Podcast
Questions and Answers
What is the recommended duration for trauma-focused psychological treatment for PTSD resulting from a single event?
What is the recommended duration for trauma-focused psychological treatment for PTSD resulting from a single event?
What is a key focus of Phase Two in Trauma-Focused CBT?
What is a key focus of Phase Two in Trauma-Focused CBT?
Which of the following statements is true regarding trauma-informed care?
Which of the following statements is true regarding trauma-informed care?
What factor is particularly important when addressing PTSD with complex needs?
What factor is particularly important when addressing PTSD with complex needs?
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What signifies a trauma-informed organization?
What signifies a trauma-informed organization?
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What is the focus of Trauma Informed Care (TIC)?
What is the focus of Trauma Informed Care (TIC)?
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Which of the following is NOT one of the components of the 3 E's of trauma?
Which of the following is NOT one of the components of the 3 E's of trauma?
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According to the bio-psycho-social model, what influences vulnerability to trauma?
According to the bio-psycho-social model, what influences vulnerability to trauma?
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What does the principle of 'Resist' in TIC aim to achieve?
What does the principle of 'Resist' in TIC aim to achieve?
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What should organizations recognize according to TIC principles?
What should organizations recognize according to TIC principles?
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What is one of the recommended practices in the NHS Trauma-Informed Mental Health Policies?
What is one of the recommended practices in the NHS Trauma-Informed Mental Health Policies?
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How can trauma be experienced in relation to psychosis?
How can trauma be experienced in relation to psychosis?
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What is one way organizations can make relationships safer within TIC?
What is one way organizations can make relationships safer within TIC?
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What was a primary reason for creating the Trauma & Life Events Checklist?
What was a primary reason for creating the Trauma & Life Events Checklist?
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What conclusion was drawn from the meta-analysis regarding trauma-focused therapy for PTSD in psychosis?
What conclusion was drawn from the meta-analysis regarding trauma-focused therapy for PTSD in psychosis?
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What was the outcome of the meta-analysis on trauma-focused therapy's effect on delusions?
What was the outcome of the meta-analysis on trauma-focused therapy's effect on delusions?
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Which technique was found to be beneficial for individuals with voices linked to trauma?
Which technique was found to be beneficial for individuals with voices linked to trauma?
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How many sessions does the Integrated tf-CBTp trial proposed by STAR involve?
How many sessions does the Integrated tf-CBTp trial proposed by STAR involve?
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What is the main focus of the trauma-focused therapies mentioned for psychosis?
What is the main focus of the trauma-focused therapies mentioned for psychosis?
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What is one of the trials underway for Trauma-Focused Therapy for Psychosis?
What is one of the trials underway for Trauma-Focused Therapy for Psychosis?
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What effect did trauma memory techniques have on voices according to recent findings?
What effect did trauma memory techniques have on voices according to recent findings?
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What is a significant barrier to conducting routine trauma assessments according to the content?
What is a significant barrier to conducting routine trauma assessments according to the content?
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What percentage of service users was recorded as having been asked about trauma in the audit of the REVA policy implementation?
What percentage of service users was recorded as having been asked about trauma in the audit of the REVA policy implementation?
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Which of the following is NOT highlighted as a requirement for trauma assessments in the content?
Which of the following is NOT highlighted as a requirement for trauma assessments in the content?
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What was the main focus of inpatients regarding trauma inquiry in the content?
What was the main focus of inpatients regarding trauma inquiry in the content?
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What issue arises from the current enquiry prompt regarding trauma assessments?
What issue arises from the current enquiry prompt regarding trauma assessments?
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What is a significant risk factor associated with childhood psychological trauma?
What is a significant risk factor associated with childhood psychological trauma?
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Which of the following is NOT a term related to childhood psychological trauma?
Which of the following is NOT a term related to childhood psychological trauma?
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According to the Bradford Hill Criteria, which statement is TRUE about trauma and psychosis?
According to the Bradford Hill Criteria, which statement is TRUE about trauma and psychosis?
