Dr. James O'Shea:

Mr. Collins more or less covered it. To go back to Senator Ryan's point, there is a push-pull dynamic. On the one hand, you are trying to build rapport and a relationship with clients while trying not to trigger traumas in initial and early assessments. On the other hand, however, you need to know enough about the client to be able to make a coherent response. There is always a tension in the therapeutic setting between having enough information to be able to respond effectively and not doing harm. Mr. Collins's point is well made that our addiction services have increasingly become far more trauma informed. Those more intrusive questions, which need to be asked, are being asked at a later point in the therapy when clients feel safer and there is a better therapeutic relationship.