Trauma Informed Care in Behavioral Health Services

Individuals who have experienced trauma are at an elevated risk for :

Substance use disorders Abuse and dependence Mental health problems Physical disorders All of these

A specific type of prevention, which targets people who display early signs of trauma-related symptoms is.

Indicated prevention Selective prevention Both a and b None of the above

Trauma Informed TIP 57 targets the adult population only.

True False

This TIP does not provide a comprehensive overview of the unique characteristics of each type of trauma.

True False

TIP presents fundamental concepts that behavioral health service providers can use to:

Learn the core principles and practices that reflect TIC Evaluate and build a trauma-informed organization and workforce Evaluate and initiate use of appropriate trauma-related screening and assessment tools All of the above

Traumatic events may be:

A disaster War,terrorism, or violence Sexual abuse All of the above

In Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions, 71.6 % of the sample reported:

Witnessing trauma Experiencing a trauma that resulted in injury Experiencing psychological trauma None of the above

Counselors with primary treatment responsibilities should also have an understanding of:

How to recognize trauma-related reactions How to incorporate treatment interventions for trauma-related symptoms into clients’ treatment plans How to help clients build a safety net to prevent further trauma and conduct psychoeducational interventions When to make treatment referrals for further evaluations or trauma-specific treatment services All of these

The process of recovery is more difficult, and the counselor’s role is more challenging, when clients have histories of trauma. 

True False

There is a bidirectional relationship between trauma and substance use disorders.

True False

Trauma-informed approach incorporates key elements including: 

Realizing the prevalence of trauma Recognizing how trauma affects all individuals Responding by putting this knowledge into practice All of the above

Trauma awareness (is):

An essential strategy for preventing retraumatization Encompasses a broader awareness of traumatic experiences as well as the impact of an individual’s trauma. Both a and b None of the above

Understanding the Levels within the Ecological Model of Trauma and its effects are:

Individual Factors and Interpersonal Factors Community and Organizational Factors Societal Factors,Cultural and Developmental Factors Period of Time in History All of these

The key elements in establishing a safe environment include: 

Consistency in client interactions Treatment processes policies and procedures Emergency management and disaster planning All of the above

The trauma-informed or trauma-specific interventions are:

Creating safety Engaging in psychoeducation Enhancing coping skills All of the above

--------------- help clients bridge the gap between their mental health and substance-related issues and the traumatic experiences they may have had.

A trauma-informed provider Survivors Trauma-specific interventions None of the above

Trauma occurs before substance use and mental disorders develop.

True False

If individuals engage in mental health and substance abuse treatment without addressing the role that trauma has played in their lives, they are less likely to experience recovery :

Very quickly In the long run At a normal pace None of the above

To achieve trauma-informed competence in an organization or across systems,clients need to play an active role by:

Providing program feedback Forming any behavioral health organization’s plans to improve trauma-informed competence Provide TIC and design relevant treatment services and organizational policies and procedures. All of the above

Trauma-informed principles and practices generated without the input of people affected by trauma are difficult to apply effectively.

True False

Screening should guide treatment planning.

True False

-------------- alerts the staff to potential issues and serves as a valuable tool to increase clients’ awareness of the possible impact of trauma.

Screening A trauma-informed provider Survivors Trauma-specific interventions

The specific variables that may influence screening results are:

Race/ethnicity Native speakers and language Gender and culture All of the above

Across all diverse populations and cultures that face military action and political violence,rates of traumatic stress are:

Low High No Effect None of the above

Building trauma-resistant skills begins with:

Normalizing the symptoms of traumatic stress Teaching clients about how trauma can affect their lives Developing self-care skills None of the above

------------------- is a normal occupational hazard for mental health and substance abuse professionals.

Substance use disorders Screening Secondary trauma None of the above

For trauma survivors, the impact of trauma can be far-reaching and can affect life areas and relationships long after the trauma occurred. 

True False

------ is similar to a rock hitting the water’s surface.

Screening Trauma Developing self-care skills None of the above

Counselors with unacknowledged secondary trauma can cause:

Harm to clients via poorly enforced boundaries Missed appointments Abandonment of clients and their needs All of the above

Advice to counselors for decreasing the risk of Secondary Trauma and Promoting Self-Care include:

Peer support Supervision and consultation Personal therapy Maintaining balance All of these

The absence of responses to triggers is recovery.

