PTSD arising after an injury is most frequently associated with either an assault or a motor vehicle accident, both under horrific circumstances. While there are other potential causes of PTSD, assaults and MVA account for most.
The goal is to treat the patient effectively and efficiently so that he/she may return to their job and continue their career.
In some cases, the individual may have lost his/her job after this event and/or have physical limitations which preclude returning to that particular job. In other cases, the horror of having to return to the job is simply too great, and the patient needs other/alternate employment.
Before anyone even enters psychological care, it must be determine if the individual has the option desire to return to the job. If there are no plans (or opportunity) to return to the job, care can be confined to making the patient comfortable enough for other employment.
Often, extended treatment occurs because:
a. The doctor makes the patient dependent upon continuing care
b. Matters being addressed have nothing to do with injury and/or
c. The doctor has misidentified the problem
We had a recent case in which someone was requesting authorization for what would be three years of psychological care. However, even a cursory review of the case indicates that the care being delivered will actually make the problem worse_and it has.