Welcome back to the Healing Pain Podcast with Jeremy Fletcher, PT, DPT, OCS
In this episode, we’re tackling the important but often times not spoken about the impact of trauma and PTSD on the experience of chronic pain. We’re going to be sharing a masterclass that was delivered by a physical therapist, Dr. Jeremy Fletcher, on the topic of trauma-informed pain care and why all of us as healthcare professionals should be more sensitive to the needs of people living with trauma and PTSD. Jeremy does share a number of slides. It’s got some great data and some beautiful slides to share with everyone.
Let me tell you a little bit about Jeremy before we begin this episode. Jeremy is a Physical Therapist and serves as the Director of Community Integration for a company called Veterans Recovery Resources. This is a non-profit mental health organization, which is located in Mobile, Alabama. He is a former Professor of Physical Therapy. He’s also presented at state, national, and international conferences on the topic of chronic pain, health behavior trauma, as well as community health. He’s a Major in the US Army Reserve and holds several leadership positions for non-profit organizations throughout Alabama. His service in the Afghanistan war earned him a Bronze Star for working in a combat zone. He’s also a veteran, a father, a coach, as well as a husband. I know you’ll gain a lot from this episode.
Jeremy talks about the topic of trauma from a clinician’s perspective. He also talks about it from his own perspective, as far as being in a war and suffering from his own PTSD. He’s also leading our Trauma-informed Pain Care Course at the Integrative Pain Science Institute. That course is open for registration now. It’s a five-week course with a mentor and learning session at the end of the course. You can find out more about the Trauma-Informed Pain Care Course that Jeremy is leading on this episode. You can also go over to the website at IntegrativePainScienceInstitute.com. Scroll over to the Courses tab and scroll down, and you’ll find the Trauma-Informed Pain Care Course page.
We would love to see you in that course. It is so important that all of us mental health providers oftentimes receive some trauma-informed pain care, but those of us who are physical medicine professionals, PTs, OTs, oftentimes, we need to reinforce that training. This is an incredible course to do that. Without further ado, I welcome you to read this episode of this masterclass. If you have any questions, you can reach out to us at the Institute. Our email is Support@IntegrativePainScienceInstitute.com. Without further ado, let’s begin to learn about Trauma-Informed Pain Care with Dr. Jeremy Fletcher.
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Masterclass: Trauma-Informed Pain Care With Jeremy Fletcher, PT, DPT, OCS
We’re going to talk about Trauma-Informed Pain Care. You’ll meet Dr. Jeremy Fletcher, who is a specialist in Trauma-Informed Pain Care. He works for an organization called Veterans Recovery Resources, which is a not-for-profit organization that provides mental as well as physical health services to veterans. He’s leading the Trauma-Informed Pain Care Course. Without further ado, we’re going to have some slides for you. We’ll have some Q&A at the end. I’m going to make Jeremy the host, and then we’ll get started.
Thank you again for your patience and grace this morning. I am very excited to be bringing you this course in Trauma-Informed Pain Care. I think I need to start first by saying that I’ve had my own traumatic experiences. I did an outreach and said, “I want to learn a lot about trauma.” I think trauma tried to learn a lot about me. In the process, I began to understand the influence of trauma, both on my physical body but also in my emotional and spiritual body. That’s what I hope to share more with you and then be able to address any questions that you have about the course.
We’ll start first with a brief definition of trauma. It’s basically a series of events or circumstances experienced by an individual as physically or emotionally harmful or threatening. It has lasting adverse effects on the individual’s functioning and physical, social, emotional, and spiritual wellbeing. There are three things that we want to describe is three E’s. There is an event that has been experienced. That experience has created a lasting impact on someone’s life.
As a physical therapist and other clinicians who are treating persistent pain conditions, what we are talking about most of the time when we’re thinking of trauma and its influence on the body’s ability to perceive pain and generate a pain experience, we’re describing a threat response. As you may know, our threat response is heavily influenced by portions of the brain that control that threat response. This is amazing work. I think that Hannah Ball has led the effort on describing what’s considered, from my perspective, the integration of the psychological aspects of the pain experience as well as the stressor as it’s perceived.
