Use this dialogue when a client appears distressed during a conversation. Begin with observation and permission. The goal is to understand what they need now, not to obtain more details about an overwhelming experience.
Offer a pause without assuming
Clinician: "I notice it has become harder to stay with our conversation. What are you noticing?" Client: "I feel far away." Clinician: "Would you like us to stop the topic? We can look around the room, change position, talk about the present, or just pause."
Ask before guiding
If the client chooses orientation: "Would it be okay to name where we are and today’s date together?" If they decline: "Okay. What would feel more useful?" Avoid touch or changes in proximity without permission. Use clear, brief language and allow time for a response.
Review and return control
Clinician: "Are you feeling more present, less present, or about the same?" If worse, stop the exercise and use the individualized assessment and support plan. If helpful: "Would you prefer another topic, planning for the rest of today, or ending here?" Do not require resuming the trauma discussion.
Reflection prompts
Use these questions in conversation, on paper, or in the downloaded PDF. You may adapt or skip a prompt.
- What the client chose and what helped or worsened the experience