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12 | COLUMBIA SOCIAL WORK REVIEW, VOL. IX 

CHILDHOOD DOMESTIC VIOLENCE TRAUMA- 
IMPACT AND COPING STRATEGIES AT A LATER 
STAGE IN LIFE: A QUALITATIVE EXPLORATION

ANA QUIÑONES 

Studies indicate that over 8.3 million children in the United States are 
exposed to domestic violence trauma, and results have indicated that 
exposure to this trauma can have serious developmental effects. This 
study includes qualitative data collection on six participants who 
have overcome childhood domestic violence trauma (CDVT). Each 
participant was interviewed, and successful coping strategies were 
identified in the process. Using Grounded Theory, which interprets 
the data into collective themes, coping strategies were put into 
categories and subcategories. After the strategies were organized, 
the results provided a structured framework for different coping 
alternatives that could be useful to practitioners who are working 
with people experiencing or recovering from CDVT in their lives. 
These results should be adhered to in curriculum-based practice, and 
can be used as a framework for macro, mezzo or micro application. 
Implications of this study include greater knowledge base for child 
welfare workers, along with the opportunity for new interventions 
in working with children struggling with CDVT. Furthermore, 
identification of these interventions can serve to reduce long-term 
effects of CDVT on children.

INTRODUCTION
Violence experienced by children in families and its later consequences 

for children’s personal lives is always a matter of concern. It is estimated 
that roughly 11.1% of children in the United States have been exposed to 
physical or psychological violence in the family involving an adult (Hamby, 
Finkelhor, Turner & Ormrod, 2011). Exposure to childhood domestic 
violence trauma (CDVT) has a lasting impact on children and becomes a 
serious barrier to development even after the children are safe from the 
domestic violence situation (Hardesty & Campbell, 2008). Studies have 
shown that exposure to CDVT can lead to behavioral issues in children as 
they progress through life (Moylan, Herrenkohl, Sousa, Tajima, Herrenkohl, 
& Russo, 2010). There have been some studies that provide guidelines for 
coping mechanisms (Izaguirre & Calvete, 2015). However, further research 
is needed to determine a wider range of coping mechanisms within people 
who have been exposed to CDVT. Studies indicate that there is a need 
for more professional strategies to help children who have been exposed 



COLUMBIA SOCIAL WORK REVIEW, VOL. IX | 13 

ANA QUIÑONES

to CDVT (Huang, Wang & Warrener, 2010). Furthermore, the earlier the 
intervention is put in place, the better developmental outcome the child 
will have (Huang et al., 2010).

EXPOSURE TO CDVT
In the United States, 5.8% of children revealed that they had witnessed 

family violence in which one parent assaulted the other (Finkelhor, Turner, 
Shattuck, & Hamby, 2015). Children who 
are exposed to domestic violence are more 
likely to live in poverty; however, they are 
also more resilient than “non-poor” (p. 2468) 
children (Yoo & Huang, 2012). Stressing the 
numbers of the children who are exposed to 
CDVT may provide better insight into size 
of the issue at hand for society. In a recent 
study, researchers found that children who 
are exposed to CDVT are more likely to 
experience emotional, physical, and sexual 
abuse during the time when the trauma is 
present in the home than children who do not 
experience CDVT (Holt, Buckley & Whelan, 
2008). This study also found that the emotional effects of trauma are likely 
to be present even after the children are in a safe environment. Calling for 
a more child-centered approach from professionals could alleviate the 
suffering of children who have been exposed to domestic violence (Holt et 
al., 2008) and increase their ability to use effective coping skills. 

BEHAVIORAL ISSUES
Behavioral issues arise after CDVT during childhood and well into 

adulthood. Studies show that preschool aged children exhibit long-term 
detrimental behavioral effects following CDVT (Huang et al., 2010). 
Children who focus their attention towards domestic violence are more 
at risk of developing anxiety issues (Briggs-Gowan et al., 2015). Children 
may also suffer from severe cognitive deficits, social withdrawal, and 
limited peer interactions (Hildyard & Wolfe, 2002). Izaguirre and Calvete 
(2015) found that 97% of mothers who have been victims of domestic 
violence revealed both that their children were indirect victims and that 
children often tried to interfere in the conflict. It appears that exposure to 
domestic violence may cause children to think that they have to assume 
adult roles and responsibilities; alternatively, they sometimes begin to 
exhibit aggressive behaviors that may be directed towards their mothers 
as well (Izaguirre & Calvete, 2015). Boys are more at risk of exhibiting 
externalizing behaviors (e.g. hitting, bullying) and girls are more at risk 

“Exposure to 
childhood domestic 
violence trauma 
(CDVT) has a lasting 
impact on children 
and becomes a 
serious barrier to 
development even 
after the children 
are safe from the 
domestic violence 
situation (Hardesty 
& Campbell, 2008).”



