Module #: Assignment # Student Name: Date: [Use this template to complete your assignment.] Case Vignette: Assessment Answer the following questions thoroughly: 1. You are the therapist Laurel chose to work with, and you give Laurel an appointment to conduct an intake in order to start the assessment process. During that appointment, she relays the information mentioned in the vignette to you. a. Describe the steps you will take to make Laurel feel comfortable with telling her story to you. b. Describe what methods you will use to continue with the assessment process, knowing this may take three to four visits. Be specific if you are considering using any instruments or questionnaires. Explain the rationale for using each method, and indicate what information you expect to find by using them. c. Given the information you know at this point, what would be your provisional diagnosis of Laurel? i. Use DSM criteria (including appropriate diagnosis code number). We are just looking at Axis I diagnosis for this exercise. ii. You may consider rule-outs. Any diagnosis you give should have an explanation of the criteria/symptoms supporting your choice. Page 1 of 1 Psychology of the Victim © 2013 Argosy University Page 1 of 1 Psychology of the Victim © 2013 Argosy University Treatment Relationship The following are some underlying factors the clinician must take into consideration when working with trauma survivors:  Empowerment: What would this look like?  Maintaining technical neutrality: Can you think of an example?  Maintaining a committed moral stance: When would this be most difficult for you?  Being aware of traumatic transference: Clients may oscillate between devaluing and idealizing the therapist when they are in the midst of working through difficult issues.  Being aware of traumatic countertransference: Can you identify your most common reactions?  Vicarious trauma: What kind(s) of traumatic events do you think may have more impact on you?  Burnout: Remind yourself of the differences in the previous three bullets. As part of the process of working with trauma victims, the therapist is also likely to experience an increased appreciation of life, deeper friendships, increased authenticity in living, and increased social engagement. Why might this be? Isn't that counterintuitive? Is it possible that the same also might be true for a trauma survivor? What research is available to support the ideas above? In Module 4, you will focus on treatment and intervention strategies geared toward stabilization. The first stage in stabilization involves correctly naming the problems and restoring a sense of control to the patient by providing the individual with a sense of safety in the room with you and in the process of therapy. After the experience of trauma, a victim may feel out of control, helpless, and hopeless. If these feelings continue and grow stronger, the likelihood increases ...

1. Module #: Assignment #
Student Name:
Date:
[Use this template to complete your assignment.]
Case Vignette: Assessment
Answer the following questions thoroughly:
1. You are the therapist Laurel chose to work with, and you give
Laurel an appointment to conduct an intake in order to start the
assessment process. During that appointment, she relays the
information mentioned in the vignette to you.
a. Describe the steps you will take to make Laurel feel
comfortable with telling her story to you.
b. Describe what methods you will use to continue with the
assessment process, knowing this may take three to four visits.
Be specific if you are considering using any instruments or
questionnaires. Explain the rationale for using each method, and
indicate what information you expect to find by using them.
c. Given the information you know at this point, what would be
your provisional diagnosis of Laurel?
i. Use DSM criteria (including appropriate diagnosis code
number). We are just looking at Axis I diagnosis for this
exercise.
ii. You may consider rule-outs. Any diagnosis you give should
have an explanation of the criteria/symptoms supporting your

2. choice.
Page 1 of 1
Psychology of the Victim
© 2013 Argosy University
Page 1 of 1
Psychology of the Victim
© 2013 Argosy University
Treatment Relationship
The following are some underlying factors the clinician must
take into consideration when working with
trauma survivors:
example?
most difficult for you?
lients may oscillate
between devaluing and idealizing
the therapist when they are in the midst of working through

3. difficult issues.
identify your most common reactions?
kind(s) of traumatic events do you
think may have more impact on you?
three bullets.
As part of the process of working with trauma victims, the
therapist is also likely to experience an increased
appreciation of life, deeper friendships, increased authenticity
in living, and increased social engagement.
Why might this be? Isn't that counterintuitive? Is it possible
that the same also might be true for a trauma
survivor? What research is available to support the ideas above?
In Module 4, you will focus on treatment and intervention
strategies geared toward stabilization. The first stage in
stabilization involves correctly naming the problems and
restoring a sense of control to the patient by providing the
individual with a sense of safety in the room with you and in the
process of therapy. After the experience of trauma, a victim
may feel out of control, helpless, and hopeless. If these feelings
continue and grow stronger, the likelihood increases that the
victim may fall into depression and perhaps display suicidal
behavior. This is a key reason why immediate intervention and
instilling a sense of universality and hope are so important.
Victims need to be made to feel that they are not alone, their
experiences are not unique, and their circumstances are
survivable.
An important part of the skills you will develop in designing

