Six-Core Principles
A clinic shifts from asking “What’s wrong with you?” to “What happened to you?”
Which trauma-informed principle is primarily being applied?
Empowerment, voice, and choice (also reflects shift toward safety & trust)
What is one key difference between Housing First and treatment-first models?
Housing First provides housing without requiring sobriety or treatment first
What is meant by the “revolving door” in homelessness services?
Cycling between shelters, hospitals, detox, and streets without long-term stability
What does it mean when trauma is described as “compounding”?
Multiple traumas and stressors build on each other, increasing impact
An 11-year-old client from a close-knit immigrant family begins to hint at “something bad” happening at home but becomes visibly anxious when asked directly. The child states, “If I say anything, my family will fall apart,” and expresses fear of bringing shame to the family.
What is a culturally responsive, trauma-informed approach that builds trust, uses gradual and indirect exploration, normalizes feelings, and addresses shame and stigma without forcing disclosure?
In an HIV clinic, staff openly explain policies, expectations, and follow through consistently with patients. Which principle is being demonstrated and why does it matter for trauma survivors?
Trustworthiness & transparency — reduces fear, unpredictability, and mistrust rooted in past trauma
Why is caregiver involvement essential in treating intrafamilial child sexual abuse?
Attachment relationships & healing and safety: Principle #6
How can mandated reporting create ethical tension in cases of intrafamilial abuse?
Balancing safety/legal obligation with potential family disruption and client trust
How might homelessness, substance use, and trauma interact?
Each worsens the other → creates cycles of instability and vulnerability
James a 54-year-old man recently moved into supportive housing after being unhoused for 3yrs. During that time, he struggled with opioid use and untreated depression. After being housed, James initially engaged well with services, attended appointments, and expressed hope about rebuilding his life. However, after receiving news that his sister passed away, James began isolating himself and stopped attending case management meetings. Staff discovered that he had relapsed and used opioids in his apartment. Staff expressed frustration, saying he was “not taking housing seriously” and suggested he should face consequences for violating program expectations. As a Clinician, what is a trauma informed response?
Respond with empathy, avoid punishment, maintain housing stability, and re-engage the client in supportive services using harm reduction.
A clinician working with a child reports they are experiencing intrafamilial abuse, determined to include the parent in treatment. Which TWO principles are being balanced here?
Collaboration & Empowerment
A clinician uses motivational interviewing with a client experiencing homelessness who is unsure about treatment. Why is this approach effective?
Supports autonomy/reduces resistance/aligns with harm reduction and trauma informed care
Why might individuals living with HIV mistrust healthcare systems?****IZZY REVISIT
ADD DENTAL PIECE PLEASE :)
Historical trauma, discrimination, stigma, systemic inequities
Why is intrafamilial sexual abuse particularly complex compared to other trauma?
Occurs within attachment system → disrupts safety, trust, and relationships simultaneously
A patient with HIV yells at staff over a missed benefit. What is a trauma-informed interpretation?
Response driven by stress, survival needs, and past trauma — not intentional hostility
Trauma can affect attachment, especially in this population.
Who are children?
In HIV care, how does untreated trauma directly impact medical outcomes?
Decreased medication adherence, lower engagement in care, higher viral loads
A family avoids reporting sexual abuse due to fear of community shame. What system-level factors are influencing this decision? ****BELINDA REVISIT
Cultural stigma, social norms, fear of institutional involvement, systemic mistrust
How do cultural stigma and trauma interact to delay disclosure?
Stigma increases shame and fear → reduces likelihood of seeking help
A clinician is working with a family where a 13-year-old youth has disclosed ongoing sexual abuse by their 15-year-old sibling. The caregiver appears visibly distressed and states, “I don’t know who to protect,” expressing fear that reporting will “tear the family apart.” Both youth are still living in the home, and the caregiver has not yet taken steps to separate them.
What is a trauma-informed, family systems approach that prioritizes safety planning, mandated reporting, and coordinated, separate interventions for both the survivor and the youth who caused harm?
Trauma exposure is especially high in these two adult populations.
Who are individuals with HIV and unhoused individuals?
You are working with a survivor of sibling sexual abuse who minimizes their experience. What trauma-informed intervention approach would you use and why?
Psychoeducation + gentle exploration of meaning + normalization of feelings due to family dynamics (loyalty, minimization) complicate recognition of abuse
A provider insists a client must be sober before receiving housing. What systemic barrier does this reflect, and how does Housing First challenge it?
Barrier: Conditional access to care
Housing First removes barriers → prioritizes stability first to support recovery
A Black woman living with HIV, experiencing homelessness, and trauma faces barriers to care. Explain how intersectionality creates compounded risk in this scenario.
Multiple identities (race, gender, health status, housing instability) intersect → amplify discrimination, barriers, and trauma impact
You notice staff frequently label clients as “difficult.” What intervention would you implement at the organizational level?- shouldn't this question be in intervention
Trauma-informed training + reflective supervision + shift in language and culture