14 | COLUMBIA SOCIAL WORK REVIEW, VOL. IX 

CDVT - IMPACT AND COPING STRATEGIES LATER IN LIFE

of internalizing behaviors (e.g. anxiety and powerlessness) due to the fact 
that boys are more likely to be conditioned at a young age to be dominant 
while girls are taught to be submissive (Blair, McFarlanne, Nava, Gilroy, 
& Maddoux, 2015). Extensive studies that focus on the repercussions of 
CDVT have found that adolescents are more likely to fall into delinquency 
and depression if they have been exposed to domestic violence and/or child 
abuse than adolescents not exposed to either form of violence (Moylan, 
Herrenkohl, Sousa, Tajima, Herrenkohl, & Russo, 2010). The social 
learning theory, which focuses on the pattern-repeating behavior that 
occurs when an individual learns from his or her environment (Bandura, 
1973) can be correlated to aggression displays later in life from CDVT. 
Aggression in university students has also been confirmed to be a possible 
effect of CDVT (Feroz, Jami, & Masood, 2015).

COPING
Children who have been exposed to childhood domestic violence 

exhibit unique coping strategies depending on their family system. External 
coping strategies indicate the extent to which caregiver support makes an 
enormous difference in how children respond to stress (Hildyard & Wolfe, 
2002), as caregivers provide a model that children follow for problem-
solving, personal control, and predictability (Luthar, Cinchetti, & Becker, 
2000). A child’s adjustment is largely reliant on how their parent functions 
throughout the trauma (Graham-Bermann, Gruber, Howell, & Girz, 2009). 
The child’s family as a whole also plays a role in coping for the child. The 
family stress theory states that a family’s ability to deal with stress is an 
indicator of how each individual family member will deal with it as well 
(Hardesty, Campbell, McFarlane, & Lewandowski, 2008). Connecting with 
supportive loved ones, enacting family rituals, and staying busy are all 
examples of family coping mechanisms that, according to the family stress 
theory, can also help the individual child cope (Hardesty et al., 2008). In 
contrast, exposure to intimate partner violence (IPV) can lower maternal 
warmth (Holmes, 2013) and, in turn, affect the children’s ability to adjust 
after domestic violence trauma. Currently, studies surrounding childhood 
domestic violence experiences lack a strengths-based perspective, and 
more research is necessary to identify specific coping strategies that were 
used by participants to transition into adulthood (Izaguirre & Calvete, 2015).



COLUMBIA SOCIAL WORK REVIEW, VOL. IX | 15 

ANA QUIÑONES

METHODOLOGY
This qualitative research study had six participants over the age of 25. 

Participants consisted of five women and one man. There were no gender- 
or race-specific requirements for participation. Inclusion criteria for the 
sample included having experienced domestic violence trauma before 
the age of 18. Referral and recruitment were completed through social 
media sites such as Facebook and referrals from department heads at 
Family Support Services in Amarillo, Texas. Potential participants were 
given information about the research process and goals. Their questions 
regarding any part of the research were answered truthfully, and deception 
was not used in any portion of this study. Each interview and participant 
was anonymized through use of codes and pseudonyms for names, 
towns, workplaces etc. The research was conducted in compliance with 
Institutional Review Board standards and with approval.

 This study utilized a qualitative approach to gain a reliable amount of 
data. The Grounded Research method was used for the qualitative portion 
of data collection. The method for this study was an in-depth analysis of 
interviews and discussions with participants. Each participant had one 
interview with the researcher and on some occasions, two interviews 
were conducted based on the preliminary data analysis. The duration of 
the interviews varied based on the quality of the information received. 
These interviews/discussions included explorative and strength-based 
questions from the Changed Lives New Journeys (2013) website to help 
guide the discussion along (Appendix A). Participants were encouraged to 
engage in discussion and an in-depth narrative of their trauma and their 
coping mechanisms. They were also encouraged to submit any additional 
information that came to mind after the interviews via an electronic form 
and were allowed to submit any creative work that they might want to 
share for analysis. The data was collected within a month’s time. 