I think it’s important to recognize that the threat response is what is continuing to drive most of the persistent pain conditions that we all see in clinical practice. On this slide here, what this schematic explains is how this stressor or the fear-based threat. Trauma is an event that is experienced that does have a lasting impact. A lot of our reactions, as well as responses to traumatic experiences, are heavily regulated by the amygdala and its connections to the vagus nerve, as it influences the physiology that drives a lot of the endocrine responses that persist in pain, inflammation and depression. What you begin to see is the influence of how our body reacts to stressful situations.
As we worked our way a little bit through this schematic, we had this fear-based threat or this response. We then have a physiological stress response, which is regulated through epinephrine and norepinephrine in our cortisol levels in our body. Based on generally previous experiences, namely, adverse childhood experiences and how those influence how our body reacts and has been trained to react, over time and our nervous system has developed as a result of the environment that we’ve been in, we adopt or have these adaptive or maladaptive responses.
To give you some context on this particular story that I’m hopefully painting for you at this point in my own pathway that I had as a child. I grew up in a home where I had a mother who was abused. She also was an addict. She was addicted to drugs and alcohol. Growing up in that environment had an influence on my nervous system and how it’s developed. There are many benefits to that. There are also many risks.
Some of those risks include how my body generally reacts to trauma. Having a war experience as a veteran who’s been in a combat zone in Afghanistan and experienced both small arms fire as well as someone who has experience where they’re constantly under threat, my body knows how to react to those things. I had my catastrophizing rumination, feelings of helplessness, and symptom magnification that led to prolonged or excessive activation of my hypo pituitary adrenaline system, which led to adrenal fatigue.
That resulted in systemic inflammation, ongoing pain, and subsequently a diagnosis of PTSD, anxiety, and depression. I became essentially my own patient, which was a very interesting experience. Fortunately, through counseling, use of medication, and exercise, and all sorts of pathways, I’ve been able to recover from that experience. Now, I’m able to take that experience and help others, particularly veterans, as part of a non-profit organization in South Alabama in the United States called Veterans Recovery Resources.
For me, I feel like trauma is a privilege. It’s something that led to growth for me personally. As I’ve begun to study those concepts and constructs and now help lead an organization whose primary mission is to address trauma in pain, those things heavily influenced everything that I’m doing at this point and why I’m so passionate about bringing this particular topic to you through the Integrative Pain Science Institute.
We have the trauma and persistent pain image here. What I would like to also consider, as you’re thinking about this and as I think about this quite often, is how people are coping and adapting to our environment. As we think about the environment we’re all in, I know that all of us are affected by a COVID environment. All of us have this potential situation where this experience is leading to some effect.
There are many studies out there about how people are coping and adapting. What’s interesting to me is some people are adapting well and some people are not adapting so well. They hopefully will seek care. They will find you and you will have the ability to walk them through these things. On this slide, as the definition of trauma described, there are lasting adverse effects on the individual’s ability to function in both physical, social, emotional, and spiritual aspects.
What’s interesting about trauma and concepts like post-traumatic growth is that there is a need to integrate the person’s spirituality into the recovery process. From a 2017 study from the American Psychological Association, this is how people tend to cope and adapt. They find ways to regulate their nervous system through listening to music, exercising and walking, prayer or meditation, and yoga. There are implications for the spiritual as well as our need to socially connect through these challenging times.
I definitely did want to highlight that as well. Another thing I wanted to point out is the different adverse childhood experiences. For many of you, that may be a new term. It may not be a new term for you. There are different experiences that we have in our childhood that influence how our nervous system develops. When we get to look into the data around this, we are learning more and more about the negative effects of adverse childhood experiences on prolonged health outcomes.
