From the Assessment and Diagnosis section of the ASWB exam outline, an important topic: The indicators of traumatic stress and violence. Let's review.

The Signs

Traumatic stress and violence can have a profound impact, manifesting in various ways, which can vary depending on the individual and the specific circumstances. But there are common signs associated with traumatic stress and exposure to violence. Experiencing some of these symptoms doesn't necessarily mean someone has undergone trauma (many of these are symptoms of depression and/or anxiety disorders), but a cluster of these signs may suggest the need for further evaluation or support. Here are some indicators:

Emotional Signs:

  • Intense fear or anxiety
  • Irritability or anger
  • Mood swings
  • Emotional numbness or detachment
  • Guilt or shame
  • Depression
  • Hopelessness

Behavioral Signs:

  • Social withdrawal or isolation
  • Changes in sleep patterns (insomnia or excessive sleep)
  • Changes in appetite (overeating or undereating)
  • Substance abuse (alcohol, drugs)
  • Risky behaviors
  • Aggression or violence towards others
  • Self-harm or suicidal thoughts

Cognitive Signs:

  • Intrusive memories or flashbacks
  • Difficulty concentrating
  • Memory problems
  • Hypervigilance (excessive alertness)
  • Negative thoughts about oneself or the world
  • Difficulty making decisions

Physical Signs:

  • Fatigue or chronic exhaustion
  • Headaches
  • Gastrointestinal problems
  • Muscle tension or pain
  • Changes in sexual functioning
  • Increased heart rate or palpitations

Relational Signs:

  • Difficulty trusting others
  • Problems forming or maintaining relationships
  • Social withdrawal
  • Increased conflicts with family, friends, or colleagues

Avoidance and Numbing:

  • Avoidance of reminders of the traumatic event
  • Numbing of emotions
  • Avoidance of activities or places that were once enjoyable


  • Exaggerated startle response
  • Difficulty sleeping
  • Irritability and angry outbursts
  • Difficulty concentrating

Flashbacks and Intrusive Thoughts:

  • Re-experiencing the traumatic event through memories, nightmares, or flashbacks


Social workers treat trauma survivors. There are exceptions, but for the majority of social workers, this is what we do every day. How? Some of the currently favored approaches to treating trauma (which we've posted elsewhere before) follow:

  • Trauma-Informed Therapy:

    • Cognitive-Behavioral Therapy (CBT): Focuses on identifying and challenging negative thought patterns and behaviors associated with trauma.
    • Trauma-Focused CBT: Specifically designed for survivors, especially children and adolescents, TF-CBT integrates cognitive-behavioral techniques with trauma-sensitive interventions.
    • Eye Movement Desensitization and Reprocessing (EMDR): A form of psychotherapy that helps individuals process distressing memories, reducing their impact.
    • Dialectical Behavior Therapy (DBT): Combines cognitive-behavioral techniques with mindfulness to address emotional dysregulation.
  • Mindfulness-Based Approaches:

    • Mindfulness Meditation: Helps individuals develop awareness of the present moment, reducing anxiety related to past traumas.
    • Yoga and Mindful Movement: Combines physical activity with mindfulness to promote relaxation and self-awareness.
  • Expressive Therapies:

    • Art Therapy: Allows survivors to express emotions and experiences non-verbally, promoting healing.
    • Music Therapy: Uses music and sound to facilitate emotional expression and stress reduction.
  • Crisis Intervention:

    • Safety Planning: Develop strategies to ensure the individual's safety during times of crisis.
    • Hotlines and Emergency Services: Immediate support for those in acute distress.
  • Education and Psychoeducation:

    • Educating Survivors: Providing information about trauma responses and coping strategies empowers survivors in their healing journey.
  • Narrative Therapy:

    • Allows survivors to reconstruct and reframe their narratives, promoting a sense of agency and empowerment.

On the Social Work Exam

How will this all look on the ASWB exam? Expect questions like these:

  • A social worker is conducting an assessment with a child who has witnessed violence in the home. The child displays changes in behavior, including aggression and social withdrawal. What should the social worker prioritize in the assessment?
  • During a counseling session, a client who experienced a recent traumatic event reports frequent nightmares, difficulty concentrating, and avoidance of reminders related to the trauma. What therapeutic approach is most aligned with addressing these symptoms?

  • A client reports self-destructive behaviors, such as self-harm and substance abuse. What is the social worker's primary concern in this situation?

Get questions like these--with answer options, answers, and rationales!--with Social Work Test Prep's full-length practice tests. How do you get to pass?

Practice, practice, practice.

November 28, 2023
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