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What might be a potential outcome if psychological trauma could be eradicated?
What might be a potential outcome if psychological trauma could be eradicated?
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What type of response might individuals with a history of childhood trauma exhibit?
What type of response might individuals with a history of childhood trauma exhibit?
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Which factor does NOT contribute to the Bradford Hill Criteria for assessing trauma's impact on mental health?
Which factor does NOT contribute to the Bradford Hill Criteria for assessing trauma's impact on mental health?
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What neurological alteration is suggested for individuals exposed to childhood trauma?
What neurological alteration is suggested for individuals exposed to childhood trauma?
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Which of the following mental disorders has been linked to childhood psychological trauma?
Which of the following mental disorders has been linked to childhood psychological trauma?
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What is an essential consideration when addressing PTSD with complex needs?
What is an essential consideration when addressing PTSD with complex needs?
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Which phase of Trauma-Focused CBT involves memory work to contextualise and elaborate memories?
Which phase of Trauma-Focused CBT involves memory work to contextualise and elaborate memories?
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In trauma-informed care, what assumption can be made about interactions with trauma survivors?
In trauma-informed care, what assumption can be made about interactions with trauma survivors?
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How do trauma-focused treatments differ from general interventions?
How do trauma-focused treatments differ from general interventions?
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What is a unique aspect of trauma-focused therapy compared to other forms of therapy?
What is a unique aspect of trauma-focused therapy compared to other forms of therapy?
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What are the two main factors that influence the development of trauma according to the theory of latent vulnerability?
What are the two main factors that influence the development of trauma according to the theory of latent vulnerability?
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What is a primary goal of Trauma Informed Care (TIC)?
What is a primary goal of Trauma Informed Care (TIC)?
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Which of the following best describes the 'Events' component of the 3 E's of trauma?
Which of the following best describes the 'Events' component of the 3 E's of trauma?
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How does the 'Relation' focus in TIC approach relationships within therapeutic settings?
How does the 'Relation' focus in TIC approach relationships within therapeutic settings?
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What is one of the key recommendations for trauma-informed care in managing psychosis?
What is one of the key recommendations for trauma-informed care in managing psychosis?
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In the context of TIC, what does the term 'Resist' refer to?
In the context of TIC, what does the term 'Resist' refer to?
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What is considered a systemic approach within Trauma Informed Care (TIC)?
What is considered a systemic approach within Trauma Informed Care (TIC)?
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Which of the following describes the 'Experience' component of the 3 E's of trauma?
Which of the following describes the 'Experience' component of the 3 E's of trauma?
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What was a key reason for developing the shortened version of the Trauma & Life Events Checklist?
What was a key reason for developing the shortened version of the Trauma & Life Events Checklist?
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What have meta-analyses concluded about the effectiveness of trauma-focused therapy for PTSD in individuals with psychosis?
What have meta-analyses concluded about the effectiveness of trauma-focused therapy for PTSD in individuals with psychosis?
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What outcome was reported regarding trauma memory techniques for voices linked to trauma?
What outcome was reported regarding trauma memory techniques for voices linked to trauma?
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What does the upcoming trial 'EASE' focus on in the context of trauma-focused therapy for psychosis?
What does the upcoming trial 'EASE' focus on in the context of trauma-focused therapy for psychosis?
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What effects did the meta-analysis of 12 studies find regarding trauma-focused therapy's impact on delusions?
What effects did the meta-analysis of 12 studies find regarding trauma-focused therapy's impact on delusions?
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Which of the following statements is true according to the emerging evidence about treatment approaches for psychosis?
Which of the following statements is true according to the emerging evidence about treatment approaches for psychosis?
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What is a common barrier to routine inquiry about trauma assessments?
What is a common barrier to routine inquiry about trauma assessments?
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Why is there an increasing interest in trauma-informed care (TIC) for psychosis both nationally and internationally?
Why is there an increasing interest in trauma-informed care (TIC) for psychosis both nationally and internationally?
