PTSD Family CoachApplication OverviewEric Kuhn, Ph.D.

VA National Center for PTNovember 22, 2013D

Application Development

Project Team• Julia E. Hoffman, Psy.D.1,3

• Eric Kuhn, Ph.D.1,2,4 • Laura H. Wald, Ph.D. 1

• Kelly M. Ramsey 1

• Josef I. Ruzek, Ph.D.1,4

1 VA National Center for Posttraumatic Stress Disorder2 VA Sierra Pacific (VISN 21) Mental Illness Research,

Education, & Clinical Center3 DoD National Center for Telehealth & Technology (T2)4 Stanford University School of Medicine (affiliated)

Subject Matter Experts• Steven L. Sayers, Ph.D.• Katherine Iverson, Ph.D.• C. Perry Bosmajian, Ph.D.• Shirley Glynn, Ph.D.

5 VA Puget Sound Health Care System, MIRECC 6 University of Washington, School of Medicine7Durham VA Medical Center, MIRECC8 Duke University School of Medicine9 VHA Office of Clinical Public Health

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Need for PTSD Family Coach

• Involvement of family members/loved ones is critical to treatment of someone with mental illness (e.g., Dausch et al., 2012)

• PTSD symptoms such as anger, violence, numbing, and avoidance may negatively impact close relationships, including those with spouses and children (e.g., Galovski & Lyons, 2004; Sayers, 2011; Sayers, Farrow, Ross, & Oslin, 2009)

• Family members and friends of someone with PTSD may experience distress as result of their interactions with that person (e.g., Dekel & Monson, 2010)

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Promise of PTSD Family Coach Mobile Phone Intervention

• Accessibleo 56% of adults in the U.S. have smartphones (Pew Internet & American Life Project, 2013)

• Evidence based featureso Content developed by PTSD subject matter experts

• Conveniento Can be used anytime & anywhereo Can be personalized with user’s own photos, music, & contacts

• Discreeto Can be used in public spaces without drawing attention/notice

• Cost-effectiveo App is free

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PTSD Family Coach Overview• PTSD Family Coach is a mobile phone

application for people who have a loved one with Posttraumatic Stress Disorder (PTSD)

• This application provides:o education about PTSDo a self-assessment toolo portable skills to address acute symptomso direct connection to crisis support o information about treatment aimed at guiding those

who could benefit into care• Can be used as a stand-alone tool or to augment

face-to-face care with a healthcare professional • Due to the application’s portability, these tools are

easily accessible when they are needed most5

PTSD Family Coach: 4 Main Components

• From the Home screen users can choose to:

o Learn

o Self Assess

o Get Support

o Manage Stress

• Personalize button can be used to customize app with user’s own photos, music, support contacts, & safety plan

• The “?” button provides info about the app development team

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(1) Learn About PTSDProvides user with information derived from PTSD experts about the following topics:

• PTSD Basicso Symptomology, treatment, ways to support a

loved one with PTSD• Self-Care

o Overview of challenges that family members or friends may experience if a loved one has PTSD

• Family Careo Impact of PTSD on children & parenting tipso Impact of PTSD on intimate partner

relationships, communication tips, & addressing concerns about IPV

• Getting Treatmento Communication tips for encouraging treatment,

types of treatment providers, counseling options, & overcoming barriers to seeking care

(1) Learn about PTSD - Basics

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(1) Learn about PTSD: Family Care

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(2) Self-Assessment

• Monitor distress levelso 10-item Perceived Stress Scale

(PSS; Cohen, Kamarck, Mermelstein, 1983; Cohen & Williamson, 1988)

o Item about stress related to loved one with PTSD

o Item about perception of safety around loved one with PTSD

• Track & view stress history over time

• Schedule future assessments

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(2) Self-Assessment Examples

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(3) Get Support

Users can locate resources for:• Immediate services in

emergency situations• Loved ones with PTSD• Children or family

members affected by PTSD

• Veterans & Service Members

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(3) Get Support - Examples

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(4) Manage Stress

• Identify problem areas & severity of distress related to:o General stresso Isolation/Lonelinesso Anger/irritationo Sleeplessnesso Parenting challengeso Safety concerns

• Immediately access specific tools for coping

• Determine preferred tools • Thumbs up – Tool is saved to “Favorites” List

• Thumbs down – Tool is not suggested again 14

(4) Manage Stress - Process

• User selects symptom area• User rates distress on 0 to 10

thermometer scale• Depending on problem & severity,

user is routed to any of a number of cognitive-behavioral skills

• After completing tool, user re-rates distress

• User receives feedback on score• Option to give thumbs up/down

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(4) Manage Stress – Process Example

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Users can determine which tools they like

(4) Manage Stress – Toolkit

• All tools are based on Cognitive Behavioral Therapy and are empirically supported

• Tools include:o Activity planningo Motivational messageso Mindfulness exerciseso Positive imageryo Reframing techniqueso Relaxation exerciseso Sleep hygiene tipso Time outs

• Also includes option to create personalized safety plans if user has safety concerns

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(4) Manage Stress – Toolkit Examples

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(4) Manage Stress – Toolkit Personalization

• User can add personal photos, music, and contacts into the app for customized distress support

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(4) Manage Stress – Personalized Safety Plan

User can:• Access info

about safety plans

• Create a customized safety plan

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(4) Manage Stress – Safety Planning

User can:• Access info about safety plans, such as:

o Who to contacto What to pack if leaving is necessaryo Where to go

• Create a customized safety plano Specific contactso Safe locations in the homeo Safe locations outside the home

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(4) Manage Stress – Safety Plan Access (3 Locations)

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(4) Manage Stress – Customize Safety Plans

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Tool Preference Removal

• All tool preferences can be removed

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Clearing All App Data

• All data can be cleared from the app– Helps protects

security of user– Allows for

multiple users

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