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Complete the online checklist below, and we will email a copy to you. Or, download the checklist as a pdf.

Download Checklist as PDF

Indicators of Possible Trauma Checklist:

Please check any statements that apply to your patient:

Behavioral traits: Please check any statements that apply to your patient: *

Exhibit high emotional charge that is greater that the situation warrants (e.g. very angry, distressed or sad)
Agrees with everything; does not question treatment and/or medication directions
Has a need to talk more than most patients/feels desperate to share their story and be heard.
Unusual eye contact patterns – either the gaze is fixed on you OR finds it hard to establish and maintain eye contact.
Unable to maintain a cohesive narrative (may have gaps in memory, or be unable to maintain focus on a single topic)
Listless and apathetic/does not seem present
Voice is either shrill or lifeless AND/OR speaks very quickly or very slowly
Inability to sit still (tapping foot, wringing fingers, touching themselves, wriggling/fidgeting)
Worried to let go of their phone
Nail-biting
Meltdowns/tantrums
Nightmares
Low sensory threshold, e.g. is affected by ticking clock, too many people in waiting area, lights in the room etc

Environmental factors: *

Extensive medical history with little or no improvement (this client has done the rounds of doctors and/or mental health and/or alternative health and not getting better)
Heavily medicated and/or on multiple medications with little or no improvement
Recent loss of a loved one
Volatile relationship
Grew up in a dangerous environment/period in history/poverty
Has recently gone through a major life transition or dramatic experience (e.g. moved overseas, divorced, been in an accident)

Physical factors: *

Fibromyalgia / Chronic pain
Weight gain (that is not responsive to diet and exercise regimes)
Migraine history
Gut issues (irritable bowel syndrome and/or malabsorption)
Adult onset allergies
Chronic muscle pain/tension that is unresolved or re-appears after intermittent resolution
Inflammatory skin conditions
Chronic fatigue syndrome
Hormonal & thyroid conditions that do not resolve with treatment
High blood pressure or racy heart
Bracing patterns (pelvic floor, respiratory diaphragm, jaw, neck & shoulders, eyes)

Rating:

* 1-5 checked: Low risk of origins of trauma

* 6-20 checked: moderate risk of origins of trauma

* More than 20: high risk of origins of trauma

Next steps:

1) As a practitioner, you may like to gently enquire about possible origins of trauma and/or refer them to appropriate support

2) If you are unsure if this assessment indicates possible trauma or how to proceed with your client/patient, you can email us a complete history and our Director Natalia Rachel will respond with insights.

Email *

We will forward to your email what you have filled in.

Any other notes you want to leave yourself as a practitioner (this will be emailed to you).

Message

Soma Clinic @ CBD

144 Robinson Road, Robinson Square, Unit 08-02,
Singapore 068908

Call +65 6951 1290
Sms +65 9006 8393

Soma Clinic @ Orchard

545 Orchard Road, Far East Shopping Centre Unit 16-07, Singapore 238882

Call +65 6204 6009
Sms +65 8809 9396

hello@somaclinic.sg

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