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What percentage of service users were recorded as having been asked about trauma during the implementation audit?
What percentage of service users were recorded as having been asked about trauma during the implementation audit?
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What is the primary goal of the trials underway for Trauma-Focused Therapy for Psychosis?
What is the primary goal of the trials underway for Trauma-Focused Therapy for Psychosis?
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Which of the following is emphasized as a necessity before conducting a trauma assessment?
Which of the following is emphasized as a necessity before conducting a trauma assessment?
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What outcome did inpatient service users want from routine trauma inquiry?
What outcome did inpatient service users want from routine trauma inquiry?
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What is a noted issue with the enquiry prompt used in trauma assessments?
What is a noted issue with the enquiry prompt used in trauma assessments?
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What is the risk factor associated with childhood psychological trauma in relation to psychosis?
What is the risk factor associated with childhood psychological trauma in relation to psychosis?
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Which statement about the Bradford Hill Criteria is correct?
Which statement about the Bradford Hill Criteria is correct?
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What could be a potential outcome of eradicating psychological trauma according to the content?
What could be a potential outcome of eradicating psychological trauma according to the content?
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What neurological alterations are associated with childhood trauma?
What neurological alterations are associated with childhood trauma?
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What does the term 'childhood maltreatment' refer to?
What does the term 'childhood maltreatment' refer to?
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Which is NOT considered a potential outcome of childhood psychological trauma?
Which is NOT considered a potential outcome of childhood psychological trauma?
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What did Freud contribute to the understanding of psychological trauma?
What did Freud contribute to the understanding of psychological trauma?
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How does childhood trauma potentially influence cortisol responses?
How does childhood trauma potentially influence cortisol responses?
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What is a key component of Phase One in Trauma-Focused CBT?
What is a key component of Phase One in Trauma-Focused CBT?
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When should the duration of trauma-focused psychological treatment be extended?
When should the duration of trauma-focused psychological treatment be extended?
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What assumption is made about trauma-informed care interactions with survivors?
What assumption is made about trauma-informed care interactions with survivors?
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Which statement is false regarding trauma-specific treatments?
Which statement is false regarding trauma-specific treatments?
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What does the term 'Effects' refer to in the 3 E's of trauma?
What does the term 'Effects' refer to in the 3 E's of trauma?
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Which of the following is a principle of Trauma Informed Care (TIC)?
Which of the following is a principle of Trauma Informed Care (TIC)?
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How should organizations approach the issue of retraumatization in TIC?
How should organizations approach the issue of retraumatization in TIC?
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What role does the concept of 'Resist' play within Trauma Informed Care?
What role does the concept of 'Resist' play within Trauma Informed Care?
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Which statement correctly describes the bio-psycho-social model in relation to trauma?
Which statement correctly describes the bio-psycho-social model in relation to trauma?
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What is a recommendation for organizations implementing TIC principles?
What is a recommendation for organizations implementing TIC principles?
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What is a primary focus of NHS Trauma-Informed Mental Health Policies?
What is a primary focus of NHS Trauma-Informed Mental Health Policies?
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In the context of TIC, how should relationships be approached?
In the context of TIC, how should relationships be approached?
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What is a significant limitation of the longer version of the Trauma & Life Events Checklist?
What is a significant limitation of the longer version of the Trauma & Life Events Checklist?
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What approach is suggested for trauma memory techniques related to voices in psychosis?
What approach is suggested for trauma memory techniques related to voices in psychosis?
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What was a conclusion regarding trauma-focused therapy from the meta-analysis on PTSD in psychosis?
What was a conclusion regarding trauma-focused therapy from the meta-analysis on PTSD in psychosis?
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What does the mini-TALE include that distinguishes it from the longer version?
What does the mini-TALE include that distinguishes it from the longer version?
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Which factor was observed to affect the results of trauma-focused therapy on hallucinations and negative symptoms?
Which factor was observed to affect the results of trauma-focused therapy on hallucinations and negative symptoms?
