Childhood Trauma Questionnaire

What is the Childhood Trauma Questionnaire?

The Childhood Trauma Questionnaire is a nifty tool that allows mental healthcare professionals and trauma experts to get to know their patients better to help structure their discussions with them as they progress through their treatment program.

This questionnaire is the revised version of what David P. Bernstein and his group created before. It used to be a seventy-item questionnaire, but this one is the twenty-eight-item version.

The questions revolve around five different types of childhood trauma, which are: physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect. Here are some of the items that need to be answered by the patient:

• I did not have enough to eat when
• I was hit so hard that I had to see a doctor
• My parents were too drunk/too high to take care of me
• I was punished with a belt, board, cord, or another hard object
• My family said hurtful or insulting things to me
• Someone molested me
• Someone tried to make me do sexual things or watch sexual things
• Someone in my family hated me

Most of these items are emotionally challenging, so do not be surprised if your patient has a hard time answering this questionnaire.

How to use the Childhood Trauma Questionnaire

Administer this questionnaire to your patient.

There are two ways to go about administering this questionnaire to your patient:

1. You can conduct this like an interview during your first appointment with them. If you opt for this, do not expect them to answer. Given that childhood trauma is a difficult subject to talk about, even among close family/friends, it’s even more complicated when talking about it to professionals and strangers. Before anything, you have to make them feel they can trust you and that your clinical space is safe for them.

2. The second choice is to hand them a copy of the questionnaire and have them answer it on time. This gives them the distance, space, and time to think about their childhood traumas and answer accordingly. Just make sure to agree as to when you should receive a fully-accomplished questionnaire.

Now, how do they answer the items? It’s simple. They just have to select any one of the following per item:

• Never true = 1
• Rarely true = 2
• Sometimes true = 3
• Often true = 4
• Very often true = 5

Some items have the inverse, though. These specific items are Items 2, 5, 7, 13, 19, 26, and 28. So, “Never true” is equal to 5, and “Very often true” is equal to 1.

Calculate the scores.

Once you receive a fully-accomplished questionnaire, it’s time for you to calculate the scores. You will be tallying the scores per childhood trauma type, and they are arranged as such:

• Physical Abuse: Items 9, 11, 12, 15, and 17
• Emotional Abuse: Items 3, 8, 14, 18, and 25
• Sexual Abuse: Items 20, 21, 23, 24, and 27
• Physical Neglect: Items 1, 2, 4, 6, and 26
• Emotional Neglect: Items 5, 7, 13, 19, and 28

Don’t forget the Items with the inverse scoring!

Besides those five categories, there is another one called “Minimization/Denial,” which tries to measure if the patient is still positing that their family is great despite having answered items related to family that would say otherwise.

For that section, you only need to look at Items 10, 16, and 22. For each of these, if the patient answers “Very often true,” it’s equivalent to 1 point. If they picked other answers, then it’s equivalent to 0. The maximum score that they can get for Minimization/Denial is 3.

As for interpreting the scores, here are the cut-off scores and designations per type:

Just so you know, if the level of abuse is “None” for the particular childhood trauma type, it doesn’t mean that they don’t have trauma. Always refer to their answers. There might be something there beyond what the number tries to say.

Determine the next steps based on the scores.

Once you have calculated the scores, the next step is to determine how you can assist your patient in addressing their childhood traumas. For instance, if they score high in emotional abuse and neglect, you might develop a plan that includes providing relevant worksheets and facilitating discussions aimed at enhancing their emotional regulation skills. Consider incorporating self-esteem exercises based on their scores. It's essential to tailor your care plan specifically to each patient's needs. You can explore our care plan template to further structure and organize your approach.

When does one typically issue the Childhood Trauma Questionnaire?

The Childhood Trauma Questionnaire is normally used during a patient’s initial assessment. This is when the healthcare professional doesn’t know anything about the patient, so to find ways to help them work through their trauma, professionals tend to issue assessments for them to answer to get to know the patient and have them open up.

The questionnaire is not just used to get the patient to open up during discussions. This questionnaire is also used when healthcare professionals are at the point where they are supposed to develop a care plan for their patients. This is one of the best times to issue this questionnaire to their patients because the scores they will get will help shape what goes into their respective care plans.

Who can use the Childhood Trauma Questionnaire?

The following healthcare professionals can use the Childhood Trauma Questionnaire for their work:

• (Clinical) Psychologists
• Psychiatrists
• Counselors
• (Mental Health) Therapists

So long as the healthcare professional is highly trained in dealing with and caring for patients who have had childhood traumas as well as those with PTSD, they are more than welcome to use this questionnaire.

Psychometricians and researchers can also use fully-accomplished questionnaires to determine the commonalities and outcomes of childhood trauma regarding how people think, act, and what they feel like years after going through traumatic experiences. This can also be used by them to evaluate the efficacy of care plans implemented by professionals.

What are the benefits of using the Childhood Trauma Questionnaire?

It can help patients open up to healthcare professionals.

Getting to know the patient is the first step for any healthcare professional focusing on helping patients work through their problems, especially traumas. But that first step may not be easy. Depending on the patient, it might just be a massive mountain to climb, given that traumas are not exactly things people are normally willing to discuss.

Using assessments such as the Childhood Trauma Questionnaire helps them open up because having them answer assessments is a way to get to know patients, even if only you’ll get a simple background of them. The Childhood Trauma Questionnaire can frame discussions with the patient moving forward and get them to elaborate on their traumatic experiences. Just make sure to assure them that everything will be kept confidential, there won’t be any judgment, and that you can be trusted.

It gives the professional a comprehensive look at the patient’s background.

Concerning the Childhood Trauma Questionnaire being a good assessment to help you get to know the patient, the questionnaire looks at five childhood trauma types. This means that the questionnaire will help you understand your patient better by giving you perspective on different aspects of life that were impacted by their traumatic experiences.

Were they sexually abused? Were they emotionally hurt by their loved ones or by other people? Were they physically harmed by their loved ones or by other people? By learning about these things, especially during subsequent appointments where they elaborate on their answers, you’ll be able to have a better understanding of your patient, their traumatic experiences, how these experiences have impacted their view of themselves, and how they cope.

It helps professionals create tailor-fitted treatment plans.

To jump off the point about getting a comprehensive understanding of the patient, this leads to making a comprehensive care plan that is tailor-fit for the patient. By having a well-rounded view of the patient, you can determine what the patient needs to do.

Do they need to take self-esteem exercises? Do they need to learn skills related to managing their emotions? Do they need anger management and related programs to combat anger episodes, crying episodes, etc.?

These are just some of the questions you might be able to answer when you consider the scores for the five types of childhood trauma on the questionnaire and the conversations you have had with your patient.