Victim and Survivor Care: Trauma-Informed Assessment and Intervention
This domain tests trauma-informed assessment and intervention: recognizing trauma responses, creating safety, supporting choice, and avoiding re-traumatization during forensic care.
Principles and assessment
- Core principles include safety, trustworthiness, peer support, collaboration, empowerment, and cultural humility.
- Trauma responses include fight, flight, freeze, fawn, and tonic immobility; memory fragmentation and delayed disclosure are common.
- Obtain informed consent for each step, explain before touching, and offer choices such as examiner gender, support person, breaks, and positioning.
- Screen for immediate safety, suicide risk, medical needs, and follow-up resources.
Worked example
A patient laughs and jokes during a sexual assault examination. Laughing can be a trauma response such as nervous laughter or fawning, not evidence of consent or fabrication. The nurse should not confront the patient; acknowledge the response, offer a pause, continue with choices and validation, and document the behavior objectively rather than labeling it "inappropriate affect."
Traps that cost marks
- Judging credibility by affect, demeanor, or delay in reporting.
- Demanding a detailed narrative before stabilization and consent.
- Ignoring language, disability, or cultural needs, or using a family member as interpreter.
- Promising unconditional confidentiality without explaining mandatory reporting limits.