapy group

is determined on an individual basis as is clinically appropriate. Participation in this group may increase

length of stay. Additional therapeutic interventions include participation in recreational therapy, art therapy,

choral group, service dog training, parenting skills, family therapy, family open houses, biking group, gym

time, and swimming. Referrals for speech therapy, physical therapy, and other specialty medical services

are available if clinically indicated.



The Trauma Recovery Program is a voluntary program and we ask that all referred individuals be ready to

participate in active treatment for their PTSD. A copy of the Treatment Contract is enclosed which the

veteran or service member is required to sign as part of the application process. Please discuss these

treatment expectations with the individual you are referring prior to submitting an application. When

deciding whether to refer an individual to the Trauma Recovery Program, please keep the following

Admissions Criteria in mind:



 Current problems are primarily due to military related PTSD or post-deployment adjustment difficulties;

 Patients must be psychiatrically and medically suitable for admission to the residential rehabilitation level of

care and able to actively participate in and benefit from treatment in this setting;

 Must be able to remain alcohol and illegal substance free during treatment at the program and not be actively

withdrawing from alcohol or illegal substances;

 Off benzodiazepines for at least 5 days (medically/clinically appropriate exceptions are considered on a case

by case basis);

 May be on prescribed opiates at standing doses for the purpose of managing stable chronic pain. Please

include a pain consult or other notes regarding the use of opiates with the application;

VAPATRP (rev. 10/5/09) Page 1

 Must not have any outstanding legal issues requiring the veteran or active duty service member to be absent

during any portion of the program or to be court ordered specifically to this program;

 For active duty service members: Must be assigned or attached to a Military Medical Command (e.g.

Wounded Warrior Battalion, Warrior Transition Unit, medical hold unit, etc.).





Referral Process: After an interdisciplinary review of the application, the Admissions Coordinator will notify

the referring clinician regarding any further information needed to process the application, acceptance into

the program, or recommendations and reasons if the veteran or service member is found not to be

appropriate for this program at this time. As directed by the Uniform Health Services Guidelines, all

individuals must now receive a mental health evaluation within 7 days of discharge. You will be contacted

by a clinician from the Trauma Recovery Program to schedule this appointment.



Please submit the following documents to the Admissions Coordinator at the address below, in order for the

veteran or service member to be considered for admission:



1. Referral Information packet – completed by the referring clinician, NOT the applicant

2. A signed Treatment Agreement

3. A copy of DD214 (if a veteran)

4. If Active Duty, please include a copy of attachment orders for Military Medical Command

5. Please attach a current medication list to all applications





Applications can be faxed to (650) 617-2686 or mailed to:



Admissions Coordinator (352/117)

Trauma Recovery Program

VA Palo Alto Health Care System

795 Willow Road

Menlo Park, CA 94025





If you have questions regarding referrals, please call:





Men’s Trauma Recovery Program Admissions Coordinator

Kristen Marchak, LSW

(650) 614-9997 ext. 24692.



Women’s Trauma Recovery Program Admissions Coordinator

Marion Gautschi, MSW

(650) 614-9997 ext. 22843









VAPATRP (rev. 10/5/09) Page 2

VA Palo Alto Health Care System

Trauma Recovery Program

Referral Application

Name of Referring Clinician: VISN#: Clinician Phone:

( ) -

Agency/Organization: Clinician FAX:

( ) -

Clinician Address: Clinician Email:



Name of Applicant: Applicant SSN: Applicant DOB: Gender:

______ - ______ - ______ ____ /____ /____  Male

 Female

Applicant Address: Applicant Phone:

Home ( ) -

Cell ( ) -

Ethnicity: Marital Status:  Active Duty  Veteran

 Asian / Pacific Islander  Never Married If Veteran -- Branch of Service:

 African American  Married  Army  Navy

 Hispanic / Latino American  Domestic Partner  Air Force  Marines

 Caucasian  Separated  Coast Guard

 Native American  Divorced Service Connection:

 Mixed Ethnicity  Widowed  Yes  No If Yes, then

________________ # Children living with you: ____% For:_________________

 Other (list)

Service Dates: Warzone Dates, if Military Jobs:

From: To: applicable:

/ / / / From: To: Highest Rank:

/ / / /

Theater: POW: Badges/Medals: Disciplinary: Discharge:

 Korea  Desert Storm  Yes _____________  Article 15  Honorable

 Vietnam  Iraqi Freedom  No _____________  Court Marshal  General

 Panama  Afghanistan _____________  Other  Medical

 Grenada  Other  Other

If Active Duty, Guard or Reservist; Please complete the following:

Branch of Component: Current Service Status: Service Entry Date

Service:  National Guard  Active Duty (currently)

 Army  Reserve  Retired ETS

 Air Force Status: Date of Retirement:

 Navy  Activated  TDRL

 Marine Corps  Drilling (Weekend)  PDRL Release from Active Duty

 Coast Guard  IRR

 Separated

Parent Command & POC & Phone Number





 In Process of Discharge  ETS  MEB  Limited Duty  Admin Sep  Other:

Anticipated date of separation (if known): Status of MED/PEB:





VAPATRP (rev. 10/5/09) Page 3

Current Psychiatric Diagnoses:

Axis I:



Axis II:



Axis III:



Please describe your clinical experience with this applicant. What is(are) the applicant’s trauma issues and how

are they being addressed in treatment? Please describe any other issues that are also being addressed in

treatment.









Why are you recommending inpatient rather than continued outpatient treatment?









Psychiatric History:

Does the applicant have a history of suicidal ideation?  No  Yes

Has the applicant made suicide attempts?  No  Yes Dates: _________________________________

Does the applicant have a history of self harm behaviors (cutting/burning self, eating disorders, etc.) ?

