CBHCM Trauma-Informed Care — Questions and Answers
Question 1: Which of the following best describes the core principle of trauma-informed care?
- Focusing treatment exclusively on resolving the original traumatic event
- Recognizing the widespread impact of trauma and integrating this knowledge into all aspects of service delivery (Correct answer)
- Requiring clients to disclose trauma history before receiving services
- Reserving trauma-focused interventions for clients with a formal PTSD diagnosis
Correct answer: Recognizing the widespread impact of trauma and integrating this knowledge into all aspects of service delivery
Trauma-informed care (TIC) is an organizational and practice approach that recognizes the prevalence and impact of trauma across populations and integrates that awareness into policies, procedures, and all interactions — without requiring trauma disclosure or limiting care to those with a PTSD diagnosis.
Question 2: SAMHSA's six key principles of trauma-informed care include all of the following EXCEPT:
- Safety
- Trustworthiness and transparency
- Mandatory trauma disclosure (Correct answer)
- Empowerment, voice, and choice
Correct answer: Mandatory trauma disclosure
SAMHSA's six principles are: Safety; Trustworthiness and Transparency; Peer Support; Collaboration and Mutuality; Empowerment, Voice, and Choice; and Cultural, Historical, and Gender Issues. Mandatory trauma disclosure contradicts the foundational principle of client safety and choice.
Question 3: A client becomes visibly agitated when asked routine intake questions about family history. A trauma-informed response would be to:
- Document the client's non-compliance and reschedule the appointment
- Continue with the questions to gather necessary clinical information
- Pause, acknowledge the client's reaction, and ask how to make the process more comfortable (Correct answer)
- Refer the client to a psychiatrist before proceeding with case management
Correct answer: Pause, acknowledge the client's reaction, and ask how to make the process more comfortable
A trauma-informed response prioritizes safety and trust. Pausing to acknowledge distress and inviting the client to guide the process honors the principle of empowerment and choice, helping re-establish a sense of control.
Question 4: Secondary traumatic stress (STS) in behavioral health case managers is BEST addressed by:
- Limiting case managers to clients with less severe trauma histories
- Organizational supports including regular supervision, peer consultation, and manageable caseloads (Correct answer)
- Advising case managers to maintain strict professional detachment from all clients
- Scheduling additional training on trauma treatment modalities
Correct answer: Organizational supports including regular supervision, peer consultation, and manageable caseloads
Secondary traumatic stress (also called compassion fatigue) is best mitigated at the organizational level through regular clinical supervision, peer support, manageable caseloads, and self-care policies — not by restricting case assignments or demanding emotional detachment.
Question 5: In a trauma-informed framework, the question 'What happened to you?' is preferred over 'What is wrong with you?' because it:
- Shifts liability from the organization to the client's history
- Reframes behavior as an understandable response to adversity rather than a character deficit (Correct answer)
- Satisfies mandatory documentation requirements more efficiently
- Allows the case manager to skip the formal diagnostic assessment
Correct answer: Reframes behavior as an understandable response to adversity rather than a character deficit
The shift from 'What is wrong with you?' to 'What happened to you?' is central to trauma-informed practice. It reframes problematic behaviors as understandable coping responses to adverse experiences, reducing stigma and building therapeutic alliance.
Question 6: A trauma-informed case manager working with a survivor of domestic violence should prioritize which of the following in service planning?
- Immediate reunification with family to restore social support
- Rapid placement in group housing to reduce isolation
- Collaborating with the client to identify safety planning goals she chooses (Correct answer)
- Contacting the abuser to obtain collateral information about the client's history
Correct answer: Collaborating with the client to identify safety planning goals she chooses
Trauma-informed care with domestic violence survivors centers safety and client self-determination. Allowing the client to lead goal-setting respects her autonomy and lived expertise, which is essential for rebuilding trust and agency after abuse.
CBHCM Trauma-Informed Care
Which of the following best describes the core principle of trauma-informed care?