4. appropriate interventions is the ability to design a treatment
plan focused on stabilization appropriate for the particular
client being treated. It is important to keep in mind that victims'
responses vary widely, and it is imperative that treatment
planning and approaches be individualized to the specific
victim's needs. In this module, you will create a treatment plan
for stabilization based on the information provided in the case
study. Additionally, you will discuss the effects of child sexual
abuse on emotion.
· Identify and evaluate commonalities and differences in
demographic variables and psychological profiles between
subtypes of victims that may present in forensic settings.
· Compare and contract empirical research findings for related
to treatment for victims.
Please view Treatment Relationship
Safety
Creating safety for the client is the first of three stages outlined
by Herman as necessary for the treatment of trauma survivors.
The first stage involves correctly naming the problems and
restoring a sense of control to the survivor by providing the
survivor with a sense of safety in the room with you and in the
process of therapy. The second stage, remembrance and
mourning, and the third stage, reconnection and thriving, will
be covered in the next module.
Some thoughts about safety:
· Patients are not likely to feel safe until they are in control of
their symptoms, and a therapist will not be able to help clients
achieve control over their symptoms if the therapist has not
properly assessed the patients. Thus, the first goal within the
safety stage is assessment, which is as follows:
· This means getting a thorough history of the presenting issue
and anchoring it in measurable terms. For example, you might
say to the client, "Describe your panic on a scale of one to ten
and explain how difficult it is to get to work now, as compared
to six months ago." Conducting an assessment allows the client

5. to explain the symptoms being experienced on an easy-to-
comprehend scale and allows the therapist and the client to
quickly create a shared understanding as to the client's
experience.
· You are there to assess not only problems but also strengths.
When assessing for problems and strengths, you will explore
feelings, thoughts, and behaviors. It is very important to model
the exploration of strengths from the very beginning of
treatment. If the client is unable to name any area of strength,
you may ask what other people in the person's life have
described as strengths in the individual, or you may name
qualities you have noticed, and then encourage the client to
name one. One of the advantages of strengths-based
intervention is that it teaches clients to believe and trust in their
own abilities, to navigate their environments successfully, and
to envision a life for themselves beyond their immediate
experience of posttrauma pain.
· Unlike some traditional medical models, the trauma model is
going to keep coming back to the idea of empowerment and
assuming the victims have within themselves the best solutions.
The therapist will work with the clients to help them regain
access to those parts of themselves—so you will want to be sure
to focus on strengths, too! For example, "We have spent some
time talking about problems you are having currently; however,
I get the sense you have been doing some things to help
yourself already. Tell me what things you have tried that
haven't helped at all, as well as things you do that reduce your
feeling of panic or have helped you with anxious situations in
the past." These types of statements help a client to remember a
time when he or she felt more competent and in control and
instill a sense of hope that such a state can be rediscovered.
· The Diagnostic and Statistical Manual of Mental Disorder
(DSM) states differential diagnosing is also going to be an
aspect of this step. Keep in mind that not all survivors of
trauma will have posttraumatic stress disorder (PTSD), but they
may have other maladaptive coping methods, resulting in

6. another diagnosis (such as agoraphobia, depression, or
substance abuse).
· Be sure to assess social support as part of the assessment
phase. In trauma cases in particular, the presence or absence of
a supportive family, friends, religious community, work
environment, or a partner (among others) often has a dramatic
impact on the recovery, and you need to take this into
consideration as you develop the treatment plan and discuss
coping skills. In addition, intervention may be offered to family
members, especially domestic partners, who may be struggling
with their own feelings regarding what has happened to their
loved ones. Family members of survivors can benefit from being
educated about types of trauma and common reactions, self-care
strategies, and also how best to be a source of support to the
survivors.
Restoring Control
Once the primary presenting issues are identified, you can begin
to help the patient to regain control over the most troubling
aspects immediately—the ones getting in the way of the
individual's functioning. This process can take days, weeks, or
even years, but it should always be part of the starting point.
In this step of gaining safety, you work with the individual to
help the patient regain control over his or her body, over the
immediate environment, and the larger community. Picture a
series of circles inside each other. You are going to help the
patient take control from the inside to the outside.
You begin by helping the client establish a routine in self-care
of such aspects as sleep, nutrition, and exercise, which often are
not taken care of adequately in mental health realms. However,
especially in cases in which the violation has been physical,
resuming control of this part of a person's life can be very
empowering.
Some examples of interventions include working with a client
on deep-breathing exercises, muscle relaxation, and
visualization techniques and developing a list of strategies to
deal with anxiety, depression, sleeplessness, panic, or rage—all