At this point, you might be asking, as I did, what are the adverse childhood experiences? Essentially, they’re broken down into three categories, and that is that of abuse, household dysfunction, and neglect. These can be broken down into sexual, verbal, or physical abuse. Household dysfunction could be people that have grown up in an environment where alcoholism or addiction is prevalent. Mental illness is prevalent within the home.
If there was intimate partner violence, a family member that was incarcerated or someone experienced divorce, as also, in neglect, emotional and physical neglect. There is a way to evaluate individually, someone’s score using an ACE scoring tool. What we now know about the prevalence of adverse childhood experiences is they have lasting effects. That’s what I’d like to tell you now is what those lasting effects are.
Four seems to be an important number for how many adverse childhood experiences that someone experiences before the age of eighteen. An ACE score of greater than four or more increases your prevalence of certain medical conditions. You’re 240% more likely to develop hepatitis or sexually transmitted infection, 390% is more likely to have COPD, 460% is more likely to suffer from depression and greater than 1,000% is more likely to have attempted suicide.
This is so profound for me because when I took this scale myself, my adverse childhood experience was seven. An adverse childhood experience for six or more shortens someone’s life span by about twenty years versus age-controlled matches. Some powerful information here speaks to how the nervous system develops as we grow up. Our ability to be resilient or cope and adapt later on in adulthood is often a function of what happens to us.
That’s the fundamental shift that we want to make within a Trauma-Informed Care Practice. It’s thinking about what are these fundamental shifts in the way we care for people that allow us to shift our view from what’s wrong with this person but what happens to the person. In clinical practice, we’re already experiencing people that are telling these deeply profound stories of traumatic experiences.
Within the United States, anyway, our mental health systems are struggling and physical therapists are essentially becoming the de facto mental health clinician. We are taking on the prevalence of these traumatic experiences. As clinicians, we’re listening to these things with an empathetic ear and that does help us to build a connection and relationship. It does also expose us to the risk of secondary or vicarious trauma.
This is an example of what we’ll be discussing in week two of the Trauma-Informed Pain Care Course. These are the Trauma-Informed Care Guiding Principles. Trauma-Informed Care comes from the Substance Abuse and Mental Health Administration, which is a function of the Health and Human Services within the United States government that describes guiding principles of how to reduce the negative effects of trauma, both from the patient’s perspective, but also from the clinician’s perspective.
It acknowledges all of the components of experiences in a comprehensive view of experiences people might have as they come into our healthcare system and environment. Within that, it considers the different types of traumatic experiences, which could include adverse childhood experiences, natural disasters, and many different forms. We can come back at the end and address any questions as well about different types of traumas that people experienced.
Trauma-Informed Care Guidelines have been developed to provide the medical community with guidelines. That’s what we will cover in week two. There are six fundamental guiding principles for Trauma-Informed Care. The first is creating an environment of safety, and we do this in a couple of different ways. There’s the physical space in which our patient moves into our clinic. There’s also the personal space that we can create for our patients. Many of us already do these things routinely in clinical practice.
Some of them are communication things that we’re not necessarily intentional about, but we’re doing. Things like motivational interviewing where we ask questions. We give permission. We ask for permission when we get these questions, these things that help the patient feel empowered. Anytime you enter into a relationship with someone else, especially whenever you are under threat, you feel the need to protect yourself.
Creating an environment in a personal relationship built on safety is helpful. It helps to lessen the power differential that is inevitable in anyone that’s seeking help for something. It begins to put that person at ease. We’ll talk about specific strategies to do that. Transparency and trustworthiness, the pathway to building relationships, is always through transparent and accountable relationships. We want to make sure that those processes are included within our care program.
If we have a clinic and we’re a clinic owner, for example, we want to make sure we have policies, procedures, and communication strategies that help to build transparency and trustworthiness. Peer support maybe is a new idea within the concept of physical therapy, especially if you’re a physical therapist. Peer support is using someone’s lived experience. If someone has had the lived experience of pain or trauma, using that experience to build trusting relationships with those people that might not feel like they can build a trusting relationship with you.
