HRC Trauma-Informed Care 1 — Questions and Answers
Question 1: Which of the following best defines trauma-informed care (TIC) in the context of harm reduction?
- Providing therapy to process past traumatic experiences
- An approach that recognizes the widespread impact of trauma and integrates knowledge about trauma into policies, procedures, and practices (Correct answer)
- Screening clients exclusively for PTSD before delivering services
- Referring all clients with trauma histories to mental health specialists
Correct answer: An approach that recognizes the widespread impact of trauma and integrates knowledge about trauma into policies, procedures, and practices
Trauma-informed care is an organizational framework that recognizes trauma's prevalence and integrates that knowledge into all aspects of service delivery to avoid re-traumatization.
Question 2: The SAMHSA model of trauma-informed care is built on six key principles. Which of the following is NOT one of those principles?
- Safety
- Trustworthiness and transparency
- Diagnosis and labeling (Correct answer)
- Empowerment, voice, and choice
Correct answer: Diagnosis and labeling
SAMHSA's six principles are safety; trustworthiness and transparency; peer support; collaboration and mutuality; empowerment, voice, and choice; and cultural, historical, and gender issues — diagnosis and labeling is not among them.
Question 3: A harm reduction worker notices that a client becomes hostile when asked to sit in a chair facing the wall. The worker allows the client to move the chair. This is an example of which TIC principle?
- Peer support
- Safety (Correct answer)
- Collaboration and mutuality
- Cultural responsiveness
Correct answer: Safety
Allowing the client to reposition themselves addresses their physical and psychological sense of safety, a core TIC principle.
Question 4: Adverse Childhood Experiences (ACEs) research is foundational to trauma-informed harm reduction because it demonstrates that:
- Childhood trauma only affects mental health, not substance use
- Higher ACE scores are associated with increased risk of substance use disorders and chronic disease (Correct answer)
- ACEs primarily affect individuals from high-income backgrounds
- ACE scores above 3 require mandatory reporting to child protective services
Correct answer: Higher ACE scores are associated with increased risk of substance use disorders and chronic disease
The landmark ACE Study found a dose-response relationship between the number of adverse childhood experiences and risk for substance use disorders, mental illness, and chronic disease.
Question 5: Which term describes the process by which staff in trauma-informed settings absorb and internalize the traumatic stress experienced by the clients they serve?
- Burnout
- Compassion fatigue and secondary traumatic stress (Correct answer)
- Vicarious learning
- Countertransference overload
Correct answer: Compassion fatigue and secondary traumatic stress
Compassion fatigue and secondary traumatic stress refer to the emotional and physical depletion that can occur when helpers are repeatedly exposed to clients' traumatic experiences.
Question 6: Re-traumatization in a harm reduction setting most commonly occurs when:
- Clients are asked to complete required intake paperwork
- Staff impose control, use coercive practices, or replicate dynamics similar to the client's original trauma (Correct answer)
- Naloxone training is delivered in a group setting
- Clients are offered peer support services
Correct answer: Staff impose control, use coercive practices, or replicate dynamics similar to the client's original trauma
Re-traumatization happens when service interactions mirror the power imbalances, coercion, or loss of control that characterized a client's original trauma.
Question 7: A trauma-informed harm reduction program emphasizes 'universal precautions for trauma.' This means:
- Assuming all clients have infectious diseases and using PPE accordingly
- Assuming all clients may have trauma histories and delivering services in a way that is safe for everyone (Correct answer)
- Requiring all clients to complete trauma screening before receiving services
- Only serving clients who have documented trauma diagnoses
Correct answer: Assuming all clients may have trauma histories and delivering services in a way that is safe for everyone
Universal precautions for trauma means operating as if any client could have a trauma history, building safety and sensitivity into all interactions without requiring disclosure.
HRC Trauma-Informed Care 1
Which of the following best defines trauma-informed care (TIC) in the context of harm reduction?