Art Therapy Trauma History Assessment
Client Information
Name
Date of Birth
Date of Assessment
Presenting Concerns
Describe main concerns or symptoms
Relevant Trauma History
Summarize known trauma history (types, frequency, duration, etc.)
Trauma Impact
How has trauma impacted emotional functioning?
How has trauma impacted behavior?
Has trauma impacted physical health?
Current Supports
Current support systems (family, friends, professionals, etc.)
Coping Strategies
How does client currently cope with trauma?
Art Therapy Goals
Goals for art therapy related to trauma history
Additional Notes
Other relevant information