I’ll give you an example of that. What that looks like from a clinical perspective is imagine we have 3 or 4 patients or clients in a clinic. We are working with those patients and clients with their pain, regardless of the body part, but we know each individual person has a story. Sometimes these stories are powerful and they form a connection with other people.
I can think back early into my clinical experience where I was in a total joint replacement center and watched how people would engage socially around their shared struggle with pain within the confines of this hospital settings. What seemed to be amazing to me was the social bond that they created were forming this protection and encouraging each other through this process of recovery. What you’re talking about with peer support is using someone’s lived experience to bolster their competence in both the recovery process as well as the clinician. We use this quite frequently at our facility.
The fourth is collaboration and mutuality. Some of the guiding principles within communication strategies like motivational interviewing are helpful here to understand the power differential that exists when someone is under a level of threat, which is what we’re describing here in trauma and pain is the intersection of the threat appraisal. What we have to do is to be very intentional about how we do things like our informed consent processes.
If we are not attentive to the nonverbal that our patients are providing, then we’re not paying attention to whether or not they feel if they have the power to make a decision. This is also where it’s helpful to provide people with choices. We can give them choices so that they know, “I do have a choice in my care decisions.” I always have a choice because inherent in trauma is the fact that something else happened to you, and we lose our sense of control.
Part of our restoration and rehabilitation is to return control back to the individual so that they’re moving in the direction of self-actualization. We’ll talk about some of those things in the course as well. Empowerment, voice, and choice, if you think about the social issues that exist in our particular nation, I say our being the United States as a nation, there is certainly a movement toward increasing voice.
What we’re saying is people are tired of not being heard, not being listened to, and being told what to do consistently by our medical system. They are seeking different ways to amplify and raise their voice. I pay attention to social media because I’m always interested in hearing people’s perspectives on things. When I’m listening to those things, I see a lot of people that have been traumatized by our medical system and they no longer trust it. The only way to regain that trust is to allow people to have a voice without judgment of that voice. I think that’s another thing that we’ll discuss in this course as well.
Another guiding principle is the recognition that cultural, historical, and gender issues play in the medical system and how we can be much more intentional about how we address these issues within our clinical practices and what that means for how we work through those issues in a relational context. I was a part of a leadership program here locally and we took a look at the history of our city. As we’re looking through the history of the city over the last couple of hundred years, people are constantly continually bringing up traumatic experiences.
Those are the things that were most memorable. Mobile, Alabama was home to the last slave ship to leave Africa and arrive in the United States. That had a profound impact on how our future as a city has moved forward. We have to be able to take knowledge of those things within the clinical context and how that level of trauma carries into the interpersonal space that we create with another human being given our therapeutic context. We’ll describe ways that we can be more intentional about that as well. That is Trauma-Informed Care and the Trauma-Informed Guiding Principle.
For those of you who don’t know the work that Jeremy does, it’s groundbreaking. There are not too many professionals, no matter from any profession, whether it’s mental health or physical medicine is doing this kind of work, which is why I wanted to share Jeremy, his work and his story. I think it’s super powerful. There are some questions that came in that I want to have Jeremy chime in and go through them. Jeremy, I’m going to read these to you. Let’s start with this one, “I work primarily with athletes who are in good shape and healthy. How does a trauma-informed approach help if you’re working with athletes, let’s say in a college setting?”
First, I was a college athlete. I played baseball in college. Before I moved into this trauma environment and chronic and persistent pain, I was assigned to a Light Infantry Brigade Combat Team in the US Army. I’ve worked with a lot of high-level athletic folks. The application of Trauma-Informed Care within the athletic population is recognizing that the athletes have an identity. Within that identity often is their ability to be an athlete.
