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  • 1.  Asking about Trauma

    Posted 08-08-2019 08:56

    Hello everyone,
    Our agency is developing a new clinical assessment.  We want to ask a few questions related to trauma history, while maintaining the values of trauma informed care.  It is important to us that we don't ask more of an individual than is actually needed to successfully treatment plan.  What does everyone ask as part of their assessment?  

    We are avoiding actual questionnaires/checklists/screening tools. 


    Any input is appreciated, thank you!!



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    Dominique Schroeder
    Quality Manager
    CARE of Southeastern Michigan
    Fraser MI
    586-541-2273
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  • 2.  RE: Asking about Trauma

    National Council Staff
    Posted 08-09-2019 17:41

    Hi Dominque,

     

    Great question!

    Our trauma-informed services team here at the National Council supports asking questions about trauma with clients and patients with a trauma-informed approach. Several of the agencies we work have started to integrate these types of questions into their initial and ongoing conversations. And, you're right, they can be simple questions.

     

    Before you start to integrate simple questions into your process, be sure to prepare what your response will be. We've learned through our Trauma-Informed Primary Care Initiative that it is important to prepare your response to the questions. We recommend:

    1. Share information about trauma – Your clients and patients may be confused as to why you are asking questions about their trauma histories. Not everyone is familiar with the connections between trauma and health. Educating your patient empowers them to lead the conversation about their own experiences. You can also use general psychoeducational pamphlets and posters to identify your clinic's commitment to addressing your clients' whole health.
    2. Train your staff on the process – Staff should clearly understand the process for including this new questions in their sessions with clients and patients. They, too, need training on trauma and its connection to health in addition to training on the new process.
    3. Determine the appropriate response – Depending on the answers to the questions, your staff may need to take specific action. As necessary, please be sure to comply with mandated reporting laws and explain what that means to your clients and patients as they proceed. If no immediate action is needed, many providers rely on their motivational interviewing and shared decision-making skills to have a discussion with the client about how you can adapt their services to their needs based on this information.

     

    One example of trauma inquiry questions come from the Native American Rehabilitation Association of the Northwest. The questions they developed are simple and culturally-relevant to the population they serve:

    • Do you feel you have experienced trauma in your life in the past?
    • Do you currently feel safe from trauma in your life?
    • Do you feel you carry the trauma of your ancestors in your life?
    • Would you like more support in taking care of your body, emotions and spirit?
    • Do you feel that trauma affects your participation in medical care?

     

    It is common for agencies to simply say, "We know that our health can be impacted by things we've experienced. Have you had an experience that was frightening or upsetting that has stayed with you?"

    Whatever questions you choose to go with, we strongly recommend that the questions and the response are designed to be culturally relevant. That may mean that you won't use the word "trauma" because it does not resonate with your patient population. For example, Malama I Ke Ola, an agency in Hawaii, engaged their community health workers and outreach teams to help create questions that would fit their patients' needs best.

     

    Please feel free to reach out to our trauma-informed services team at the National Council if you'd like more support leading your agency's trauma-informed care work.

     

    Thanks!

    Sarah



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    Sarah Flinspach
    Pronouns: she/her/hers
    National Council for Behavioral Health
    Washington DC
    (202)684-7457
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