Transitioning a technology-assisted stepped-care model for traumatic injury patients to a fully remote model in the age of COVID-19

Abstract

ABSTRACT Each year nearly three million individuals require inpatient hospitalization following a traumatic injury (e.g. gunshot wounds, injuries sustained in motor vehicle collisions, burns) in the United States. Approximately 20–40% of these individuals go on to develop posttraumatic stress disorder and/or depression one-year post-hospitalization. Despite the high rate of psychological morbidity in this population, the vast majority of hospitals do not address the emotional or behavioral health needs of this population. The Trauma Resilience and Recovery Program, a technology-assisted stepped-care program, was developed to address these needs in one hospital system and to create a scalable model. Telepsychotherapy is a key part of this model due to the unique needs of this population, including trauma center catchment area and barriers due to physical injury. This manuscript describes the use of telepsychotherapy to deliver evidence-based interventions to traumatic injury patients across the lifespan, presents challenges created by the COVID-19 outbreak, as well as efforts to address these challenges, adaptations to our training model, and considerations for the use of telepsychotherapy in the age of COVID-19 and beyond. The goal is to present a model for remote screening and treatment of individuals that can be applied to other settings and populations.