Trauma-Informed Intake Commentary

Essential Standard: Your agency has a documented trauma-informed protocol for client intake.

Trauma-informed care is an essential aspect of providing quality care to survivors of trafficking and exploitation. Trauma-informed practices must not only be uplifted in everyday interactions with clients of your program but must also be implemented from the moment of client intake, including before a potential client enters the program. By ensuring that your intake process and orientation is trauma-informed, your agency ensures that survivors entering your program are not re-traumatized by the process of finding a place for recovery. It is critical that the survivor’s voice, choice, and dignity is valued throughout the client intake process so survivors feel that they are able to confidently and comfortably choose your agency as a part of their healing journey.

Trauma-Informed Practices for Potential Clients: Before Entering the Program

The six key principles of the trauma-informed approach are safety; trustworthiness & transparency; peer support; collaboration & mutuality; empowerment, voice, & choice; and cultural, historical, & gender issues. These principles must be uplifted within the client intake process (For more information on the trauma-informed approach, see NTSA’s Trauma-Informed Baseline).

The table below specifies both required and recommended attributes evaluated during the accreditation process. Attributes labeled as required must be present for accreditation. Attributes labeled as recommended could be reviewed, but are not necessarily required, during the accreditation process. Each requirement and recommendation is further explained in the sections below.


  • Implement clear informed consent procedures to ensure the client’s consent to treatment 
  • Utilize trauma-informed practices when potential clients are considering entering the program. Required trauma-informed intake practices include:
    • Brief intake assessments and screenings 
    • Clear explanations and instructions for each aspect of the intake 
    • Confirmation of trafficking with minimal details of a client’s story to prevent further traumatization
  • Provide complete transparency about your program’s policies and practices for potential clients, both before entering the program and during orientation 
    • Provide clients with a Resident Manual that outlines all restrictions, rules, and program aspects before entering the program 
    • This manual must include the program’s position on faith-based participation
  • Implement clear informed consent procedures to ensure client’s consent to treatment


  • Intake should take place via conversation with note taking rather than a form to be filled out by the client 
  • Clients should have the opportunity to converse with current or past clients in order to gain insight into the program’s efficacy or policies 
  • Clients should be integrated slowly into regular program life. 
  • Program should offer additional housing for the purpose of orientation and successful integration

Trauma-Informed Practices for Client Intake

Informed Consent for the Intake Process 

When providing quality, trustworthy care to clients, it is imperative to adhere to the proper informed consent practices in the field of residential care. Informed consent is often misunderstood in the field of mental health as it has a strong background in the field of healthcare and research. Understanding and utilizing informed consent policies is a cornerstone of ethical healthcare. 

At its core, informed consent is about providing individuals with comprehensive and understandable information. This includes details about the purpose of treatment, policies and procedures, potential risks, expected benefits, and available alternatives related to the intervention or study. This information must be conveyed in a language and manner that the individual can comprehend, taking into account their educational background, cultural beliefs, and any physical or cognitive impairments.

The informed consent process goes beyond merely disclosing information about the intake and treatment process. The person seeking consent should answer any questions, address concerns, and ensure that the individual giving consent has an opportunity to make an informed decision without feeling coerced or rushed into treatment. Informed consent also requires that individuals have the capacity to understand the information presented and the freedom to exercise their right to refuse or withdraw consent at any time without experiencing negative consequences.

Obtaining informed consent is not a one-time event but an ongoing process. It should be documented through written consent forms or other means, and individuals should be given the opportunity to re-evaluate their decision as they gain more knowledge or experience throughout the course of their participation in the program.

By ensuring that clients have access to complete and understandable information, and by respecting their autonomy and right to make informed choices, informed consent serves as a critical safeguard in promoting ethical conduct and fostering trust between clients and the residential program. Informed consent should take place through every component of the intake process and regularly throughout the course of a survivor’s treatment. 

The Three Components of the Intake Process 

The intake process should be considered a two-way conversation between the prospective client and the organization, where the client communicates their needs and desires for a program and the organization clearly communicates their approach to service provision. By utilizing this transparency in communication from the very beginning with each client, the program will better be able to foster trust, safety, and choice with clients. 