7. with the goal of helping the client get the most troubling
symptoms out of the way so the individual can function
adequately in his or her day-to-day life.
Convincing a client to buy into an individualized goal can be an
important step toward making immediate progress toward
restoring previous functioning. Examples of goals might be that
the client will take a ten-minute walk in the neighborhood each
day or will drive to work on time and stay all day at work as
scheduled. As the survivor is able to master these smaller goals,
more advanced goals can take their place.
All these interventions need to happen before the second stage
of treatment.
Measurement Tools
The National Center for PTSD lists more than seventy
assessment tools for measuring PTSD (US Department of
Veterans Affairs, n.d.). Information on each tool is available to
the general population. Information on how to obtain the
assessments is provided for qualified mental health
practitioners. We have discussed that assessments and
interventions should be selected on a case-by-case basis taking
into consideration the presenting issues of the individual
survivor. For example, not all survivors will experience
immediate anxiety following a traumatic event. The selection of
assessment measures may be influenced by a survivor's age,
clinical presentation, self-report, existing support system, and
current mental status and survivor status reports made by family
members.
With the plethora of assessment tools out there, a practitioner
should become familiar with those measures that are a best fit
for the populations to which he or she provides services.
Reference:
US Department of Veterans Affairs. (n.d.). PTSD: National
Center for PTSD: List of all measures. Retrieved from
http://www.ptsd.va.gov/professional/
assessment/all_measures.asp

8. Conclusion
In this module you learned a great deal about assessment and
evaluation of victims. Some of the topics that you learned more
about included:
· Differential diagnosis process
· Complex PTSD
· Measurement tools
· Revictimization, risk variables, and the cycle of violence
Understanding these issues is essential to the treatment process,
which includes diagnosis and assessment.
Page 1 of 1
Psychology of the Victim
© 2013 Argosy University
Vignette—Laurel
When Laurel was a freshman in college, she was one day
walking back from her part-time job in town to the
dorm where she lived. It was dusk when she reached the
outskirts of a quiet neighborhood and started to
cut across a large field that lay between town and campus.
Suddenly, a man in a stocking mask jumped
from a hedge that bordered the field. He grabbed her arm,
pushed her down, and shoved the barrel of a

9. gun into her mouth as he raped her. She thought she was going
to die. But just as quickly as he had
appeared, he disappeared. His only words were, “If you tell
anybody about this, I’ll really get you.”
Somehow, Laurel made it back to the dorm, and her roommate
drove her immediately to a hospital
emergency room. After she was examined and treated, she spoke
briefly to a psychiatrist who suggested
she talk to someone at the college counseling center. She was
also questioned by police, who investigated
the incident but were never able to develop a lead.
The next day, Laurel felt strange, as if the experience had been
a bad dream. She found herself jumping
out of her skin at the slightest noise. Over the next few weeks,
she had trouble falling asleep and woke from
nightmares she could not clearly remember. But she did not go
to the counseling center; she did not want to
talk about the rape. It was as if talking about it might make it
more real. She also felt vaguely guilty—she
should not have taken the shortcut home.
Over the next few weeks, Laurel’s life changed. Prior to the
rape, she had started a relationship with a
fellow student. Afterwards, she abruptly stopped seeing him or

10. socializing much with anybody. She had
difficulty concentrating on her schoolwork. Her grades, which
had been consistently high before the rape,
fell sharply. At the end of the semester, she dropped out of
college where she had been doing
preprofessional coursework. Only after working two years in a
dead-end job did she finally decide to try
again and enroll in a business course that trained her to do
secretarial work.
Five years later, following the breakup of a serious relationship,
Laurel sought therapy for “depression.” She
also complained of dissatisfaction with her job. She was
beginning to see her problems with men as a result
of her own ambivalence. Every time she got close to someone,
she said, she began to panic and did
something to force distance. Laurel considered her childhood
normal and reasonably happy. Her parents
seemed to have a good marriage, as did her siblings. She had
concluded that something must be wrong
with her.