Trauma-Informed Sexual History Taking · Clinical Exercise

In What Order

Ten moves that make up a first sexual health assessment, scrambled. Put them in the order you would actually run them. There is one placement this exercise exists to catch, and the reveal will say so plainly rather than letting it pass as a near miss.

What this exercise practises

Sequencing an interview so that the hardest question arrives at the point where it can be answered honestly, and recognising which moves are fixed points rather than preferences.

Part 2 is what you do when the question you placed seventh arrives, unprompted, at position four.

Estimated time to complete this exercise: 20 minutes

1The sequence
2Position four
3Close

Before you begin

How this one works

Ten moves that make up a first sexual health assessment, presented in a scrambled order. Click them in the sequence you would actually run them.
Clicking an item assigns it the next position. Clicking it again takes it back out, and there is a reset if you want to start the ordering over.
There is one placement this exercise exists to test, and if you get it wrong the reveal will say so plainly rather than letting it pass as a near miss.
Part 2 is what you do when the thing you placed seventh arrives, unprompted, at position four.
Nothing is graded and nothing is recorded. Reloading starts it again.

The timing of trauma inquiry within a sexual health interview is a matter of clinical judgment rather than of thoroughness. Asked in the first minutes of a first session, before any relational trust has been established, the question is rarely productive and can be actively harmful.

References

  1. Courtois, C. A., & Ford, J. D. (2013). Treatment of complex trauma: A sequenced, relationship-based approach. Guilford Press.
  2. Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8
  3. Levenson, J. S. (2017). Trauma-informed social work practice. Social Work, 62(2), 105–113. https://doi.org/10.1093/sw/swx001
  4. Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. U.S. Department of Health and Human Services.