At the center of the intake process must be goals of getting to know the survivor and adequately identifying their needs to then ensure they are connected with available resources to address those needs. By listening to the survivor identify their needs and helping them to pinpoint necessary services, your organization can better understand if your program is a good fit.

Each organization should develop their own intake form and procedure based on their practices and needs.There are three essential components of intake in the field of residential care that work together to ensure a proper program entrance. These components are: 

    1. Assessing the needs of a potential client through transparent disclosure about the program
    2. Gathering basic demographic information and appropriate screening forms to identify the client’s needs 
    3. Orienting the client to the program to ensure a smooth and regulating transition into the program

Component 1: Assessment of potential client’s fit through transparent program disclosure

The organization should utilize complete transparency surrounding the program’s policies and practices, including any restrictions, rules, and program aspects. The intake is an important place to provide transparency about your program to the client. This information should be found in the Residential Manual or Handbook provided to all clients, but it should also be verbally discussed with prospective clients in the intake process. This applies especially to clients who have low literacy, language constraints, or cognitive impairments. Offer the client the opportunity to ask questions about the program and assure them that their orientation will provide them with more answers to their questions.

It is recommended that a variety of staff members or former/current clients be present for some portion of this intake component so that a potential client gets a more authentic sense of the program. Programs should consider facilitating a virtual or in-person interview with a few other individuals involved with the program and allow for the potential client to ask questions. This practice should be done in a manner where there can be confidentiality of the questions asked of the peer or a direct service provider. Not only will the information the survivor gains help them in making an informed decision about coming to your program, but upon arrival they will already know some friendly faces. Virtual intakes should occur on a HIPAA-secure platform to ensure encryption of data that will protect the client.

Component 2: Intake Assessments/ Screening Forms

During the intake process, prospective clients may be asked to fill out screening and/or assessment forms. It is recommended that the intake form is blended into normal processes and conversation so that the client regards intake as a conversation and comfortable process, rather than an interview. To do so, advocates and/or staff can use the intake form as a guide while meeting with the client and naturally incorporate the questions into conversation.

Before continuing with screening questions, the organization should also clearly communicate confidentiality policies. Confidentiality statements allow the client to provide informed consent to how their information will be stored, utilized, and shared. Reinforce your state’s mandated reporting laws and your role as the organization to uphold confidentiality. It is recommended that a clear confidentiality policy is communicated at the beginning of all contact with clients and should read something like the following: 

I wanted to let you know before we begin talking that this conversation is confidential. This means I will not share details about our call to anyone outside of our program without your consent.  However, there are some times when I might have to share details about this conversation. I am telling you about this now because I care about you and want you to feel safe and in control of your story. I will have to share details about this call with a third party if you disclose any of the following: 

  • There is ongoing physical or sexual abuse or neglect of any person under 18 years of age, an elderly person, or a disabled person 
  • You are threatening serious harm to another person
  • Someone else is threatening serious harm to you that will imminently take place
  • If there is evidence that you are a danger to yourself and I believe that you are likely to harm yourself or end your life unless protective measures are taken

I will always tell you if I am going to contact another individual regarding the details that you share with me. I want to remind you that these are safety measures that are for your protection. Do you have any questions about confidentiality? 

Although it might be instinctual for service providers to conduct a thorough initial intake that details a survivor’s information and personal experiences, the intake form should be clear and concise. The only personal information that should be gathered in the intake form itself should be identifying information/demographic information required for state regulation/funders, information about mental/physical health (including medication), client goals for program engagement, and a safety assessment. 

Additional mental health screening forms can be included in the intake process in order to identify client functioning. Consider incorporating a PTSD screening, a depression screening, an anxiety screening, a substance use screening, and a Adverse Childhood Experience (ACEs) screening (links to well-researched and highly regarded screenings have been included for reference, but other screenings can be substituted to align with program standard practice). These screenings allow for data collection that can be utilized in program goal setting, as well as provide counselors and therapists with essential information for treatment. Occasionally, these screenings can be triggering or troublesome for survivors to complete. Allow clients to take breaks in the intake process or step away from mental health screenings altogether until they feel more stabilized in your program. 

