Abstract

Background: Trauma-related symptoms are associated with impaired functioning, increased distress, and limited access to timely evidence-based care in rural communities. Local Problem: In a rural Permian Basin outpatient mental health setting, patients with trauma-related symptoms experienced barriers to structured coping support while awaiting or engaging in trauma-focused care. Intervention: This quality improvement project implemented a self-guided cognitive behavioral therapy (CBT) workbook supported by four planned biweekly provider check-ins during an eight-week period. Methods: Ten adults enrolled. Feasibility was evaluated using provider reachability, workbook engagement, participant feedback, and available PTSD Checklist for DSM-5 (PCL-5) scores. Quantitative findings were summarized descriptively; three participants had two PCL-5 scores available for exploratory paired analysis. Qualitative feedback was organized into themes related to perceived utility, trauma activation, competing life demands, and care coordination. Results: Twenty-three of 39 eligible provider contact opportunities were completed (59.0%). No participant had a documented baseline-to-Week 8 PCL-5 pair. Among the three participants with two short-interval scores, all second scores were lower; the mean within-participant change was -10.33 points. Exploratory paired tests were not statistically significant. Five participants described aspects of the workbook as helpful or useful, while two reported trauma-related discomfort, including distressing memories or dreams. Four participants reported competing life demands that interfered with participation, and one experienced a care-coordination delay. Conclusions: The project demonstrated partial feasibility. Findings support refinement of participant orientation, follow-up strategies, outcome collection, pacing and grounding guidance, and coordination with existing providers before broader implementation.

Date of publication

2026

Document Type

DNP Scholarly Project

Language

english

Persistent identifier

http://hdl.handle.net/10950/5221

Committee members

Gina Dudley, DNP

Degree

Doctor of Nursing Practice

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