Given the high rates of trauma exposure among people entering AOD treatment, it is recommended that AOD workers and services adopt a ‘universal precautions’ approach; that is, operating on the assumption that all clients have experienced trauma [136, 385]. Operating under this assumption does not, however, negate the need to assess clients individually. Trauma exposure should be routinely assessed sensitively by suitably trained practitioners. Before conducting trauma assessments, workers should seek training and supervision in dealing with trauma responses.
Incorporating some questioning into most initial assessments signals that this is a standard process that is important in both understanding why people present to treatment and in determining appropriate treatment pathways; however, each AOD worker must use their judgement and expertise in determining when it is clinically appropriate to ask more detailed questions based on a client’s presentation. In some situations, for example, it may be more beneficial to raise the issue of trauma some weeks after the initial assessment interview, once the client feels safer and a therapeutic relationship has been developed [389]. Further information on identifying client trauma histories is provided in Chapter B3.