The intake process also might be the time where your organization should be confirming that the potential client has been trafficked. Identifying trafficking in a client should be done along the guidelines of your state, but when possible, adherence to the U.S. The Department of Justice’s Trafficking Victim Identification Tool (TVIT) should be prioritized.

 The intake process must be a time to get to know the whole person and not the survivor’s victimization and trauma. While information regarding a survivor’s trafficking and exploitation is important for identifying necessary services and information, the initial intake is not the time to request that a survivor shares their story. Many survivors choose to only share aspects of their story in a therapeutic setting after building many weeks of rapport with their provider. Asking for detailed information beyond what is included in the TVIT does not utilize a trauma-informed approach.

Component 3: Program Orientation

After all screenings have been completed and the client has arrived in the program’s care, a proper program orientation should be conducted as the final step of the intake process. Proper trauma-informed orientation into a residential program is a vital component of creating a safe and supportive environment for survivors. The program orientation component offers the client the opportunity to engage in program life at their own pace and should include regular contact with direct service staff to ensure effective integration.

First and foremost, a trauma-informed orientation should prioritize safety and stabilization. This means creating physical and emotional spaces that are secure, predictable, and non-threatening.  When creating a stabilization period for clients, individual programs might have varying approaches based on staff and physical space capacity. It is recommended that programs offer a specialized orientation process that lasts no less than 30 days. This orientation can take place in the residential facility or, preferably in a separate on-site facility that is specifically designed for orientation and stabilization. A separate facility for the purpose of orientation can contribute to stabilization for the new client, as well as provide protection for existing clients as new editions to any program can cause disruption. 

During the orientation phase, the client should have access to necessary resources to meet any pressing physical needs. This can vary based on the client, but should include access to medical care, dental care, clean clothing, personal care items, and any preliminary contact with a mental healthcare provider. Collaboration and coordination are essential in a trauma-informed orientation. Interdisciplinary teams should work together to provide holistic care, ensuring that the client’s physical, mental, and social needs are addressed. We recommend establishing a network of trusted community providers and partners that will be consistent throughout the client’s entire course of treatment. 

The orientation phase should also include a comprehensive explanation of program rules, expectations, and structure. This explanation should be more in depth than in the initial assessment component, but the content should not be new or surprising to the client if proper transparency is established. Programs should use understandable and clear language and be sure to create a safe space for open communication channels. Enable the client to voice their concerns or questions at all times in the orientation phase of your program and beyond. Consider bringing other, more established residents into this phase of the orientation to help the new client feel connected socially. By valuing residents’ input and involving them in their own care, a sense of empowerment is fostered among both new and established clients alike. 

Discussing program rules or structure can also take place over several meetings with direct service staff as the adjustment period to a new program for a client can be overwhelming. Offering a 30-day minimum orientation period allows for several conversations to ensure a client’s stabilization and understanding of your program’s expectations, goals, and offerings. Clients should also be expected to engage in programming with other residents at their own pace. We recommend that participation in otherwise mandatory programming be opt-in within the first few weeks of orientation. This allows for clients to build rapport with staff and other residents before engaging in regular mandatory or optional program offerings such as group therapy, equine therapy, religious prayer or book studies, exercise, games, or artistic activities.


A trauma-informed intake and orientation is a crucial component of a residential program for survivors as it sets the foundation for safety, stability, and empowerment during the recovery process. The orientation phase helps clients acclimate to their new environment at their own pace and allows for open communication, fostering a sense of empowerment and involvement among clients’ pertaining to their own care. Offering flexibility in program engagement and involving established residents in the orientation process further promotes social connection and a supportive atmosphere during client onboarding. Ultimately, a trauma-informed intake and orientation procedure paves the way for clients to embark on their healing journey within the residential program with confidence, understanding, and the necessary tools for recovery while balancing the needs of program staff pertaining to gathering requisite details about the client that will facilitate their care

Appendix: Resources for Intake Process

Commentary Sources​

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