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1. For an organization to embrace a trauma-informed care (TIC) model fully, it must implement an agency-wide strategy for workforce development that is in alignment with the values and principles of TIC and the organization’s:
A. Executive structure
B. Mission statement
C. Overall goals and responsibilities
D. Functional design
2. In many behavioral health settings, the work environment itself can be toxic to the workforce and may hinder the delivery of individualized, respectful, collaborative, and client-centered care to service recipients.
A. True
B. False
3. According to the authors, organizational factors that contribute to chronic levels of high stress and often lead to high staff turnover in behavioral health settings include each of the following EXCEPT:
A. Expecting counselors to maintain high caseloads of clients who have experienced trauma
B. Not providing trauma-informed clinical supervision and training to counselors and failing to provide adequate vacation
C. Lack of health insurance, and other reasonable benefits that support counselors’ well-being
D. Failure to implement regular, consistent clinical supervision and training for all clinical staff members
4. The Seeking Safety model of treating substance abuse and PTSD can help counselors focus on the primary goal of stabilization and safety in TIC, while emphasizing safety, honesty, and compassion, and by making cognitive–behavioral therapy accessible and interesting to clients who may otherwise be difficult to engage.
A. True
B. False
5. In order to demonstrate trauma awareness, a trauma-informed counselor will:
A. Maintain clarity of roles and boundaries in the therapeutic relationship
B. Demonstrate an ability to identify clients’ strengths, coping resources, and resilience
C. Understand the importance of ensuring the physical and emotional safety of clients
D. Respect clients’ ways of managing stress reactions while supporting and facilitating taking risks to acquire different coping skills
6. As part of a comprehensive informed consent process, behavioral health administrators are responsible for helping counselors engage in a respectful dialog with clients about their rights and responsibilities.
A. True
B. False
7. Which of the following is NOT one of the counseling behaviors that clinical supervisors should be aware of that may indicate boundary confusion with clients?
A. The counselor refuses to engage in any self-disclosure with the client, even when such information would be beneficial to the therapeutic process
B. The counselor feels reluctant or embarrassed to discuss specific interactions with a client or details of the client’s treatment in supervision or team meetings
C. The counselor feels possessive of the client, advocates with unusual and excessive vehemence for the client, or expresses an unreasonable sense of overresponsibility for the client
D. The counselor becomes defensive and closed to hearing ideas from the supervisor or the treatment team members about approaches to working with a client and/or exploring his or her own emotional reactions to a client
8. While boundary crossings are defined as departures from the customary norms of counseling practice in relation to psychological, physical, or social space that are harmless, boundary violations are unwanted, dangerous, and exploit the client.
A. True
B. False
9. Ongoing supervision and consultation supports the organizational message that TIC is the standard of practice, and normalizes secondary traumatization as ______________ and reinforces the need for counselor self-care to prevent and lessen the impact of secondary traumatization.
A. An expected response
B. An intrinsic concern
C. A systemic issue
D. A natural reaction
10. Supervision of counselors working with traumatized clients should be regularly scheduled, and the styles and types of supervision and consultation will generally be the same regardless of the type of trauma work and its context.
A. True
B. False
11. Although the organization itself can create a social context with risk factors that can increase the likelihood of counselors experiencing STS reactions, it also contains protective factors that can lessen the risk and impact of STS reactions on staff members.
A. True
B. False
12. In behavioral health settings, one of the risk factors for developing STS is being older in age and having years of exposure as a clinician treating trauma-related conditions.
A. True
B. False
13. One of the organizational strategies to prevent secondary traumatization is providing regular trauma-informed clinical supervision that is:
A. Geared toward counselor strengths
B. Relationally based
C. Focused on intense case management
D. None of the above
14. Indicators that counselors may be experiencing cognitive shifts as a result of secondary traumatization include:
A. Exhibiting distressing emotions such as grief, depression, anxiety, dread, fear, rage, and shame
B. Experiencing decreased intimacy and trust in personal/professional relationships
C. Disconnecting from one’s sense of identity
D. Feeling an extreme sense of helplessness or exaggerated sense of control over others or situations
15. Components of the Professional Quality of Life Scale allow counselors to reflect on their resilience and reminds them of why they choose to work with people with substance use and trauma-related disorders, despite the fact that this work can lead to secondary traumatization.
A. True
B. False
16. Decisions about strategies for addressing secondary traumatization should be based on clinical supervisor experience, awareness, and preference.
A. True
B. False
17. Counselor self-care is an ethical imperative, and the key to the development of a self-care plan is maintaining balance between home and work, balancing the focus on self and others, and balancing vulnerability.
A. True
B. False
18. Each of the following is an accurate statement about the components of a comprehensive self-care plan EXCEPT:
A. Regular clinical supervision and personal psychotherapy or counseling can be positive coping strategies for lessening the impact of STS on counselors
B. Recommended strategies to help maintain balance include talking with colleagues about difficult clinical situations, participating in social activities with family and friends, exercising, limiting client sessions, balancing caseloads, and making sure to take vacations
C. The plan should include a self-assessment of coping skills that were effective in the past and address the personal, social, cultural, and behavioral domains
D. Tools for self-reflection may be used to help counselors discover which specific self-care activities might best suit them
19. The “ABCs” of self-care that effectively address the negative impact of secondary traumatization on counselors are acknowledging limitations and boundaries, becoming aware of the value of nourishing oneself, and creating coping strategies to counteract the intensity of trauma work.
A. True
B. False
20. Standards of humane practice of self-care include physical rest and nourishment, the universal right to _________, emotional rest and nourishment, and sustenance modulation.
A. Wellness
B. Happiness
C. Dignity
D. Wholeness
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