Patients in medical settings with more adverse childhood experiences (ACEs), such as sexual abuse, demonstrate reduced treatment adherence and greater relational difficulties with providers, potentially contributing to negative health outcomes. Integrated care addresses holistic patient healthcare needs within an interdisciplinary treatment team. Trauma-informed care serves as a potential approach to address patient and provider difficulty, yet practical guidance as to how to implement this approach within integrated care settings is lacking. This article makes the case for trauma-informed integrated care and provides a case example in an oncology setting to illustrate the utility of trauma-informed integrated care with the use of an embedded mental health counselor. Resulting training and practice recommendations include (a) universal screening for ACE in medical settings, (b) enhanced interprofessional education, and (c) provision of embedded counseling and supervision services within integrated care settings. Future research directions are explored.

Objective. The purpose of this study was to provide an in-depth analysis of the components and outcomes of telehealth interventions for family caregivers of individuals with chronic health conditions. Methods. A systematic review of 17 databases was conducted for randomized controlled trials published between January 2002 and January 2017. Interventions were analyzed based on type of telecommunication modality, caregiver and care recipient characteristics, intervention components, and caregiver outcomes. Results. A total of 57 articles met criteria for inclusion. Telephone was the most frequently used mode of telehealth delivery and focused primarily on caregivers of older adults with dementia and stroke. Skills training was the most prevalent treatment strategy across telephone, web, and combined telephone and web modalities. Improved psychological functioning was reported most frequently across telehealth modalities. Conclusion. Telehealth is an effective tool in delivering caregiver interventions and leads to significant improvement in caregiver outcomes. Telephone was used most often to deliver cognitive-behavioral and psychoeducational strategies as compared to web and combined telephone and web modalities. Further research is needed to examine the effects of telehealth interventions on caregiving skills and self-efficacy, as well as health outcomes.

Adverse childhood experiences (ACEs) predict physical and mental health. We examined dyadic differences in intimate partner relationship health by ACE score among couples with low to moderate income enrolled in a relationship education program. Overall, we found a high prevalence of ACEs, disproportionate representation in the highest risk ACE group, and a significant effect between ACEs and indicators of mental and relational health. Implications for counselors include support for an ACE‐informed approach to couples counseling services, as well as a holistic and systemic view of mental and relational health.

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