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What was found regarding the effectiveness of trauma-focused therapies on delusions during follow-up assessments?
What was found regarding the effectiveness of trauma-focused therapies on delusions during follow-up assessments?
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What type of trauma-focused therapy trial is associated with the EASE study?
What type of trauma-focused therapy trial is associated with the EASE study?
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What can be inferred about the future of trauma-informed care (TiC) for psychosis from the content?
What can be inferred about the future of trauma-informed care (TiC) for psychosis from the content?
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What is a significant barrier to conducting routine trauma assessments?
What is a significant barrier to conducting routine trauma assessments?
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What does the current enquiry prompt regarding trauma assessments fail to align with?
What does the current enquiry prompt regarding trauma assessments fail to align with?
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What is a proposed recommendation for improving trauma inquiries in mental health settings?
What is a proposed recommendation for improving trauma inquiries in mental health settings?
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How should questions about trauma be framed to ensure they are effective?
How should questions about trauma be framed to ensure they are effective?
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What is the relationship between childhood psychological trauma and the development of psychosis?
What is the relationship between childhood psychological trauma and the development of psychosis?
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According to the Bradford Hill Criteria, which criterion involves exposure to trauma predicting future mental health outcomes?
According to the Bradford Hill Criteria, which criterion involves exposure to trauma predicting future mental health outcomes?
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What percentage of psychosis prevalence could potentially be reduced by eradicating psychological trauma?
What percentage of psychosis prevalence could potentially be reduced by eradicating psychological trauma?
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Which of the following does NOT describe childhood psychological trauma?
Which of the following does NOT describe childhood psychological trauma?
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What type of brain alterations have been suggested to occur in individuals exposed to childhood trauma?
What type of brain alterations have been suggested to occur in individuals exposed to childhood trauma?
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Which common misconception regarding trauma and psychosis does the content address?
Which common misconception regarding trauma and psychosis does the content address?
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What physiological response might individuals with a history of childhood trauma exhibit?
What physiological response might individuals with a history of childhood trauma exhibit?
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Which of the following statements best reflects the impact of childhood trauma on treatment response?
Which of the following statements best reflects the impact of childhood trauma on treatment response?
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What is a key benefit of involving patients and public in research studies?
What is a key benefit of involving patients and public in research studies?
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Which practice is suggested to start early in the research process?
Which practice is suggested to start early in the research process?
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How is public involvement distinguished from public engagement in research?
How is public involvement distinguished from public engagement in research?
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What organizational action is essential for improving public involvement in research?
What organizational action is essential for improving public involvement in research?
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What is a recommended approach when developing research materials?
What is a recommended approach when developing research materials?
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What are the alterations associated with the hypothalamic-pituitary-adrenal (HPA) axis in the context of trauma?
What are the alterations associated with the hypothalamic-pituitary-adrenal (HPA) axis in the context of trauma?
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What is the significance of the theory of latent vulnerability in understanding trauma effects?
What is the significance of the theory of latent vulnerability in understanding trauma effects?
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Which component is NOT one of the 3 E's of trauma according to Trauma Informed Care principles?
Which component is NOT one of the 3 E's of trauma according to Trauma Informed Care principles?
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Which aspect of trauma-informed care emphasizes organizational policies regarding trauma?
Which aspect of trauma-informed care emphasizes organizational policies regarding trauma?
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What is a critical consideration in developing trauma-informed therapies?
What is a critical consideration in developing trauma-informed therapies?
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What percentage of service users were recorded as having been asked about trauma in the REVA policy implementation audit?
What percentage of service users were recorded as having been asked about trauma in the REVA policy implementation audit?
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What is a critical requirement for trauma assessments under the CPA?
What is a critical requirement for trauma assessments under the CPA?
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What is a significant risk of discussing trauma with individuals during assessments?
What is a significant risk of discussing trauma with individuals during assessments?
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Which aspect of existing trauma assessments has been criticized according to the content?
