Trauma history: measurement and training

  • Lisa Coyle

Student thesis: Doctoral ThesisDoctor of Philosophy

Abstract

Does Trauma-Related Training Have a Relationship with, or Impact on, Mental Health Professionals Frequency of Asking About, or Detection of, Trauma History?
Objective: Traumatic exposure is prevalent, with the impact of trauma and its relationship with other conditions widely documented. Research suggests that clinicians do not routinely ask about trauma history in clinical settings and trauma-related training has been recommended as a means of addressing this. The impact of such training on clinician behaviour (i.e. frequency of asking about or detection of trauma history), or the relationship between these variables, has not been formally reviewed. Method: A systematic literature review was conducted using PsychINFO, Scopus and Web of Science. The grey literature and reference lists of included articles were consulted. Nine articles met the eligibility criteria for inclusion. Results: Two-thirds of the studies reported either a statistically significant correlation between trauma-related training and detection of trauma history, or provided statistically significant evidence to suggest the following; (1) an increase in asking about, (2) more frequent asking about, and (3) greater detection of trauma histories, in mental health professionals who have received trauma- related training. Effect sizes ranged from very small to medium. Conclusions: Whilst acknowledging the limited number and variable quality of studies, as well as the failure to detect statistical significance in all studies, this review provides some evidence that trauma-related training has a relationship with or impact on clinician behaviour with regards to trauma enquiry or detection. However, further high quality research is needed. Training programmes should balance skill and educational components and consider the potential for variation in enquiry behaviour across trauma subtypes, as well as the barriers to clinician enquiry.

A Survey on the Use of Trauma History Measures.
Objective: Research has highlighted the role of trauma history measures in assessing traumatic exposure, as well as the limitations associated with these measures. With such an array of measures available, the extent to which trauma history measures are used and considered most useful is unknown. Method: An online self-report survey enquiring about the experience of trauma history measures was completed by 528 clinicians, researchers and clinician-researchers working in the field of traumatic stress. Results: Participants identified accessible language and clear presentation as the most important feature of trauma history measures. Trauma history measures appear to be used “often” and “very often” by 56.3% of participants, with evidence suggesting that trauma history measures are used less frequently by clinicians in comparison to clinician-researchers and researchers. Trauma history measures were considered useful in research and clinical practice. Participants reported using measures due to the impact of trauma and its relationship with other presentations, and to provide a comprehensive assessment of trauma. Despite well-known measures (e.g., CTQ; Childhood Trauma Questionnaire) being used by participants in the past year, the majority of participants reported infrequent use of these measures. However, the Life Events Checklist (LEC) and CTQ were identified as the most frequently used measures and were considered most useful. Conclusions: Clinicians should be skilled in assessing trauma history and encouraged, supervised and trained to use trauma history measures when appropriate. Further research is needed to establish a consensus as to the most used and useful trauma history measures in the field.
Date of AwardDec 2018
Original languageEnglish
Awarding Institution
  • Queen's University Belfast
SupervisorDavid Curran (Supervisor) & Donncha Hanna (Supervisor)

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