Trauma Appraisal Worksheet

When to Use

Use during the cognitive restructuring phase of CT-PTSD to identify and update the negative appraisals of the trauma and its aftermath that maintain PTSD symptoms. Target appraisals identified during formulation and reliving work.

How to Introduce

Explain that trauma often leads to understandable but inaccurate conclusions about ourselves, others, or the world. The worksheet helps examine these conclusions with the same curiosity and evidence-based approach used throughout therapy.

Adaptations

For clients with deeply held guilt or shame appraisals, begin with less emotionally charged appraisals to build the skill before tackling core beliefs. For clients who intellectually restructure but retain the emotional conviction, combine with reliving-based updating at the hotspot where the appraisal was encoded.

Avoid purely cognitive restructuring for appraisals rooted in pre-trauma schema without addressing the developmental context. Do not use in a way that implies the client's emotional response to the trauma is 'wrong' — validate the emotion while examining the appraisal driving it.

Clinical Tips

The most common trauma appraisals fall into categories: self-blame, permanent change, inability to cope, and the world as completely dangerous. Identify which category applies and tailor the Socratic questioning accordingly. The goal is a more balanced and contextualised appraisal, not a positive one.