I remember thinking that I am a baseball player. I also went through some rehabilitation myself. While I was going through that rehabilitation process, I remember feeling under threat, as if my identity was going to be taken away. I wasn’t a good student, so I was banking on my ability to play baseball to be the way ahead for me, how I was going to survive and provide a living for myself. There was a need for someone to identify that my identity was under threat and to be able to create a safe environment that would allow me to communicate that because the athletic environment is highly competitive. I think that’s one way in which that helps.
The other part is I think having the shared experiences from other athletes that have been through a rehabilitative process is the essence of peer support. Someone that’s had a lived experience of recovery matching that person up with another person that has a lived experience will bolster the athlete’s confidence. We know a lot from the literature and sets things like ACL Rehabilitation, for example. The psychosocial factors do play a pivotal role in their ability to recover.
Leveraging relationships to build a sense of social connectedness within the athletic population can be helpful. I think back to my military experience and what they would do sometimes is pull someone out of the unit and isolated that individual, which generated feelings of hopelessness. Those are implications.
We’re going to go on to the next one here. How does Trauma-Informed Care fit into a women’s health PT practice, where I may have to touch women in places where they were previously violated?
It’s amazing to me the work that is required from a relational perspective to gain trust from someone to touch them in an area where they probably and potentially have been traumatized in the past. I think about the women’s health, physical therapists that I know, and the conversations that we’ve had. What we talked about from the trauma perspective is the ability to identify trauma and also work with that individual to help create this new story of resilience and their ability to overcome those things.
While also being able to refer out to someone else for any of the behavioral aspects that they may need to deal with. Those are the couple of things that I’ve talked with a lot of women’s health physical therapists about. Do you have a strong relationship or consulting relationship with a behavioral health professional? How do you communicate between those two for the best benefit of the patient so that person feels safe, so you’re aware of anything that may be retraumatizing the individual, and then also to be able to use the informed consent process as a way to build trust? I think those are the applications that I’ve talked about with some of my friends that are in women’s health on this particular topic.
I always tell other professionals and people in our profession that some of the work that the women’s health PTs have done in our profession in PT, I think is so forward-thinking because they were probably ahead of the curve on integrative care, bio-psycho-social issues, and receiving that spillover. I always try to give the women’s health section the respect they deserve for identifying things early. Along the line is a question, how does a therapist working with adults with chronic pain intervene when someone is carrying adverse traumatic experiences from their past?
I’m going to go back to the last question, 1 in 3 now is the number for intimate partner violence in the United States. 1 in 3 women have experienced some form of intimate partner violence in the United States. That’s from work at the CDC. Thinking about the applications to women, it’s unbelievable. This particular question about working with adults with chronic pain, from my perspective and my experiences, both personally and professionally, the value and the shift in perspective from what’s wrong with you.
In other words, let me go and evaluate someone from a deficit-based perspective. I’m going to go through and collect a whole huge list of all these things that are wrong with you or impairment if we’re using the ICF language, and then we’re going to develop this plan of care to address these impairments. I think the fundamental shift that I’ve made in my clinical practice as a result of using the Trauma-Informed Care Guiding Principles is that I want to recognize that your previous traumatic experiences may be influencing your ability to decrease the threat response. Thereby, decrease the amount and intensity that you’re experiencing.
That is part of what we know is pain neuroscience education. We deliver this information about how the pain experiences and what the nervous system is doing. What I have found, though, is everybody’s got this story. Everyone has a story and they need to feel heard and listened to. If we’re using the Trauma-Informed Care perspective, what happened is what we want to listen for. When we hear that, the essence of listening builds this therapeutic relationship to a greater degree than my previous experiences, where I was entering into this relationship, looking at someone from a deficit-based approach.
Now I look at someone from a strength-based approach and I want to know how did you manage to overcome the adversity that you had before. What are the skills that you didn’t learn before to overcome these adverse experiences and how can we apply those now? For me, if I looked back at my own story, by the time I was nine years old, I was raising my brother and my half-sister because my mom was incapable of doing that.