A thematic analysis was used for this qualitative research. Each 
interview was transcribed and coded respectively by the primary 
researcher. Line by line coding was used to minimize the exclusion of any 
vital information to provide a dense analysis (Glaser & Holton, 2004). 
The interviews were read and analyzed for sub-themes to later group 
into main themes. The themes were discussed with co-investigators for 
analyst triangulation and further modified based on the analysis of the 
co-investigators. Furthermore, the researcher discussed findings with the 
participants to make sure that the results were trustworthy.



16 | COLUMBIA SOCIAL WORK REVIEW, VOL. IX 

CDVT - IMPACT AND COPING STRATEGIES LATER IN LIFE

FINDINGS
The participants in the study identified several coping strategies 

that were beneficial to them during and while overcoming CDVT. Every 
participant identified physical and emotional trauma occurring in his or 
her home as a child. All expressed some feeling of helplessness during the 
trauma. One elaborated:

“I really don’t remember a time when anybody 
actually spoke to me about what was going on; it was

 always just kind of always happening around me.” (David)

The analysis of the participants’ stories of overcoming CDVT led to 
the identification of coping strategies during three phases. The description 
of the three phases, coping strategies used, and statements from the 
participants follow. (For a summary chart, see Appendix B).

COPING STRATEGIES DURING CDVT
The most significant coping strategies identified by the majority of 

participants included school, focusing on having good grades, writing, 
avoiding conflict when possible, having sibling support, having a positive 
professional intervention, having role models, and going with the flow. 

Using external resources allowed for a healthy coping process that 
helped most of the participants define goals to move them towards 
emotional progress. Having role models present in their lives while 
experiencing the CDVT allowed half of the participants to begin to 
establish goals for themselves. Out of the six participants, all but one 
identified having positive professional intervention growing up that made 
a significant difference in how they perceived and coped with the conflict. 
The experiences range from interactions with social workers, counselors, 
therapists and law enforcement. A participant explains the impact of 
having that resource available to her:

“The social worker at the rehab center and the counselor 
at the school were probably the two most vital things 

in my life that helped me.” (Alice)

All of the participants identified school as their main coping 
mechanism during their time experiencing the trauma. It proved to be a 
distracting factor that allowed them to focus their energy on something 
besides the negative environment at home. 



COLUMBIA SOCIAL WORK REVIEW, VOL. IX | 17 

ANA QUIÑONES

Being focused on school and channeling their energy towards getting 
good grades was identified as a motivating factor to begin forming values 
for themselves at a young age. Going with the flow and using writing as a 
way to vent, as 66.6% of the participants did, allowed them to express their 
emotions in a private manner.

“I used to write a lot. Especially during that 
time period, I had journals and journals full.” 

(Angelina)

Avoiding conflict while growing up was another coping mechanism 
that allowed participants to emotionally disengage from the negative 
situation at home. Avoiding conflict involved sneaking out of the house, 
locking themselves in their room, and not getting physically involved. One 
participant also stressed the importance of sibling support to help get 
through rough days and avoid conflict:

“My sister and I are very close…. A lot of the times
when my parents would be fighting or whatever, 

I would read to my sister.” (Claire)

COPING STRATEGIES WHILE BREAKING THE CYCLE
When the participants were old enough to make their own decisions, 

many were focused on breaking the cycle of abuse, which they defined as 
wanting to avoid the repetition of the negative behavior patterns they had 
seen in their parents. Coping methods identified by the participants to 
break the cycle included moving out, setting goals, and focusing on school. 
Moving out as soon as possible from the toxic environment at home was 
something five out of six participants did. Most participants were looking 
for a safe place away from home and were ready to live a different lifestyle 
than the one they grew up around. A participant narrates the emotional 
whiplash of being away from home:

“It’s like it wasn’t normal to not have that chaos…. 
We were so used to the dysfunction.” (Alice)

Soon after, five out of the six participants unexpectedly found 
themselves in similar dysfunctional relationships after leaving home. One 
participant revealed the vulnerability of being alone for the first time:

“When I ran away initially…I didn’t heal from any 
of it, you know…. I was probably broken in any way 

I humanly could be.” (Claire) 



18 | COLUMBIA SOCIAL WORK REVIEW, VOL. IX 

CDVT - IMPACT AND COPING STRATEGIES LATER IN LIFE

Statements from the five participants who found themselves repeating 
the negative cycle expressed the importance of becoming aware and 
setting standards for themselves and their future. One participant shared 
the desperation felt: 

“You have no idea what it is to live like that as 
a child and as an adult, in a situation like that.” 

