Trauma-Informed Care Pathway — OneVillage Whole Health Pathways

Who this is for

Adults with disclosed trauma history and PC-PTSD-5 >=3 or PCL-5 >=31. Members with active suicidality, severe dissociation, or active self-harm are co-managed with LCSW from day one. Active SUD routed to SUD pathway in parallel.

What brings people here

Self-disclosed trauma history with current functional impact; PC-PTSD-5 >=3; LCSW referral; member returning from leave related to trauma.

Clinical framework

OneVillage-developed (SAMHSA principles).

How the 8 weeks run

Onboard

Before you begin

Baseline assessments, your first SMART goal, and the 1:1 that sets up everything after it.

Build

Weeks 1 to 3

Specialist coaches rotate in, and sessions come thickest here. One change at a time, in the domains your baseline flagged.

Mid-program

Week 4

Re-score, refresh the care plan, and check in 1:1 on what is and is not working.

Integrate

Weeks 5 to 7

The remaining domains, at a lighter cadence, and the work of making the early weeks hold under pressure.

Maintain

Week 8

Final re-score, relapse prevention, and the plan for what happens next.

When your sessions fall

The program is built in four-week modules. Sessions come thickest at the start, when what you decide matters most, and step down as things settle. That is 5 sessions of 45 minutes across 8 weeks, counting the visit before week 1.

Module	Weeks	Sessions	Cadence
Module 1	Weeks 1 to 4	2	every other week
Module 2	Weeks 5 to 8	2	every other week

Week by week

Before you begin
Before you begin
This is the reading before your first visit. Read as much of it as you want to. You can stop, and you can come back. That is not politeness: choice and control are part of how this pathway is designed, and they start here.
Week 1
What actual treatment looks like
The most useful thing this pathway can give you in week 1 is an accurate map of what treatment exists, so that you can tell whether you are being offered it. Trauma attracts a large amount of confident, expensive and unevidenced help, and knowing the difference is protective.
Week 2
Grounding, and the window of tolerance
This week you meet Christine Squires, your stress management coach, for 45 minutes. Everything in this session is a skill, practiced when you are steady, so that it is available when you are not. Nothing in it involves talking about what happened.
Week 3
Sleep, and the nights
Sleep is where trauma keeps working after the day has ended, and it is one of the parts of this pathway where something concrete can be done quite quickly. It is also the part most often treated with a drink, which is why that appears here rather than being left implied.
Week 4
Halfway: is treatment actually happening
This week you see Cindy Cathcart again for 45 minutes and complete the PCL-5 again. The midpoint has one question at its center, and it is not how you are feeling. It is whether the treatment that is supposed to be happening is happening.
Week 5
What it does to the rest of the body
This week covers the physical health side, and it needs a warning at the front: everything below is population-level association, none of it is a prediction about you, and none of it is a verdict.
Week 6
Movement, at an intensity you set
This week you meet Melissa Tuell, MOT, OTR/L, for 45 minutes of trauma-sensitive movement work. One rule governs the entire session and you are the one who enforces it: you set the intensity, and nobody pushes you past it.
Week 7
People, and rebuilding safe connection
Of everything studied as a risk factor for post-traumatic stress, the one most open to change is other people. That is the reason this week exists, and it is also the week most likely to be difficult, because trauma frequently happened at the hands of someone.
Week 8
Making it hold
This is the last session with Cindy, 45 minutes. For most of the pathways at OneVillage, week 8 is a graduation.

Who you will work with

Your Whole Health Coach takes your first visit and closes every module, so it is the same person from the first session to the last. The specialists below lead the weeks where their work is the focus.

Cindy Cathcart, RN, MSN, BCPA

Whole Health Coach

Professionally, Cindy has been a clinical nurse for nearly a decade. She served in both clinical and administrative capacities throughout her career and holds a Master's degree in Nursing Leadership. As a staff nurse, nurse leader, and quality improvement specialist, she led multidisciplinary teams in academic medical settings throughout Boston, New York, and Ohio to deliver high-quality care to patients across complex diagnoses.

Christine Squires

Stress Management Coach

Are you ready to take control of your stress and embrace a more fulfilling life? Meet Christine, a dedicated stress management coach with over a decade of experience helping individuals navigate life’s challenges. Since 2011, she has worked in various addiction and mental health settings, equipping clients with effective tools to manage stress, overcome crises, and cultivate resilience.

Melissa Tuell, MOT, OTR/L

Functional Movement Therapist

Melissa Tuell, MOT, OTR/L is a licensed Occupational Therapist with more than 30 years of experience helping people restore function, manage chronic conditions, and rebuild confidence in the activities that matter most to daily life.

What we work on

Domain	What this pathway does
Nutrition & Metabolism	Eating patterns disrupted by trauma. Regular meals; gut-brain emphasis. ED screen routine.
Movement & Mobility	Body-based regulation. Trauma-sensitive movement (yoga, walking, somatic). NEVER push intensity.
Sleep & Recovery	Sleep restoration is core. Nightmares tracked. CBT-I principles.
Stress & Resilience	Window of tolerance; grounding skills; nervous-system regulation.
Mind & Mood	PCL-5 + PHQ-9 + GAD-7. Co-occurrence common. Dissociation tracked.
Relationships & Purpose	Healthy connection is core to recovery. Boundaries; safe relationships.

How progress is measured

These are the validated tools this pathway uses: at your first visit, at the mid-program review, and at the end.

Tool	Cadence	Owned by
PC-PTSD-5	Onboard	WHC; LCSW reads
PCL-5	Onboard, q4 weeks	LCSW
C-SSRS	Onboard; PRN any concern	LCSW
PHQ-9 + GAD-7	Onboard, q4 weeks	WHC; LCSW reads
ISI	Onboard, q4 weeks	Sleep Coach
Safety plan	Onboard; reviewed every session in Stabilize	WHC + LCSW

The research behind this pathway

Your clinician playbook was built from the guidelines and studies below. They are listed so you can read them yourself: every one is a real, published paper and the number at the end of each line is its PubMed ID.

Guidelines this pathway follows

SAMHSA trauma-informed care principles · Substance Abuse and Mental Health Services Administration
Safety, trustworthiness, peer support, collaboration, empowerment and cultural humility.
PC-PTSD-5 · Prins and colleagues
The five-question screen used before anything longer. PMID 27170304
Adverse Childhood Experiences framework · Felitti and colleagues; Hughes and colleagues
Why this pathway asks about history at all. PMID 9635069

Key studies

Felitti VJ et al. (1998). Am J Prev Med
Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study
The original Adverse Childhood Experiences study, 9,508 adults, showing that childhood adversity tracks with the leading causes of death decades later. PMID 9635069
Hughes K et al. (2017). Lancet Public Health
The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis
Pooled 37 studies and 253,719 people. Four or more adverse childhood experiences raised the risk of every one of the 23 health outcomes examined. PMID 29253477
Cusack K et al. (2016). Clin Psychol Rev
Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis
Pooled the trials of psychological treatment for post-traumatic stress disorder. Exposure-based and cognitive therapies had the strongest evidence. PMID 26574151
Goldstein E et al. (2024). Perm J
Effectiveness of Trauma-Informed Care Implementation in Health Care Settings: Systematic Review of Reviews and Realist Synthesis
Reviewed what actually happens when health systems adopt trauma-informed care, and what has to be in place for it to change anything. PMID 38444328
Prins A et al. (2016). J Gen Intern Med
The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5): Development and Evaluation Within a Veteran Primary Care Sample
Developed and evaluated the five-question PC-PTSD-5 screen, which is the short screen this pathway uses before anything longer. PMID 27170304