That’s certainly been a strength for me because I’ve been able to lead in many different ways than my peers were not able to. One is because I have empathy for the suffering and I can make a connection in a way that others can’t. I think that’s how I’ve been able to bring these principles into how I practice. Hopefully, that answers that question.
There’s a couple of questions here that are the same theme. I’m going to summarize these all together in one question. They revolve around a physical therapist using psychologically informed care or treating trauma and knowing that trauma is looked upon as a mental health diagnosis, which is a big topic for another time that we can all discuss. Some of the best research shows that bottom-up mechanisms, which is what we do as physical therapists, often are one of the most important parts of trauma care.
There are some aspects of mental health, physical therapy. Knowing that within 2020, the APTA House of Delegates came out and said that it’s within the PT scope of practice to screen for and intervene in behavioral and mental health problems. I think a lot of the work you’re doing, Jeremy, is opening the world’s eyes to the fact that PTs have a critical role in the mental wellbeing of patients.
Yeah. I feel strongly there’s a need to integrate these constructs that we tend to isolate and the medical system forces us to do this. It forces us to divide our humanity into physical, emotional, and spiritual, so we try to treat people that way. We try to say, “Go to the physical therapist, behavioral therapist, the clergy or the pasture person, or the primary care physician for your physical component.” We break these things up. Granted, each one of us has to have a scope of practice. We have a scope in which we can operate. Yet all of these other functions seem to be influenced by the individual right there in front of us.
How do we expand our ability to do that within the context of a relationship? That’s where I feel like a physical therapist can’t own these things. We like to claim ownership over areas of the body, the mind, and the spirit. We can’t own them. We have to build working relationships and collaborations with other professionals for the sake and the good of the person that’s sitting in front of us. We need to recognize both our professional scope of practice, but our individual scope of practice and the things that we feel comfortable working with.
I would not feel comfortable working with someone that has a vestibular disorder because I don’t work well with that, but I’m going to reach out to somebody. I’m going to ask them for help because that’s what the person in front of me needs. Those are the ways I think we need to be thinking as we relate to both the patient’s need and the system that we’re working in. There is this question that naturally arises where we ask ourselves, “How far do we delve into the psychological aspects of care?”
What I’ve come to learn and experience as well is that we already do so many of these things. We already build relationships with people. We can learn to optimize that. We already do things to bolster self-efficacy. We already do the things to make a person’s pain experience feel smaller while their life feels bigger. That’s where we need to expand as a physical therapist is understanding how we can help someone’s life feel bigger so that their pain feels smaller.
I think that is where the opportunities lie in terms of understanding that we are not this fragmented being. We are an integrated being of mind, body, soul, and spirit. I know that’s not a direct answer and like, “We need to do this.” I do think it’s one where we need to reconceptualize our idea about what physical therapists do and how they go about understanding the integrative nature of humanity.
I like your response around the idea of seeing oneself, whether you’re a PT or another healthcare professional, and learning how to be an integrative professional. Reaching outside your own scope if you need to if you’re outside your own scope and then building relationships, but also realizing that now, we function in silos and we need to do less of that in our healthcare system here, especially in the US. A couple more here. When you’re working with first responders like police, firefighters, and corrections officers, there’s a stigma with regard to seeking help, especially things that are involved in the mental health arena. How do we approach that population and push them out of recovery?
First, I’m thankful that you asked that question because it means that you care. That means a lot to me as a veteran and someone who has had his own stigma about seeking help. It recalls my own experience where I knew I was at a place where I didn’t want and needed to be. I was not healthy at all. I realize it takes this for those folks that have been affiliated with the paramilitary cultures like police, law enforcement, fire and rescue, and also the military population. It takes a trust broker and that’s what appears support specialist is.
It’s something about this lived experience, “I’ve been there. I know what that’s like. I know you don’t want to trust.” I’m not saying this for everybody. In the US military population, I used to call psychologists witch doctors and that was a general culture in the military. It also had implications for my career. I couldn’t necessarily reach out for help from my command and say, “I’m struggling,” because it would have implications for my performance in my career.