(Alice)

They ultimately found a way to break the cycle and move on to the final 
phase of coping. 

COPING STRATEGIES AFTER CDVT
Overcoming CDVT later in life proved to be an emotional journey 

for all of the participants. Some of the coping mechanisms mentioned 
included having a working relationship with the victim and perpetrator 
of the domestic violence, staying busy, family, and turning negatives into 
positives. They also identified school, sibling support, support from a 
significant other, being responsible, talking about the trauma, working 
with kids, and learning about DV as protective factors. 

All of the participants in this study received or are in the process of 
receiving a degree from a higher education institution. School became 
a portal to learning more about DV, staying busy, and being responsible. 
Learning more about the trauma and the processes involved during CDVT 
gave all but one of the participants a settling feeling of understanding. One 
participant shares: 

“I’m able to understand more of that time, you 
know, what they must have been going through.” 

(Claire)

School was also a helpful way to stay occupied. All of the participants 
mentioned that getting through school was an important part of overcoming 
the trauma:

“What school really did was put me in my place 
because it just gave me structure I needed.” 

(Abagail)

Four out of the six participants explained the resourcefulness of 
focusing energy towards school instead of “wallowing” in the past. 83.3% 
of the participants shared that taking on responsibility as a core personal 
value permitted them to become more objective in their views of the world 



COLUMBIA SOCIAL WORK REVIEW, VOL. IX | 19 

ANA QUIÑONES

and their own life. Assuming responsibility for their emotions became a 
source of strength that contributed a feeling of control in their daily life:

“You are in control of your emotions, and that’s 
really all you have control over.” (Abagail)

Taking opportunities to better themselves for the sake of their loved 
ones was also significant. More than half of the participants also made 
points to learn from the mistakes of others. 

“I had all of the opportunities in the world to be 
such a horrible person and I—I didn’t.” (Angelina) 

Five participants also acknowledged the importance of having support 
from a sibling or significant other after the trauma had occurred. It gave 
them the opportunity to voice their feelings and questions to somebody 
they trust. 

“Having somebody to share it with is something I 
hadn’t I guess experienced before.” (David)

When the participants engaged in a positive relationship with their 
childhood caregivers from the time of the trauma, they expressed gaining 
a better understanding of the DV situation. Only one participant expressed 
having forgiven the perpetrator for his or her actions, and at least half of 
the participants still feel some sort of resentment towards their caregivers 
but have worked through it by talking about it with them.

“It always helps to talk about it.” (Angelina)

DISCUSSION
Transitioning from a difficult childhood 

in which violence, manipulation, and stress 
are common in the household, many children 
grow up to become caught up in the negative 
cycle of dysfunction as adults. Using silent 
methods of venting their feelings proved to 
be an effective way for study participants to 
stay out of the conflict at hand. Moving out 
of the home environment and having space 
away from the conflict always proved to be 
beneficial for the participants, as they found 
the time to get to know themselves without 
the environmental stress. 

“Establishing a 
sense of who they 
are and having 
standards for 
themselves, their 
significant others, 
their children, and 
their lifestyle gave 
them control over 
their emotions 
concerning the 
CDVT.” 



20 | COLUMBIA SOCIAL WORK REVIEW, VOL. IX 

CDVT - IMPACT AND COPING STRATEGIES LATER IN LIFE

Setting up barriers against negative family influence and allowing 
people back into their lives conditionally was vital in moving forward. 
Establishing a sense of who they are and having standards for themselves, 
their significant others, their children, and their lifestyle gave them 
control over their emotions concerning the CDVT. With school as a major 
driving force and inspiration, the participants were able to set goals and 
achieve a successful lifestyle that is completely shaped by them instead 
of their CDVT. Establishing a relationship with the DV victim and the 
DV perpetrator gave them the opportunity to talk about and express the 
emotions that were ignored as children.

