Trauma Assessment - How detail (First session)?

The more I think about my 1st session, I'm getting scared. I spoke with the T briefly when scheduling and mentioned the jist of why I contacted him.

He said he will e-mail me some forms to fill out the day before 1st session one of which will be a trauma assessment. Online I found some but many ask about CSA and I don't want to talk about it.....at least not right now (my reason for contacting him has NOTHING to do with CSA). Yet some forms ask if there is CSA, age, relationship to person etc. That's way too much for me to share given that I have never disclosed it to ANYONE. Even if I leave that Q blank...not answering it itself is telling him what the answer is which makes me feel very....exposed.

I'm panicking thinking about this. Is there a standard one Ts use here in the U.S.? Can anyone share their experiences/tips on dealing with this?

I wasn't expected to give a detailed description of my CSA. I just told my T that I had some issues with SA that I wasn't ready to talk about yet. This was at my first appointment. He nodded and we moved on. He did ask how old I was.

I don't think any T is going to expect details at a first visit. If you are uncomfortable talking about it just write that I'm not ready to talk about this yet.

I wonder if it's a gender thing. I have only had male pdocs ask me this. Only one female therapist had a box for this on her form, but all the others (upwards of 10 or so) never included it on a form or asked outright. They let it emerge.

If I were to fill out a form like yours, I would just write something like: not ready to discuss.

Just because a form has a place for something does not mean a person is compelled to respond in my opinion. I leave things blank.

as mentioned earlier, no details are expected first session. You can also choose how much you reveal in the forms. I will acknowledge the various abuses, but don't talk about them until I trust the therapist.
Also, I think every intake I have has asked about abuse on the intake form. There was only 1 clinician I didn't have an intake for with, and that one did a longer intake appointment asking all those questions. Even in person I did not give all the details right away (and it was an intake for a trauma group).
Good luck and I hope it goes ok. Try to remember to breathe.

I really hate when therapist's put that on a freakin' form! If they meet a new client and feel that a solid initial rapport has been established, I think it's fine for them to ask if there is any history of abuse (emotional, sexual and/or physical), but putting it on a form and asking someone to check a box or pour out their heart on a single line just irritates me.

When I was doing the search for my therapist recently (interviewed over 10), yep 10 , and some had it on a form, some asked during the initial interview and others didn't ask. I never responded to the question on the form, but then I didn't answer other stupid questions either. I feel that an intake form should be: Name, address, phone number, insurance information & emergency contact person. In my opinion, no one should have to reveal information on an intake form; that stuff belongs in the face-to-face discussion that comes afterwards. Lengthy intake forms are a lazy man's attempt to "get it all down on paper" instead of spending the time to build a rapport and talking a bit about what a client can expect from therapy with that person, IMHO.

The few therapists that asked me outright I responded, "Yes, I was sexually abused from age 7 to 11 and I'm not in a place at this point that I want to discuss it. Thank you for honoring my privacy." Of course, I had to rehearse it a few times before actually using that statement. It worked just fine. One woman that I started with told me that she would honor that but in the next session, she ambushed me with a direct question that really triggered me and set me in a spin. Needless to say, she is no longer my therapist. I think we get to decide when we're ready to share that information. I hope you find someone who is a good match.

My intake form for the county has a similar type question: do I ever have thoughts of harming myself? Right below the question: "if checked yes, the client must immediately meet with a clinician after the assessment. I'm still stuck on how to answer it. If I put yes, how bad are they going to overreact? If I put no, then I'm lying. I'm asking my T tomorrow for advice.

Wow. That's a good way to discourage honesty. Talking to your therapist first is a good idea. My inclination would be to answer honestly and then tell them you have no plans, that you are in therapy and have a pdoc. But, maybe your therapist will know more specifically how the county responds to these disclosures. No reason to cause more stress.

Wow....right now I can't even say this out loud to myself! I will also try practicing saying something similar if its brought up in the first session. Thank you.

Hi Seeking_Peace...

I was (and am!) in a similar place. I can't even get my head around some of my "stuff", and am in no way ready to say it out loud. I also found it scary and offensive that people would put very blunt questions on a form.

I had a T, years ago, that had been highly recommended for dealing with trauma stuff. I was working hard to keep myself present while waiting for him before the first session... and then I saw the intake form, with all these questions ("just check off every awful thing that has happened to you!"). And that was it. It pretty much ruined intake for me... I was pretty badly dissociated/spacey and not able to talk much at all.

He ended up being a bad fit for me for a lot of reasons, so that didn't work out.

But as for the form, I just left most of it blank. Like you, I felt like if I just skipped one specific question, the answer would be obvious. So, I simply declined to fill out anything in that section.

I guess I wanted to share that, so that you wouldn't feel alone, or like you're the only one to do that! I bet it's not that uncommon, I saw some statistics at one point that people who use those forms generally expect people to lie on them (?!). I'd just not do it, personally.

If T asks about it, I'd say - "I'm not really comfortable discussing that at this point." Personally, I find that if a T can't respect that, they're probably a bit too pushy for me (I feel "pushed" very easily), and not going to be a good fit, so I'd take that as a sign to keep looking!

Also... this may sound awful, but I think for something like that, if you get pushed, it's ok to lie in intake. I'm sorry, I know everyone's going to disagree, but I feel like... if you're going to push me into a corner, and you don't know me well enough to help mitigate the after effects (and no T does after one session), then I'm going to keep myself safe by not going there.

My current T did not ask any of these questions on his intake form, it was very basic (name/phone/address/emergency contact/insurance). But in the session, he asked... because of something I said that wasn't making sense to him. So in context, the question made sense... but I had prepared myself and let it slide across the front of my brain without letting it rattle me, and said, "Nope!". He actually asked a second time later, because again, my reaction to something was clearly not making sense, and again I said, "nope!".

But, pretty quickly thereafter, I found a way to let him know (that did NOT involve me talking about it). This was after I had the feeling that I could trust him to listen to me and respect my boundaries on this, and it was all in writing, but at that point, I wanted him to know so that he could understand how things fit together (and so he'd stop looking for the missing puzzle piece!). It's been a good thing... he's the first T Ive told (!) and he's been very respectful of it, and it helps knowing that he knows, so that he can better understand why some things freak me out!

Hope this helps... when do you go to see this T? Remember, you get to pick your T... so if he's too pushy for you, and you don't feel like your boundaries are being respected, you should absolutely keep looking. Especially with trauma stuff, I think, having a T that can respect your boundaries is REALLY important.

*** Good luck ***

^ Thank you for the kind words. I spoke with the T for a few minutes when I called to make the appointment. He had a very gentle/caring voice and I got the impression that we will click.

I'm not worried about him pushing me too far during the first or even second session. I'm just very anxious about my own reaction if CSA is brought up at all. I don't know...it's just not something I've ever had to acknowledge to anyone. I don't usually even think about it. But for some reason, knowing that someone part of my current life will be aware that it happened is making me feel.....exposed, ashamed, and panicky.

Anyway, thank you for all the kind words.