PTSD Emergency Procedures & Response 3 — Questions and Answers
Question 1: A clinician suspects a PTSD client has been re-exposed to domestic violence. Under mandatory reporting laws, what determines whether a report is required?
- Whether the client explicitly asks for help
- Whether a vulnerable adult or child is at imminent risk of harm (Correct answer)
- Whether the trauma is the same as the original PTSD trauma
- Whether the perpetrator is known to law enforcement
Correct answer: Whether a vulnerable adult or child is at imminent risk of harm
Mandatory reporting is triggered by imminent risk of harm to a vulnerable person (child, dependent adult), regardless of client request.
Question 2: Which crisis intervention model is most widely used and evidence-supported for acute PTSD crisis response?
- The Transtheoretical Model
- Roberts' 7-Stage Crisis Intervention Model (Correct answer)
- The ACE (Adverse Childhood Experiences) Framework
- The Biopsychosocial Model
Correct answer: Roberts' 7-Stage Crisis Intervention Model
Roberts' 7-Stage Model provides a structured, empirically supported framework specifically designed for crisis assessment and intervention.
Question 3: A PTSD client discloses a specific plan to harm a specific third party. The clinician's duty under Tarasoff v. Regents of UC requires:
- Immediate hospitalization of the client only
- Warning the intended victim and notifying law enforcement (Correct answer)
- Confidential documentation with no outside contact
- Consulting a supervisor and waiting 48 hours before acting
Correct answer: Warning the intended victim and notifying law enforcement
Tarasoff established the duty to protect identifiable third parties, requiring clinicians to warn the potential victim and contact law enforcement.
Question 4: In mass casualty or disaster scenarios involving PTSD survivors, which psychological first aid (PFA) principle should guide all early interventions?
- Promote immediate processing of traumatic memories
- Ensure safety, calm, connectedness, self-efficacy, and hope (the five PFA principles) (Correct answer)
- Conduct structured trauma interviews within 24 hours
- Prioritize medication management over psychosocial support
Correct answer: Ensure safety, calm, connectedness, self-efficacy, and hope (the five PFA principles)
The five core principles of Psychological First Aid — safety, calm, connectedness, self-efficacy, and hope — guide evidence-informed early disaster mental health response.
Question 5: When a PTSD client refuses emergency treatment that you believe is necessary, which step should come AFTER explaining the risks of refusal?
- Forcibly administer treatment
- Document the refusal and the client's capacity assessment, then consult supervision (Correct answer)
- Immediately discharge the client from services
- Contact the client's family without the client's consent
Correct answer: Document the refusal and the client's capacity assessment, then consult supervision
When a capacitated client refuses treatment, clinicians must document the refusal, assess decision-making capacity, and seek supervisory guidance while respecting autonomy.
Question 6: Which physical symptom presentation in a PTSD client during crisis is most likely to indicate a need for immediate medical evaluation rather than solely psychiatric intervention?
- Crying and emotional distress
- Hyperventilation with chest pain and numbness in extremities (Correct answer)
- Intrusive thoughts about the trauma
- Social withdrawal and avoidance
Correct answer: Hyperventilation with chest pain and numbness in extremities
Chest pain and extremity numbness can indicate cardiac or neurological events that require immediate medical triage before psychiatric intervention.
Question 7: Critical Incident Stress Debriefing (CISD) is MOST appropriately used with which population in PTSD-related emergency response?
- Trauma survivors immediately after a mass casualty event
- First responders as part of a comprehensive CISM program post-incident (Correct answer)
- Children under 12 who witnessed community violence
- Individuals with chronic, treatment-resistant PTSD
Correct answer: First responders as part of a comprehensive CISM program post-incident
CISD is designed for first responder groups within a broader Critical Incident Stress Management (CISM) framework, not for general trauma survivors.
PTSD Emergency Procedures & Response 3
A clinician suspects a PTSD client has been re-exposed to domestic violence.
Under mandatory reporting laws, what determines whether a report is required?