True False

The classification of a trauma , often referred to as “acts of God,” is :

Group trauma Human-caused trauma Natural trauma None of the above

An aircraft crash is an example of:

Individual trauma Human-caused trauma Natural trauma None of the above

The responses of survivors to natural trauma experiences often depends on:

The degree of devastation Extent of individual and community losses The amount of time it takes to re-establish daily routines, activities, and services All of the above

If the survivors share a common identity and unique experiences and characteristics of trauma-related reactions,the type of trauma is:

Natural trauma Human-caused trauma Group trauma Individual trauma

Military service members and first responders experience:

Group trauma Human-caused trauma Natural trauma None of the above

First responders are usually:

Emergency medical technicians Disaster management personnel Police officers and journalists All of the above

Events that are so wide spread as to affect an entire culture and intense enough to influence generations of the culture (is):

Group trauma Historical trauma Human caused trauma Natural trauma

In 2005, the tsunami in the Indian Ocean left hundreds of thousands dead in nine countries and is an example of:

Mass trauma Individual trauma Group trauma None of the above

Mass traumas include:

Large scale natural disasters Human caused disasters Both a and b None of the above

A pattern of actual or threatened physical, sexual, and/or emotional abuse is:

Domestic violence Human caused disasters Intimate partner violence Both a and c

Trauma events that occur (and typically continue to re- occur) between people who often know each other are:

Interpersonal traumas Historical traumas Human caused traumas Natural traumas

Substance abuse, particularly involving alcohol, is frequently associated with:

Large scale natural disasters Human caused disasters Intimate partner violence Both a and c

------- are the hidden casualties of IPV.

Former spouses Children Boyfriends or girlfriends None of the above

Developmental trauma is related to:

Adverse childhood experiences (ACEs ) Tragedies that occur outside an expected developmental or life stage A child dying before a parent or being diagnosed with a life-threatening illness All of the above

ACEs cannot negatively affect a person’s well­being into adulthood.

True False

Events that are included in Adult health ACEs are:

Physical, sexual abuse and emotional abuse Spousal abuse between parents; and divorce Substance-dependent parent;or one parent was absent during childhood Mentally ill,or suicidal household member All of these

Child neglect occurs when a parent or caregiver:

Does not give a child the care he or she needs according to his or her age Is not providing a child with medical or mental health treatment Is neglecting the child’s education All of the above

------ is a unique subtype of human-caused disasters.

Terrorism Aircraft crash School violence Domestic violence

---------- can create System-Oriented retraumatizing experiences to trauma patients:

Former spouses Children Treatment settings and clinicians None of the above

A series of traumas happening to the same person over time is known as:

Repeated trauma Human-caused disasters Natural trauma None of the above

A single trauma is limited to:

Repeated intervals A single point in time Both a and b None of the above

Trauma can involve :

A single event Numerous or repeated events Sustained/chronic experiences All of the above

People who live in chronic poverty experience

A single trauma Sustained trauma Numerous or repeated trauma All of the above

Bidirectional relationships exist between trauma and:

Substance use Mental illness Both a and b None of these

Experiencing another’s pain cannot be equally traumatic.

True False

The degree of disruption in resuming normal daily activities is a significant risk factor for:

Substance use disorders Sub clinical psychological symptoms Mental disorders All of the above

The ability to thrive despite negative life experiences and heal from traumatic events is

Resilience Repeated trauma Sustained trauma None of the above

Which statement is true?

Men are at greater risk than women for being exposed to stressful events. The older one becomes,the higher the risk of trauma. Both a and b None of the above

Lesbians and bisexual women are more likely to experience victimization than gay and bisexual men or transgender people.

True False

Delayed Emotional Reactions to Trauma include:

Anger Anxiety or severe fear Depression Denial

Sweating or shivering is an example of:


Delayed Physical Reactions Immediate Physical Reactions Delayed Cognitive Reactions Immediate Emotional Reactions

Immediate Behavioral Reactions to Trauma include:

Increased use of alcohol, drugs, and tobacco Anger Depression Denial

-----------------is one of the methods that traumatized people use to attempt to regain emotional control.

Anger Denial Self-medication None of the above

------is a biological process whereby emotions are detached from thoughts, behaviors, and memories.

Numbing Overwhelmed Somatization None of these

A focus on bodily symptoms or dysfunctions to express emotional distress is:

Numbing Overwhelmed Somatization None of the above

A ------- is a stimulus that sets off a memory of a trauma or a specific portion of a traumatic experience.