LIMITATIONS
One first limitation of this research study is that the participants were 

all recruited from Amarillo, Texas, and so the study cannot be generalized 
to populations beyond those included in the sample. Second, the study 
depended on self-report; therefore, biases and inaccuracy may be present. 

Other research has suggested that 
professionals who work with clients who 
have survived CDVT should be thoroughly 
educated, engage in collaboration, and 
constantly evaluate their practice (Campbell 
& Thompson, 2015; Lessard & Alvarez-
Lizotte, 2015). Some misconceptions that 
hinder service delivery include believing 
that the child is not a victim of the domestic 
violence because there is no physical injury, 
that if a child did not see the act they have 

therefore not been affected, or that a particular child might be too young to 
be affected (Campbell & Thompson, 2015). These misconceptions lead to 
gaps in provider education and lessen the strength of service distribution. 
Child welfare workers who interact with these clients should focus on 
forming positive conversational relationships that allow for more effective 
engagement strategies (Melchiorre & Vis, 2012).

RECOMMENDATIONS
A more child-centered approach is recommended in agencies that 

interact with victims of DV and their children. Early positive professional 
intervention has shown to be a standout resource for 83.3% of participants 
interviewed. These interventions may not always be formal, but people 
experiencing or overcoming CDVT should be given the information and 
tools to be able to find their own way to cope. Overcoming CDVT is not 
limited to formal interventions such as therapy. Survivors of CDVT may 
find comfort in knowing that there are several effective informal resources, 

“Survivors of CDVT 
may find comfort in 
knowing that there 
are several effective 
informal resources, 
as outlined by the 
participants of this 
study, that they may 
use to support their 
well-being.”



COLUMBIA SOCIAL WORK REVIEW, VOL. IX | 21 

ANA QUIÑONES

as outlined by the participants of this study, that they may use to support 
their well-being. On a micro level, the coping themes found in this article 
could be utilized to further counseling outcomes. On a mezzo level, 
collaboration between disciplines provides a better use of expertise and 
creates a more unified bridge between IPV and child maltreatment experts 
to find better solutions for their clients (Lessard & Alvarez-Lizotte, 2015). 

Finally, macro implications of the findings are rooted in keeping the 
child’s experience in perspective when designing programs or policies 
aimed at aiding domestic violence victims. Children are often overlooked 
victims who face a lifetime of challenges to overcome the effects of 
CDVT. The findings of this study show that children have serious and 
lasting repercussions from experiencing DV in their homes. Being that 
most children remember the events and suffer emotionally in the years 
afterward, they should be considered valuable players in the DV dynamics 
that occur in the household. 

REFERENCES
Atkins, M. (2013, October 8). 50 strength based questions. Retrieved from http://

www.changedlivesnewjourneys.com/50-first-strength-based-questions
Bandura, A. (1973). Aggression: A social learning analysis. Prentice-Hall.
Blair, F., McFarlane, J., Nava, A., Gilroy, H., & Maddoux, J. (2015). Child witness 

to domestic abuse: baseline data analysis for a seven-year prospective study. 
Pediatric Nursing, 41(1), 23-29.

Briggs-Gowan, M. J., Pollak, S. D., Grasso, D., Voss, J., Mian, N. D., Zobel, E., & ... 
Pine, D. S. (2015). Attention bias and anxiety in young children exposed to 
family violence. Journal of Child Psychology & Psychiatry, 56(11), 1194-1201.

Campbell, A. M., & Thompson, S. L. (2015). The emotional maltreatment of 
children in domestically violent homes: Identifying gaps in education 
and addressing common misconceptions: The risk of harm to children in 
domestically violent homes mandates a well-coordinated response. Child 
Abuse & Neglect, 48, 39-49. doi:10.1016/j.chiabu.2015.08.009

Feroz, U., Jami, H., & Masood, S. (2015). Role of early exposure to domestic 
violence in display of aggression among university students. Pakistan Journal 
of Psychological Research, 30(2), 323-342.

Glaser, B. G., & Holton, J. (2004). Remodeling Grounded Theory. In forum 
qualitative sozialforschung/forum: Qualitative social research. Retrieved Aug 
19, 2016, from http://nbn-resolving.de/urn:nbn:de:0114-fqs040245

Graham-Bermann, S. A., Gruber, G., Howell, K. H., & Girz, L. (2009). Factors 
discriminating among profiles of resilience and psychopathology in children 
exposed to intimate partner violence (IPV). Child Abuse & Neglect, 33(9), 
648-660.