Which aspect of existing trauma assessments has been criticized according to the content?
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What should staff obtain before conducting trauma assessments to ensure ethical practice?
What should staff obtain before conducting trauma assessments to ensure ethical practice?
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Which of the following best describes a challenge faced by the NHS workforce regarding trauma assessments?
Which of the following best describes a challenge faced by the NHS workforce regarding trauma assessments?
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What is a common misconception about individuals' awareness of their trauma history?
What is a common misconception about individuals' awareness of their trauma history?
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What is one reason that the trauma enquiry prompt is not considered best practice?
What is one reason that the trauma enquiry prompt is not considered best practice?
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What is the primary function of Advance Choice Documents (ACDs)?
What is the primary function of Advance Choice Documents (ACDs)?
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Which of the following names is NOT commonly associated with Advance Choice Documents?
Which of the following names is NOT commonly associated with Advance Choice Documents?
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What aspect is emphasized in the co-production strategy for the Brain and Genomics project?
What aspect is emphasized in the co-production strategy for the Brain and Genomics project?
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Why is feedback from the SUAG valuable for clinicians involved in projects?
Why is feedback from the SUAG valuable for clinicians involved in projects?
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What do Advance Choice Documents typically include?
What do Advance Choice Documents typically include?
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Which group demonstrated the most insightful analysis of the paper according to the given context?
Which group demonstrated the most insightful analysis of the paper according to the given context?
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What is a key benefit of Advance Choice Documents for family and friends?
What is a key benefit of Advance Choice Documents for family and friends?
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In the context of ACDs, what role do health professionals play?
In the context of ACDs, what role do health professionals play?
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What is a recommendation for individuals who show signs of post-trauma stress in relation to psychosis?
What is a recommendation for individuals who show signs of post-trauma stress in relation to psychosis?
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In trauma-focused psychological treatment for PTSD, what is indicated when several problems need to be addressed?
In trauma-focused psychological treatment for PTSD, what is indicated when several problems need to be addressed?
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What should be built into the care process when handling PTSD with complex needs?
What should be built into the care process when handling PTSD with complex needs?
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What is the focus of Trauma-Focused CBT for psychosis?
What is the focus of Trauma-Focused CBT for psychosis?
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What aspect is essential when planning support for patients after the end of therapy?
What aspect is essential when planning support for patients after the end of therapy?
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In trauma-informed care, how should interactions with survivors be approached?
In trauma-informed care, how should interactions with survivors be approached?
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What outcome is suggested for trauma memory techniques in recent findings related to voices?
What outcome is suggested for trauma memory techniques in recent findings related to voices?
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What is one of the key factors to consider when assessing trauma in relation to psychosis?
What is one of the key factors to consider when assessing trauma in relation to psychosis?
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What is the primary focus of Phase One in trauma therapy?
What is the primary focus of Phase One in trauma therapy?
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Which statement best describes the relationship between trauma-informed care and trauma-specific treatments?
Which statement best describes the relationship between trauma-informed care and trauma-specific treatments?
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What is a unique aspect of trauma-focused therapy as highlighted in the content?
What is a unique aspect of trauma-focused therapy as highlighted in the content?
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In the context of trauma-informed care, what should be recognized during every interaction with trauma survivors?
In the context of trauma-informed care, what should be recognized during every interaction with trauma survivors?
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Which phase of trauma therapy is primarily focused on psychoeducation?
Which phase of trauma therapy is primarily focused on psychoeducation?
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Which statement is not true regarding trauma-informed organizations?
Which statement is not true regarding trauma-informed organizations?
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What are the main components of trauma-focused CBT in terms of patient experience?
What are the main components of trauma-focused CBT in terms of patient experience?
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What assumption is made about care when interacting with trauma survivors?
What assumption is made about care when interacting with trauma survivors?
