PC-PTSD-5 (source ↗)
Brief primary-care screen for probable PTSD. A positive result indicates the need for further assessment.
BH
Brooke Harbor Health System
PMHNP Clinical Learning Environment
Updated July 31, 2026
Condition Guide
Trauma- and Stressor-Related Disorders
Trauma- and stressor-related presentations require careful attention to exposure, timing, symptom pattern, dissociation, safety, function, co-occurring conditions, and the person's readiness for treatment. Trauma-informed care supports choice, collaboration, predictability, and emotional and physical safety throughout the process.
Rating Scales & Screening Tools
Use structured tools for specific clinical questions
Select tools according to the exposure, symptom pattern, setting, and purpose of assessment; the VA National Center for PTSD provides additional professional assessment resources. For guidance on selecting, administering, and interpreting these tools, see the Toolbox's Rating Scales & Screening. When trauma intersects with threats, stalking, weapon access, or violence concerns, see Violence Risk, Threat Assessment, and Forensic Psychiatry.
PCL-5 (source ↗)
Twenty-item self-report measure used to assess DSM-5 PTSD symptoms and monitor severity. Interpretation depends on setting and purpose.
CAPS-5 (source ↗)
Clinician-administered structured interview for PTSD diagnosis and severity; requires appropriate training and access.
DSPS and dissociation assessment (source ↗)
Ask directly about depersonalization, derealization, amnesia, identity disruption, triggers, frequency, function, and safety. The DSPS can support assessment of dissociative symptoms associated with PTSD.
Medication Classes
Target symptoms within an evidence-based treatment plan
Medication decisions should follow diagnostic clarification, shared decision-making, and the treatment recommendations in the VA/DoD Clinical Practice Guideline for PTSD. For support with actual-use histories, interactions, and monitoring, see the Toolbox's Medication Reconciliation & Monitoring.
SSRIs (source ↗)
Sertraline and paroxetine have FDA indications for PTSD. Other SSRIs may be considered using current guideline evidence and patient-specific factors.
SNRI (source ↗)
Venlafaxine is supported by guideline evidence for PTSD. Monitor response, tolerability, blood pressure, discontinuation risk, and interactions.
Adrenergic treatment (source ↗)
Prazosin may be considered for PTSD-associated nightmares in selected patients. Assess blood pressure, falls risk, other medications, and individual response.
Prescribing cautions (source ↗)
Benzodiazepines are generally discouraged for PTSD. Review co-occurring substance use, sleep conditions, bipolar-spectrum symptoms, pregnancy, and medical contributors before selecting medication.
Psychotherapy Modalities
Trauma-focused psychotherapy is central to PTSD treatment
Treatment should reflect safety, readiness, symptom pattern, co-occurring conditions, access, and clinician competence. SAMHSA's trauma-informed approaches guidance describes principles for creating safer and more collaborative services. For help matching evidence-based approaches to the clinical presentation, see the Toolbox's Psychotherapy Modalities.
Cognitive Processing Therapy (training ↗)
Structured trauma-focused treatment addressing beliefs and meaning related to the traumatic event.
Prolonged Exposure (training ↗)
Structured treatment using supported engagement with trauma memories and avoided situations.
EMDR (training ↗)
Trauma-focused psychotherapy integrating memory processing with bilateral stimulation.
Other needs (source ↗)
Present-centered, skills-based, family, group, or substance-use treatment may be part of care. Match timing and intensity to safety, readiness, comorbidity, and clinician competence.
Supplements & Mind-Body Approaches
Use adjunctive approaches with clear expectations
Adjunctive practices should support defined treatment goals and be adapted when they increase dissociation, hyperarousal, avoidance, or physical discomfort. For guidance on coordinating these approaches with the broader plan of care, see the Toolbox's Treatment Planning.
Mindfulness and grounding (source ↗)
May support present-moment awareness, emotion regulation, and distress management. Adapt carefully when inward focus worsens dissociation or hyperarousal.
Movement and sleep (source ↗)
Graded physical activity, sleep support, and restoration of daily routines can strengthen recovery and function when medically appropriate.
Breathing and relaxation (source ↗)
Can reduce physiologic arousal for some people. Teach choice, pacing, and alternatives for patients who find these exercises activating.
Supplement review (source ↗)
No dietary supplement is an established first-line treatment for PTSD. Review product quality, interactions, adverse effects, pregnancy considerations, and the risk of delaying effective care.