What I’ve learned through that process, now, we do some consulting work with the fire and rescue department is there’s a culture that we need to recognize that has to shift, but it’s hard to create a cultural shift. It takes time and it takes strong leadership. That’s a recognition we all need to have. The other part is creating spaces within those environments where people are willing to share their stories about recovery from mental health. Those are the stories that are going to influence the culture. Those are important and need to happen.
That’s why I’m so vocal about my own recovery experience. It’s because we need to be talking about this more. The other thing that is helpful is if you’re seeing a lot of veterans, first responders, and paramilitary culture types, you have to use some connections with those folks that can come in and talk to these patients. You can show them as models of what it’s like to go through that process and pain, and then also leverage their strengths. The strengths that are already inherent in the culture are bravery, courage, and self-sacrificing.
Some of those things can be detrimental but if you view them from a strengths-based perspective, they can be extremely helpful. Talking out loud about your struggles, that’s a vulnerability, but if you look at what vulnerability is, it’s bravery and courage. If you frame it in that way and say, “I know you’re a courageous person. You know when something’s scary, and you know that you can overcome it. How do we use those same strengths in order to enter into this discussion about the trauma that you’ve experienced and how you show up in that every day?” I think leveraging the inherent strengths of the culture in order to start to shift it is the way ahead for those paramilitary cultures. Hopefully, that answered that question too.
We thank everyone who’s with us. Jeremy’s course is Trauma-Informed Pain Care. It’s about five weeks. There’s four weeks’ worth of training with Jeremy. In the fifth week, there is a live mentoring and coaching call at the end of that. If you can’t make the live session, that’s fine. It will be recorded. We’ll share it with you for later use, but the course is open. We look forward to seeing you in that program.
It’s super important work. As you can all tell, this hasn’t been spread around the physical medicine world the way it should. Obviously, mental health professionals are more into this but as PTs and other body-centric licensed health professionals, when you combine trauma-informed care with what you’re doing, it’s a form of psychologically informed care. More importantly, it’s a way to help your patient move on to push dramatic growth, which is what we’re looking for here.
It’s not about resolving pain and trauma. It’s about where’s the growth that happens after that you’ve worked with the patient now. How does their growth start to seed and grow basically? When I spoke with Jeremy and I listened to the stories that he has about treating patients and where they were to where they are now, the post-traumatic growth is phenomenal.
It only happens if you can approach someone in a trauma-informed way. All of us care, we’re all caring professionals, but Trauma-Informed Pain Care is a very specific way to communicate and to see your patient through a different lens. That’s the beauty of it. We hope you join us again. You can go over to the IntegrativePainScienceInstitute.com and go over to the courses tab and scroll down to Trauma-Informed Pain Care. If you have any questions, you can reach out to us. I’ll give you the email at the Institute. It’s Support@IntegrativePainScienceInstitute.com. I want to thank all of you for being here. I want to especially thank Jeremy for joining us. We’ll see you guys soon.
- Veterans Recovery Resources
- Trauma-Informed Pain Care Course
About Jeremy Fletcher, PT, DPT, OCS
Jeremy Fletcher, PT, DPT, OCS, currently serves as the Director of Community Integration for Veterans Recovery Resources, a by-Veteran for Veteran non-profit mental health organization located in Mobile, Alabama. Dr. Fletcher recently served as an Assistant Professor in the Department of Physical Therapy where he also earned his Doctor of Physical Therapy degree in 2010. He has presented at state, national, and international levels on the topics of chronic pain, health behavior, and community/population health. He is Board-Certified Orthopedic Clinical Specialist, a Major in the US Army Reserve, and holds several leadership positions for non-profit organizations in Mobile, AL. His service in the War in Afghanistan earned him the Bronze Star Medal for meritorious service in a combat zone. He is a Veteran, father, coach, and husband.
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