Trauma Screening Questionnaire (Tsq) Template printable pdf download

Trauma Screening Questionnaire (Tsq) Template

Trauma Screening Questionnaire (TSQ)

If you have recently been exposed to a potentially traumatic event

YES

(a PTE), here is a tool that may help you to identify whether or not you

at least twice in

should seek additional help in recovering from its effects. Have you

the past week

recently experienced any of the following:

1. Upsetting thoughts or memories about the event that have come

into your mind against your will

2. Upsetting dreams about the event

3. Acting or feeling as though the event were happening again

4. Feeling upset by reminders of the event

5. Bodily reactions (such as fast heartbeat, stomach churning)

6. Difficulty falling or staying asleep

7. Irritability or outbursts of anger

8. Difficulty concentrating

9. Heightened awareness of potential dangers to yourself and others

10. Feeling jumpy or being startled by something unexpected

It is recommended that the TSQ be offered 3-4 weeks post-trauma, to allow time

for normal recovery processes to take place. If at that point an individual has 6

or more YES answers, a referral to a behavioral health practitioner is indicated.

C. R. Brewin, et al, 2002. (Used by permission)

Trauma Screening Questionnaire (Tsq) Template