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Trauma-Informed Care: A Paradigm Shift Needed for Services With Homeless Veterans

Dinnen, Stephanie MS; Kane, Vince MSW; Cook, Joan M. PhD

doi: 10.1097/NCM.0000000000000038

Purpose of Study: Exposure to traumatic events is a highly prevalent, although often overlooked, aspect in the lives of homeless veterans. In this study, the prevalence and correlates of potentially traumatic events, including posttraumatic stress disorder, in the homeless veteran population are presented.

Findings/Conclusions: Presently, there exists a lack of trauma-informed case management services for homeless veterans. Failing to recognize the association between trauma and homelessness may lead to further victimization, exacerbate mental health symptomology, and hinder a provider's ability to effectively intervene on behalf of homeless veterans.

Implications for Case Management: Subgroups of homeless veterans such as those who served in the Vietnam and post-Vietnam era, more recent returnees from Iraq and Afghanistan, women, rural-residing veterans, and those who are justice involved, are discussed for unique trauma histories and service needs. Barriers to receiving trauma-informed care among homeless veterans are reviewed. Information to assist providers in assessing trauma histories and current best practices in the treatment of posttraumatic stress disorder are noted. Suggestions for how this document can be used in varied organizational settings are made.

Stephanie Dinnen, MS, is Research Coordinator for the Department of Psychiatry, Yale School of Medicine. Her research interests include the phenomenology, symptomology, and treatment of mental health disorders in older adult populations, specifically, trauma in the lives of older adult women.

Vince Kane, MSW, is Director of the National Center for Homelessness Among Veterans and the Director of the Housing and Urban Development—VA Supportive Housing (HUD-VASH) Program. He has been the site PI on numerous research projects including the Federal Partners Initiative for Chronic Homeless Veterans.

Joan M. Cook, PhD, is Associate Professor of Psychiatry for the Yale School of Medicine and researcher for the National Center for PTSD. She is funded by the National Institute of Mental Health to study the implementation and sustainability of evidence-based psychotherapies for PTSD in community settings.

Address correspondence to Joan M. Cook, PhD, Yale School of Medicine, NEPEC/182, 950 Campbell Avenue, West Haven, CT 06516 (

The authors report no conflicts of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.