Putting thoughts on trial worksheet
If you’re a therapist looking for a triggers worksheet to share with clients, you’re in the right place.
A triggers worksheet can be a valuable tool for clinicians. This article provides an overview of the different types of triggers, ways to support clients, suggestions for using the identifying triggers worksheet, and a list of trauma-related coping strategies.
What are trauma triggers?
Triggers are the internal and external stimuli that may evoke a strong emotional or physiological response related to past trauma(s).
With an identifying triggers worksheet, therapists can foster self-awareness and empower their clients to apply their introspective insights, during and outside of therapy.
A triggers worksheet can help therapists practice trauma-informed care, by collaboratively figuring out how their client responds to trauma and subsequent situations that remind them of past trauma.
Stress reactions present differently in each individual. For instance, some people may meet the clinical criteria for post-traumatic stress disorder (PTSD), and others—despite having and reacting to triggers—experience symptoms that appear subclinical.
Several factors influence how people react to trauma, such as:
- Their capacity for resilience, or distress tolerance
- Individual characteristics such as co-occurring disorders, marginalized identities, and access to resources
- Lack of support
- Environmental factors
Types of triggers
Trauma triggers vary depending on the client and their specific trauma history.
However, there are common categories of trauma, including:
Sensory triggers
These involve sights, sounds, smells, tastes, or tactile sensations. For example, a loud noise might remind a veteran of a traumatic event during combat.
Emotional triggers
Intense feelings and emotional states may trigger a trauma response, such as fear, anger, or sadness. For instance, feeling rejected by a partner might trigger a client to recall an adverse childhood memory involving neglect or abandonment.
Physical triggers
Different bodily sensations, like feeling pain in a traumatized area, may be a trigger.
Thought-based triggers
Thoughts or memories that come up spontaneously or through reflection can trigger a trauma response. For example, recalling a specific event or conversation might lead to emotional distress.
Activities or situational triggers
Specific situations, activities, or environments may trigger memories related to a traumatic place/situation. For example, being in a crowded bar or drinking might trigger a client to recall the circumstances of a traumatic event.
Date-related triggers
The anniversary of the traumatic event or significant dates related to the trauma may be a trigger. For example, the date of a loved one’s death might cause feelings of intense grief or sadness.
Interpersonal triggers
Interactions with certain people or specific behaviors from others may trigger the recollection of a traumatic event. For example, a client who experienced intimate partner violence with an ex may feel triggered by criticism from their current partner.
Media-related triggers
Social media, news, movies, or television shows that depict similar traumatic events or themes may be triggers. For example, a client who has survived a sexual assault may be triggered by a news story about a similar incident.
How to identify triggers
While triggers may arise throughout therapeutic treatment, working with the client to identify a list of specific triggers, using a triggers worksheet, specifically an identifying triggers worksheet, during sessions can be helpful.
Keep a record
Using an identifying triggers worksheet, or a journal, may be helpful to record emotional and physical reactions to situations.
Reflect on trauma
In a safe space, like therapy, you can help the client reflect on the details of their trauma(s) to identify their triggers and any patterns, or recurring themes, that may cause emotional dysregulation.
Physical check-in
Encourage the client to track physical symptoms throughout the day, reflect on whether they are related to a particular emotion, and record where in their body they feel particular emotions.
Assess behaviors
Whether using a triggers worksheet in session or at home, the client can reflect on situational factors— like specific places, activities, or people—that they avoid out of fear or cause particular reactions in them. For example, a veteran might find themselves eating less, feeling quick to anger, and being unable to sleep when triggered.
Tips for coping with triggers
Supporting clients in coping with triggers involves strengthening their emotional regulation capacity and developing distress tolerance skills.
While each client’s needs are unique, some common coping strategies include:
A safety plan
In instances where triggers may cause or be a risk factor for suicide, a safety plan may be helpful.
This might include a list of triggers, the client’s coping strategies—like removing themselves from the triggering situation, an accessible list of trusted people to call, or a list of crisis resources.
Download a free safety plan template to use in your practice.
Crisis techniques
Crisis techniques, such as the ACCEPTS skill, REST skill, and TIP practice help to manage stress, regulate difficult emotions, and calm an overwhelmed mind and body.
Grounding techniques
Deep breathing, square breathing, or mindfulness are all grounding techniques that can promote calm and reduce stress.
Self-care practices
Promoting healthy practices, such as getting adequate sleep, nourishing their body, and daily movement, may be helpful for your client.
Supportive community
Developing a network of supportive and trusted people to call can make all the difference when distressed. Your client might find it helpful to write these names on a card they can keep in their wallet or pocketbook.
Mindfulness about urges
Practices like urge surfing can help clients who deal with intense cravings to use or engage in self-injurious behavior in response to triggers.
Establish and maintain boundaries
Clients can protect themselves from people and situations they find triggering by creating strong boundaries.
Limiting media exposure
When feeling activated or in the early stages of treatment, clients may benefit from limiting their exposure to news or media coverage of triggering events.
Types of triggers worksheets
There are various types of triggers worksheets you can use in your practice.
Download these free triggers worksheets at the top of this article to use in your practice:
- Trauma triggers worksheet: This worksheet helps clients identify specific triggers related to their trauma(s).
- Identifying triggers worksheet: This free printable identifying triggers worksheet focuses on identifying the type of trigger, and the specific feelings or emotions, such as fear, anger, or sadness, that may arise.
- Coping with triggers worksheet: This type of triggers worksheet helps clients identify helpful coping strategies to improve their emotional responses and strengthen their distress tolerance skills.
Sources
- Limbu, B., Unwin, G., & Deb, S. S. (2021). Comprehensive Assessment of Triggers for Behaviours of Concern Scale (CATS): Initial Development. International journal of environmental research and public health.
- US Department of Veterans Affairs. (2024). Trauma reminders: Triggers. National Center for PTSD.
- Substance Abuse and Mental Health Services Administration. (2014). Treatment Improvement Protocol (TIP) Series, No. 57. Center for Substance Abuse Treatment. Rockville, MD: Substance Abuse and Mental Health Services Administration.
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