Trauma & Resilience Assessments

Guidelines and Cautions Regarding Individual Assessments

Screening should benefit the patient/client/consumer. Providers who screen for trauma must ensure that, once any health risks are reported, they can offer appropriate care options and referral resources.

We should take every caution not to screen just for screening sake. Why are we screening? What will we do with this information? Is it worth the risks associated with re-traumatization? Is the screener prepared to adequately address the strong emotions that trauma screening could evoke?

Re-screening should be avoided. Frequently re-screening patients may increase the potential for re-traumatization because it requires patients to revisit their traumatic experiences. Minimizing screening frequency and sharing results across treatment settings with appropriate privacy protections may help reduce re-screening.

Ample training should precede screening. All health care professionals should be proficient in trauma screening and conducting appropriate follow-up discussions with patients that are sensitive to their cultural and ethnic characteristics (e.g., language, cultural concepts of traumatic events)

When explaining trauma-informed approaches to patients, it is important to describe trauma in terms that reduce stigma and accommodate low health literacy.

Guidelines and Cautions Regarding Organizational Assessments

Organization leadership must be 100% committed to the process as well as time and investments needed to not only assess the organization but make necessary changes.

Communication about the transformation process needs to be transparent and frequent.

Clients/consumers/patients must be engaged in the process and have an opportunity to provide feedback/input.

The organizational self-assessment should be completed by all staff within an organization, including direct care staff (full time, part time, volunteers), supervisors, case managers, clinicians, administrators (e.g., program managers, directors, executive directors, etc.) and support staff (e.g., office support, maintenance, kitchen staff, etc.)

Organizational Assessments should include the following domains:

Understanding Trauma and Its Impact: Understanding traumatic stress and how it impacts people and recognizing that many behaviors and responses represent adaptive responses to past traumatic experiences.

Promoting Safety: Establishing a safe physical and emotional environment where basic needs are met, safety measures are in place, and provider responses are consistent, predictable, and respectful.

Ensuring Cultural Competence: Understanding how cultural context influences one’s perception of and response to traumatic events and the recovery process; respecting diversity within the program, providing opportunities for consumers to engage in cultural rituals, and using interventions respectful of and specific to cultural backgrounds.

Staff Stress and secondary trauma: Ensuring that staff wellness and stress is recognized and addressed.

Supporting Consumer Control, Choice and Autonomy: Helping consumers regain a sense of control over their daily lives and build competencies that will strengthen their sense of autonomy; keeping consumers well-informed about all aspects of the system, outlining clear expectations, providing opportunities for consumers to make daily decisions and participate in the creation of personal goals, and maintaining awareness and respect for basic human rights and freedoms.

Sharing Power and Governance: Promoting democracy and equalization of the power differentials across the program; sharing power and decision-making across all levels of an organization, whether related to daily decisions or in the review and creation of policies and procedures.

Integrating Care: Maintaining a holistic view of consumers and their process of healing and facilitating communication within and among service providers and systems.

Investing in Relationships: Believing that establishing safe, authentic and positive relationships can be corrective and restorative to survivors of trauma.

Recovery is Possible: Understanding that recovery is possible for everyone regardless of how vulnerable they may appear; instilling hope by providing opportunities for consumer and former consumer involvement at all levels of the system, facilitating peer support, focusing on strength and resiliency, and establishing future-oriented goals.

Please see the resource section for examples of assessments for individuals, organizations, and communities.

Adapted from Trauma-Informed Organizational Toolkit ( and Key Ingredients for Successful Trauma-Informed Care Implementation (


ACE Score Questionnaire

In recent years as knowledge of the ACEs Study has grown, many have provided the ACEs questionnaire to groups of individuals ranging from colleagues, students, to virtual strangers. The ACE score questionnaire (i.e. the number of ACEs an individual has experienced) was designed for population-level epidemiological research. It was not intended to inform practice at the individual level and should not be administered without careful thought behind having necessary supports for those who take the assessment, what might be the potential negative outcomes and costs to screening, and a clear reason for administering the screening.