 No  Yes Dates:______________________________

Does the applicant have a history of homicidal ideation or assault?  No  Yes Dates:___________________

Does the applicant have a history of psychosis?  No  Yes Dates:________________________________

(Please describe the history of psychosis, suicidal/homicidal ideation, and self harm behaviors)









Traumatic Brain Injury History, if applicable:

 Please attach a copy of any neuropsychological evaluation that was performed

Type of injury (e.g., blast, blunt injury, MVA, fall, etc.)



Date of event: Loss of consciousness:  Yes  No If yes, duration:

Post-traumatic amnesia:  Yes  No If yes, duration:

Describe other acute symptoms, or markers of severity:







Were there multiple events of TBI?  Yes  No If yes, number:



VAPATRP (rev. 10/5/09) Page 4

Substance Abuse History

Has the applicant abused:  Alcohol  Illegal Drugs  Medications ______________________________

Drug Use (more than 10 Number months # times per week Treatment?

times in a month) since last use during last use

DATE:

Alcohol  Yes  No  Inpt  Outpt

Amphetamines  Yes  No  Inpt  Outpt

Barbiturates  Yes  No  Inpt  Outpt

Cannabis  Yes  No  Inpt  Outpt

Cocaine  Yes  No  Inpt  Outpt

Hallucinogens  Yes  No  Inpt  Outpt

Opiates (Heroin)  Yes  No  Inpt  Outpt

PCP  Yes  No  Inpt  Outpt

Prescription Abuse  Yes  No  Inpt  Outpt

Other:  Yes  No  Inpt  Outpt

Comments:





Legal History

Does the applicant have any outstanding legal issues (eg. court dates, warrants, court martial, etc)?

 No  Yes (Please describe)





Has the applicant been incarcerated?  No  Yes (Please describe)



Is the applicant currently on probation/parole?  No  Yes (Please describe)



Is the applicant a registered sex offender?  No  Yes (Please describe)



Additional Legal Information:





Personal History

Pre-Military history of disruptive or antisocial behavior?  No  Yes

History of violent acting out or antisocial behavior?  No  Yes

Victim of sexual assault?  No  Yes

Victim of domestic violence?  No  Yes

Family & Relationship Status

Are there minor children in the applicant’s care?  No  Yes

Can arrangements for care of children be made while applicant is hospitalized?  No  Yes

Will family be able to meet financial obligations while applicant is in care?  No  Yes









VAPATRP (rev. 10/5/09) Page 5

Transition Plan From Trauma Recovery Program to Outpatient Care

What are the circumstances of the applicant’s current residence? (i.e. lives alone, with others,

temporary/permanent residence, renting, owns, etc..)



Where will the veteran reside after discharge from the program?



Who will follow the applicant for outpatient mental health?



Who will follow the applicant for medical issues?



Primary Care Provider Address Email Phone



Therapist Address Email Phone



Psychiatrist Address Email Phone



Case Manger Address Email Phone



Other Address Email Phone



Is there a possibility that the applicant is currently pregnant?  No  Yes

 Please attach a current complete medication list to all applications

If the applicant is treated by a provider outside of the VA system please attach the following:

 History & Physical

 Notes from theater, Medivac flight note, etc.

 MD progress notes. If patient has fractures include ortho note with weight bearing status and any other

restrictions

 Include notes from specialty services (i.e. neurosurgery, neurology, ID, plastics, ophthalmology)

 Recent therapy notes from OT, PT & SLP

 Neuropsychology testing performed

 Psychosocial assessment









VAPATRP (rev. 10/5/09) Page 6

VAPAHCS TRAUMA RECOVERY PROGRAM INITIAL TREATMENT AGREEMENT



1. I agree to participate in and attend all scheduled groups and activities and to adhere to all aspects of my individual

treatment plan, including but not limited to prescribed medications, dietary restrictions, volunteer activities, and exercise

and recreation programs.



2. I understand that I cannot be admitted to the program while under the influence of alcohol, illegal substances or any

substance other than prescribed medications.



3. I understand that I am expected to disclose all prescribed and non-prescribed medications to my referring provider during

the application process. Unless a clinical exception has been made, at least 5 days abstinence from benzodiazepines is

required prior to admission. If I am not sure, I will ask my referring provider, for more information.



4. I understand that substance use is not compatible with treatment at the Trauma Recovery Program and will result in my

discharge from the program. I understand that Alcometer/Breathalyzer tests and random drug screens are part of the

treatment program.



5. I understand that physical violence, verbal abuse or threats of violence will be grounds for my discharge from the program.



6. I will not bring weapons or contraband to the program and will not store weapons or contraband in my hospital bedroom,

vehicle or on grounds during the course of my stay in the program.



7. If admitted, I agree to a search of my belongings (which may include vehicles) for safety concerns and contraband. If I

refuse I understand that I may be denied admission or be discharged.



8. I understand that while I am an inpatient at the Trauma Recovery Program, there are some restrictions on when I can leave

the hospital grounds. I will be issued a program manual which explains this and other program policies.





I have read the Treatment Agreement. I understand the described guidelines, endorse them, and will abide by them if accepted into

the program.





______________________________________________________________________________

Applicant's signature Date



I have reviewed and discussed these treatment expectations with the applicant and support this application to the Trauma Recovery

Program. I will provide follow-up care myself within seven days after discharge or have identified an alternate clinician who can

and will provide this information to the Admissions Coordinator at the Trauma Recovery Program.





______________________________________________________________________________

Referring clinician's signature Date









VAPATRP (rev. 10/5/09) Page 7


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