Anger Denial Self-medication Trigger

Reexperiencing a previous traumatic experience as if it were actually happening in that moment is:

A flashback Denial Self-medication A trigger

Flashbacks are commonly initiated by a trigger.

True False

Substance abuse itself is a trauma.

True False

------ reflects changes to certain diagnostic criteria which will affect screening tools and criteria for trauma-related disorders.

DSM 5 TREM FREEDOM None of the above

Tools that focus on acknowledging a specific type of traumatic event.


Broad screening tools The Combat Exposure Scale The Intimate Partner Violence Screening Tool All of the above

The instrument that can screen for traumatic stress symptoms with high diagnostic accuracy is :

The four-item self- report SPAN The Combat Exposure Scale The Intimate Partner Violence Screening Tool All of these

In Distress Scale (SUDS), content that causes no or minimal distress is represented by:

1 0 10 5

One of the most controversial issues in the trauma field is the phenomenon of:

Recovered memories Traumatic amnesia Anger Both a and b

------------ was developed for rape survivors and combines elements of existing treatments for PTSD.

Integrated CBT FREEDOM Cognitive processing therapy (CPT ) None of these

Traumatic incident reduction  (TIR ) is a client-centered approach. 

True False

The ATRIUM model consists of ---- phases of treatment.

Two Three Five None of the above

--------is a 14-session individual therapy model designed for PTSD and substance use.

TREM Triad Integrated CBT None of the above

This recovery program has been adapted for individuals who are deaf;


TREM is:

The trauma resistance and educational model The trauma recovery and empowerment model The trauma resilience building and recovery program None of the above

------- is a process of learning to be present in the moment and observing internal experience  (e.g., thoughts, bodily sensations ) and external experience.

Mindfulness Couple and Family Therapy Behavioral Marital Therapy None of these

A comprehensive, trauma-informed model designed for female trauma survivors with co-occurring substance use and mental disorders who live in semi-rural areas is:

SAMHSA PTSD Triad None of the above

An organizational environment that is capable of supporting and sustaining ‘trauma-specific’ services as they develop is:

Peer support services Trauma informed services Both a and b None of these

The main purpose of peer support services is to provide:

Consumer mentoring, support for clients with histories of mental illness Care coordination for clients with substance abuse Both a and b None of the above

A strong therapeutic relationship with a counselor is one of the largest factors in an individual’s ability to recover from the overwhelming effects of trauma. 


True False

Staff members who can provide needed expertise in a trauma-informed organization to promote trauma informed policies and staff development for the organization are called:


Trauma champions Peer support groups Consumer advocacy groups None of these

Green Cross Academy of Traumatology provides guidelines on:

Professional Quality of Life Scale Ethics in Treating Traumatized Clients STS None of the above

A contributing factor in staff turnover and one reason why many behavioral health service professionals leave the field is:

Human-caused disasters Natural trauma STS Self-medication

------- has developed and revised the Professional Quality of Life Scale .

Slattery & Goodman Gutheil and Brodsky Stamm None of the above

The average score on the burnout scale is:

57 50 25 43

The tool can be used as a way for counselors to check in with themselves on their levels of stress and potential signs of secondary traumatization is:

Professional Quality of Life Scale (ProQOL ) The compassion satisfaction scale Both a and b None of the above

------- is a more general type of psychological distress related to the pressures of working in high-stress environments over time.

Burnout Human-caused disasters Natural disasters None of the above

Who should be familiar with the manifestations of STS in their counselors and should address signs of STS immediately?

Administrators Clinical supervisors Clients None of the above

Higher scores on The compassion satisfaction scale represent:

A greater satisfaction related to your ability to be an effective caregiver in your job A greater ability to find more problems with your job A greater satisfaction from activities other than your job None of the above

Secondary traumatic stress (STS) and Burnout are a component of:

Compassion Fatigue Flashback Denial Trigger

A trauma related stress reaction and set of symptoms resulting from exposure to another individual’s traumatic experiences rather than from exposure directly to a traumatic event is:

Resilience Repeated trauma Sustained trauma STS

------- are responsible for developing comprehensive self-care plans and committing to their plans.

Counselors Clinical supervisors Administrators All of these

A self-care plan should include a self- assessment of current coping skills that address the domains of:

Physical and Psychological self-care Emotional and Spiritual self-care Both a and b None of the above

Essential components of self-care that effectively address the negative impact of secondary traumatization on counselors are:

Awareness of one’s needs Balance of activities at work Connection to oneself and to others All of the above