If you have lived through something terrifying or deeply painful, the way it stays with you is not a weakness — it is how the mind and body try to protect you. Post-traumatic stress disorder (PTSD) is common, it is understood, and it responds to treatment. You are welcome here, and healing is possible.

What PTSD is

PTSD is a condition that can develop after you experience or witness a frightening or life-threatening event — such as an accident, assault, combat, abuse, a disaster, or the sudden loss of someone you love. The danger has passed, but your nervous system stays on alert, as though the threat could return at any moment. This is a normal response to an abnormal experience, and when it does not settle on its own, care can help.

Signs and symptoms

PTSD usually shows up in four ways. People do not have to have all of them:

  • Reliving the event. Unwanted memories, nightmares, or flashbacks that feel like the moment is happening again.
  • Avoiding reminders. Staying away from people, places, conversations, or activities that bring the memory back.
  • Changes in mood and thinking. Feeling numb, guilty, ashamed, or cut off from others; trouble remembering parts of the event; losing interest in things you used to enjoy.
  • Feeling on edge. Being easily startled, irritable, watchful, or having trouble sleeping or concentrating.

When these last more than a month and get in the way of daily life, it is worth being evaluated. Trauma can also show up as anxiety, depression, or trouble with alcohol or other substances, and we look at the whole picture.

How it is understood and evaluated

There is no blood test for PTSD. A careful evaluation with a provider — your history, the symptoms you are noticing, and how they affect your life — is how we understand what is happening and rule out other causes. You set the pace. You never have to share more of your story than you are ready to share for us to begin helping you.

How it is treated — and how we approach it at OhanaPsych

The strongest evidence for PTSD is for trauma-focused psychotherapy. National guidelines from the U.S. Departments of Veterans Affairs and Defense recommend specific talk therapies — Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), and Eye Movement Desensitization and Reprocessing (EMDR) — as first-line care, ahead of medication, because the gains tend to be larger and longer-lasting (U.S. Department of Veterans Affairs & U.S. Department of Defense, 2023; American Psychological Association, 2017).

Medication can also help, especially alongside therapy. Sertraline and paroxetine are the only two medications FDA-approved specifically for PTSD; other SSRIs and the SNRI venlafaxine are also supported by the evidence (American Psychological Association, 2017). We will talk through the options with you and never rush the choice.

In our practice, we hold this work with aloha and patience. Healing from trauma is not only about reducing symptoms — it is about restoring lōkahi (balance and harmony) and reconnecting you with your ʻohana, your community, and the things that give your life meaning. We coordinate care with your therapist and your primary-care team so you are supported by people who are working together, not in isolation.

Brief screening (96127)

As part of getting started — and to track your progress over time — we use brief, validated questionnaires that are administered, auto-scored, and documented on the CNS Vital Signs platform and billed under code 96127 (brief emotional/behavioral assessment). For PTSD, that includes the PTSD Checklist for DSM-5 (PCL-5), its Civilian (PCL-C) and Stressor-Specific (PCL-S) versions, and the Life Events Checklist (including the DSM-5 version) (CNS Vital Signs, n.d.). Each takes only a few minutes and gives your provider objective information to guide care.

Getting care by telehealth

Most of our care is delivered by secure video, so you can begin from a private, comfortable place of your own. Some parts of care — such as certain controlled medications — still follow the federal Ryan Haight Act and DEA rules and may call for an in-person step; we will tell you clearly if that applies to you.

Lasting access by telehealth

As we complete the final stages of becoming a Rural Health Clinic (RHC), telehealth for mental-health care is here to stay with us. Under Medicare’s rural-health rules, RHCs are permanently authorized to provide behavioral and mental-health care by telehealth — including into your home, anywhere in Hawaiʻi — not under the temporary flexibilities that expire and must be renewed. For our patients, that means dependable, lasting telehealth access to the care you need.

Wherever you live, OhanaPsych is your statewide practice. We provide care across the entire state of Hawaiʻi by telehealth, reaching every island — Hawaiʻi Island, Maui, Oʻahu, Kauaʻi, Molokaʻi, Lānaʻi, and Niʻihau. If you would rather be seen in person, you have that option at our offices in Hilo and Honolulu.

When to reach out

You do not need to be in crisis to reach out — new patients are welcome. Call (808) 777-9460 or start your request online.

If you or someone you love is thinking about suicide or self-harm, get help right away. Call or text the 988 Suicide & Crisis Lifeline (call or text 988, or chat at 988lifeline.org). In Hawaiʻi, Hawaiʻi CARES is available by calling or texting 988, or at 808-832-3100 / 800-753-6879. In a life-threatening emergency, call 911.

Medically reviewed by George Mackel, MSN, APRN, NP-C, PMHNP-BC, CARN-AP — President & Owner, OhanaPsych / Ohana Care Clinic.
Last reviewed: June 28, 2026. Citations verified: June 28, 2026.

This page is general health education from OhanaPsych. It is not a substitute for a personal evaluation by a qualified clinician who knows your situation, and reading it does not create a provider–patient relationship. If you think you may have a mental health condition, reach out to us or another licensed provider. In an emergency, call 911.

References

CNS Vital Signs. (n.d.). CNS Vital Signs computerized rating instruments. https://www.cnsvs.com/WhitePapers/CNSVS-RatingInstruments.pdf

American Psychological Association. (2017). Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. https://www.apa.org/ptsd-guideline

U.S. Department of Veterans Affairs & U.S. Department of Defense. (2023). VA/DoD clinical practice guideline for the management of posttraumatic stress disorder and acute stress disorder. https://www.healthquality.va.gov/guidelines/MH/ptsd/

U.S. Department of Veterans Affairs, National Center for PTSD. (n.d.). How common is PTSD in adults? https://www.ptsd.va.gov/understand/common/common_adults.asp


Frequently Asked Questions

Does OhanaPsych accept QUEST, Medicaid, and insurance for PTSD and trauma care?

Yes. We are in network with the Hawaiʻi QUEST Integration plans — AlohaCare, HMSA, ʻOhana Health Plan, and UnitedHealthcare Community Plan — and we also accept Medicare and most commercial insurance. If you are not sure about your coverage, contact our office and we will help you check.

Can I receive PTSD and trauma care by telehealth, or do I need to come into the office?

We offer both. You can be seen in person at our Honolulu or Hilo office, or by secure telehealth from anywhere in Hawaiʻi. Some visits or treatments may require an in-person appointment, and we will let you know if that applies to your care.

How do I make an appointment for PTSD and trauma care?

You can request an appointment through our online scheduling page, or call us at (808) 777-9460 for Honolulu or (808) 867-8002 for Hilo. We welcome new patients and will help match you with the right provider.

Who provides PTSD and trauma care at OhanaPsych?

Care is provided by our team of licensed, board-certified psychiatric providers. You can read about each member of our team on our Providers page.