Hamby, S. L., Finkelhor, D., Turner, H., & Ormrod, R. (2011). Children’s exposure 
to intimate partner violence and other family violence. National Survey of 
Children’s Exposure to Violence.

Hardesty, J. L., Campbell, J. C., McFarlane, J. M., & Lewandowski, L. A. (2008). 
How children and their caregivers adjust after intimate partner femicide. 
Journal of Family Issues, 29(1), 100-124.



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Hildyard, K. L., & Wolfe, D. A. (2002). Child neglect: developmental issues 

and outcomes. Child Abuse & Neglect, 26, 679-695. doi:10.1016/S0145-
2134(02)00341-1

Holmes, M. R. (2013). Aggressive behavior of children exposed to intimate partner 
violence: An examination of maternal mental health, maternal warmth and 
child maltreatment. Child Abuse & Neglect, 37(8), 520-530. doi:10.1016/j.
chiabu.2012.12.006

Holt, S., Buckley, H., & Whelan, S. (2008). The impact of exposure to domestic 
violence on children and young people: A review of the literature. Child Abuse 
& Neglect: The International Journal, 32(8), 797-810.

Huang, C., Wang, L., & Warrener, C. (2010). Effects of domestic violence on 
behavior problems of preschool-aged children: Do maternal mental health 
and parenting mediate the effects?. Children & Youth Services Review, 32(10), 
1317-1323. doi:10.1016/j.childyouth.2010.04.024

Izaguirre, A., & Calvete, E. (2015). Research article: Children who are exposed to 
intimate partner violence: Interviewing mothers to understand its impact on 
children. Child Abuse & Neglect, 48, 58-67. doi:10.1016/j.chiabu.2015.05.002

Lessard, G., & Alvarez-Lizotte, P. (2015). The exposure of children to intimate 
partner violence: Potential bridges between two fields in research and 
psychosocial intervention: Research and interventions often focus on a 
specific form of violence without considering other forms of victimization. 
Child Abuse & Neglect, 48, 29-38. doi:10.1016/j.chiabu.2015.05.004

Luthar, S. S., Cinchetti, D., & Becker, B. (2000). The construct of resilience: A 
critical evaluation and guidelines for future work. Child Development, 71, 
543-562

Melchiorre, R., & Vis, J. (2013). Engagement strategies and change: An intentional 
practice response for the child welfare worker in cases of domestic violence. 
Child & Family.

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(2010). The effects of child abuse and exposure to domestic violence on 
adolescent internalizing and externalizing behavior problems. Journal Of 
Family Violence, 25(1), 53-63.

Yoo, J. A., & Huang, C. (2012). The effects of domestic violence on children’s 
behavior problems: Assessing the moderating roles of poverty and marital 
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childyouth.2012.09.014

ANA QUIÑONES received a B.S.W. from West Texas A&M University in 
2016. She is a Masters of Science in Social Work candidate in Advanced 
Clinical Practice with Children, Youth and Families at Columbia 
University’s School of Social Work. She is currently employed as a family 
based specialist for Child Protective Services in the state of Texas. 



COLUMBIA SOCIAL WORK REVIEW, VOL. IX | 23 

ANA QUIÑONES

APPENDIX A
Semi-Structured Interview:
• What age were you when the abuse took place? 
• What type of abuse was it? (Physical, emotional, etc.)
• What was the level of relationship between you and the perpetrator?
• What type of support was available to you at home?
  o School?
  o Church?
  o Sports...etc.? 
• Did your primary caregiver provide support?
  o What type?
• Was there professional intervention?
• What would you say are some of your personal traits that contribute to where 

you are now? 
• What are some of your present coping strategies? 
• What were some of your coping strategies during the trauma?
• What do you value about yourself ?*
• What do you think helps you bounce back?*
• What makes you feel useful?*
• What did your transition process look like?*
• How do you manage difficult situations in the present day?*
• What are some creative solutions you have tried?*
• What resources are available to you?*

* These questions were inspired and derived from the 50 strength based questions 
article found on the Changed Lives New Journeys website (Atkins, 2013). 

APPENDIX B