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Study Notes
Psychological Trauma and Mental Disorder
- Freud linked childhood sexual abuse to later mental disorders in the 1890s
- Freud recognised childhood events have lasting impacts
Childhood Psychological Trauma - Definition
- Adverse childhood events include neglect, physical, sexual, or emotional abuse
- Different terms for this include childhood maltreatment, adverse childhood experiences, early life stress, and developmental trauma
Childhood Psychological Trauma - Risk Factor
- Associated with a 3x increased risk of psychosis (Varese, 2012)
- Population attributable risk for psychosis is 30% (Kirkbride, 2010)
- Reducing psychological trauma could reduce psychosis prevalence by 30%
- Trauma is linked to many psychiatric and poor physical health outcomes (Daníelsdótti, 2024; Nelson, 2020)
Childhood Psychological Trauma - Mechanism
- Research suggests psychological and neurological processes are involved in trauma and psychosis (Bloomfield, 2021; Pollok, 2022; Yang, 2023)
- Grey matter volume alterations are observed in those exposed to childhood trauma
- Individuals with psychosis and a history of trauma show higher (Aas, 2019) or blunted cortisol responses (Bloomfield, 2019)
How do we know there's a link? (Bradford Hill Criteria)
- Strong and consistent association between trauma & psychosis (Meta-analysis (Varese, 2012))
- Trauma exposure precedes psychosis onset (Kelleher, 2013)
- Biological gradient: more severe trauma leads to more severe symptoms; poorer treatment response
- Plausible biological mechanisms: alterations in the hypothalamic-pituitary-adrenal (HPA) axis, brain alterations in threat processing, emotion regulation in limbic regions, and dopamine transmission (Merritt, 2024; Egerton, 2016; Bloomfield, 2019)
Future Work
- Need deeper knowledge of vulnerability mechanisms (McCroy & Viding, 2015)
- Importance of risk and resilient factors
- Integrate bio-psycho-social model
- Implement trauma-informed therapies
What is Trauma?
- The 3 E's: Event, Experience, Effects
- Trauma is much broader than PTSD criteria
- Any psychological or physical threat
- Range of cognitive, emotional, behavioural, physiological, and interpersonal reactions
- Recurring range of cognitive, emotional, behavioral, physiological, and interpersonal effects
- Can be a precursor to psychosis; can accompany psychosis; or result from psychosis
Trauma Informed Care (TIC)
- Organisational approach addressing trauma-related needs
- Views trauma as "everybody's business"
- Acknowledges commonality of trauma
- Recognises trauma effects and routine enquiry
- Asking about traumatic experiences
- Access to trauma-specific support (e.g., EMDR)
Recommendations for TIC in Psychosis
- NICE Guidance for Schizophrenia (2014) to assess for PTSD in clients with psychosis
- NICE Guidance for PTSD (2018) trauma-focused psychological treatment (CBT or EMDR)
- Trauma-Focused CBT for Psychosis (tf-CBTp) - NICE guidelines followed with support based on individual needs
Routine Enquiry about Trauma in the UK
- CPA requires routine enquiry about trauma
- Only 17% of service users had the abuse question asked in 53 trusts
- This is not in line with best practice (Brooker et al., 2016)
Talking Trauma in MDTs
- Many have experienced trauma but few are assessed
- Inpatients want routine enquiry
- Assessing trauma in psychosis: trauma checklist
Is Trauma-Focused Therapy Safe and Effective for Psychosis?
- Meta-analysis of studies show some small, positive effects on delusions at follow-up but not on hallucinations and negative symptoms
- Trauma memory techniques can have beneficial impacts on voices (Brand et al., 2018, 2020a, 2020b)
- Imagery rescripting is helpful in some cases
Future of TIC for Psychosis
- Increasing international attention to TIC
- Evaluation of optimal TIC approach needed
- Trauma-focused therapy trials underway (e.g., STAR)
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Explore the profound impact of childhood psychological trauma on mental disorders. This quiz addresses definitions, risk factors, and underlying mechanisms linking adverse childhood events to later psychiatric outcomes. Evaluate your understanding of Freud's theories and recent research findings on this critical topic.