A traumatic accident or injury often means that recovery doesn’t just involve knitting bones and tissue back together.
Just ask Deanna Denman, PhD, a clinical health psychologist at the NovantHealth Orthopedic Fracture Clinic in Charlotte, where the team focuses on the whole patient as part of a carefully coordinated effort to help them recover after something terrible has happened. And the patient’s mental health is key to that effort.
“My specialty is helping people cope with the psychological effects of medical conditions and illness and helping them with rehabilitation,” she said. “There are other medical services that have been integrating behavioral health for years. With cancer treatment, for example, it's very common to find a psychologist present. But that’s not the case with ortho.”
In fact, the counseling component offered by the Fracture Clinic is a rarity in orthopedics in the U.S.
Denman works side-by-side with Dr. Todd Hall, an orthopedic traumatologist and medical director of the clinic and of the orthopedic trauma service at Novant Health Presbyterian Medical Center.
He treats people who have sustained traumatic orthopedic injuries, typically immediately after they have happened, but he also sees patients who have had a complication with their healing or an infection relating to their fracture. People who’ve been in auto accidents, kids who’ve fallen off monkey bars, those suffering from chronic pain after an injury or accident – they’re all within Hall’s realm of expertise.
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At the patient’s side
“For a lot of patients, working to overcome trauma involves getting them to stop avoiding what they experienced, to help them intentionally process what they experienced and how that has changed the way they view the world,” Denman said. “A lot of times, when somebody endures a trauma, they start avoiding reminders of it. For an ortho trauma patient, that could mean avoiding taking care of themselves.”
In fact, patients often find themselves in a scary place. Denman is there to be mentally and emotionally present to help them deal with their fear. “Their fear is reasonable,” Denman said. “I'm there to walk through that with them.
“When somebody presents with (post-traumatic stress disorder), they may be having nightmares or not sleeping,” she continued. “They tend to be on edge all the time. If they were injured in a car accident, they may have anxiety about driving or riding in a car. They tend to look depressed. Usually when we finish treatment – when they ‘graduate’ – they are back to driving, they are taking care of themselves physically, they're connecting with people and relating with people in ways they want to.”
Making a connection, building a relationship
The clinic treats mental health as the priority it is. Hall doesn’t just mention Denman’s name and suggest the patient call her. He introduces them in person.
“We try to make a connection that day,” Hall said.
If the patient decides to schedule an appointment, it can happen virtually or in person.
Denman works to build relationships. “I might start off by letting a patient know that depression and anxiety are very common trauma responses and that we have tools to help,” she said. “I may connect them to other resources, like physical therapy and occupational therapy, and remind them that their reality right now is not going to be their reality forever.”
And while Denman will be available for as long as a patient needs, she doesn’t intend to provide long-term care. “It depends on the person, but I prefer short-term treatment,” she said. “I tend to think that I'm here to give you skills to help you cope. And, in theory, you should be able to take those skills and implement them in your life. You shouldn't have to see me forever.”
The clinic treats a wide range of patients, including a number of low-income, under- or uninsured people and people experiencing homelessness.
“When somebody is dealing with something like housing insecurity, I’m not terribly inclined to even call them ‘depressed,’” Denman said. “They have very real-life circumstances that are challenging. So, I'm going to do everything I can to help get them connected to resources. Novant Health offers transportation for appointments. We try to keep treatment as reasonably priced as possible, and I try to accommodate as many of their needs as possible.”
“I have the best job in the world,” Denman continued. “It's a privilege to meet somebody when they're going through maybe the darkest, or one of the darkest, times in their lives and help support them through that.”