Trauma Questionnaire
You should ask the following questions of every client who scores 2 or more on the SRQ-8 and
reports a history of trauma. Remember that the client may be suffering from a traumatic
disorder, and thus be very sensitive about talking about the experience. You should therefore
always follow the GUIDELINES indicated in the manual.
Part one: trauma events
Please ask whether the client has ever experienced, witnessed, or heard stories
about any of the following events:
E - experienced
W - witnessed
H - heard stories
Lack of food or water
E
W
Ill health without access to medical care
E
W
H
Lack of shelter
E
W
H
Imprisonment
E
W
H
Serious injury
E
W
H
Caught up in combat
E
W
Rape
E
W
H
Forced isolation from others
E
W
Being close to death
E
W
Forced separation from family members
E
W
H
Murder of family or friends
E
W
Unnatural death of family or friends
E
W
Murder of stranger or strangers
E
W
H
Lost or kidnapped
E
W
Severe beatings
E
W
H
Torture
E
W
H
Motor traffic accident
E
W
Industrial accident
E
W
Natural disaster(flood, fire, etc)
E
W
Specify:................................................................................................................
Any other situation that was very frightening
E
W
or you felt that your life was in danger
Specify:................................................................................................................
N - none
H
N
N
N
N
H
N
H
H
N
H
H
N
H
N
N
H
H
H
N
H
N
Total Trauma Score
Experience Score
Witness Score
Heard Stories Score
Part Two: personal description
Please indicate the most hurtful or terrifying events that you have experienced,
if any. (Please specify where and when these events occurred)
Please indicate the most hurtful or terrifying events that you have experienced,
if any, when you were outside the country. (This applies only to refugees or
survivors who were refugees)
N
N
N
N
N
N
N
N
N
Select target paragraph3
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