Trauma Recovery Measure (TRM)

Trauma Recovery is proposed to exist along a continuum, as the survivor moves away from self-loathing, blaming, and self-condemnation, towards a sense of acceptance, empowerment, and self-compassion. This cognitive shift allows the individual to move away from a predominance of negative, deficit-driven cognitive processes that have been demonstrated to precipitate and maintain maladaptive behavioural and emotional reactions, towards a mastery of safe, secure, strengths-based cognitive processes that reinforce the individuals’ sense of autonomy, safety, and self-control. 

Example TRM Items

The TRM provides a total scale score and three subscale scores that evaluate an individual’s cognitions following the experience of traumatic events. The three subscales within the TRM include:

• Validation: This subscale measures a survivor’s approval and acceptance of themselves as they are, despite their experience of trauma, and assesses the development of internal value and worthiness;
• Liberation: This subscale measures a survivor’s ability to release or set themselves free from the control, imprisonment, and/or oppression of their trauma and to live a life in which they feel capable and confident to make positive decisions for themselves and others; and
• Positive Self: This subscale measures the presence of positive cognitions that generate feelings of care, compassion, and/or comfort towards oneself.

Scores on the TRM provide an evaluation of the individual’s current recovery journey, with low scores indicating the individual to be in the early stage of recovery and high scores indicating engagement in the late stage of recovery.

The total score on the Trauma Recovery Measure (TRM) ranges from 15 to 75, with higher scores indicating the individual to be in the later stage of recovery following their experience of trauma. Average scores for subscales are presented to allow for a comparison across subscales given they have different numbers of items. Percentiles are also presented for the total score and subscales in comparison to a clinical population sample. The clinical population is representative of individuals who have been exposed to traumatic experiences who are currently experiencing clinically significant PTSD symptoms. 

A stage of recovery descriptor is also presented based upon the score’s distance from the mean. There are three possible stages of recovery:

• Early Stage of Recovery: (< 1 SD below the mean): This stage suggests the individual is in the beginning phase of their trauma recovery journey. They are working towards developing adaptive cognitions related to their trauma experience, with emerging awareness of self-worth, personal autonomy, and self-compassion.
• Middle Stage of Recovery: (Between 1 SD below and 1 SD above the mean): This stage suggests the individual is making progress in their trauma recovery journey. They are developing more adaptive cognitions related to their trauma experience and are able to experience moments of self-acceptance, personal control, and positive self-regard.
• Late Stage of Recovery: (> 1 SD above the mean): This stage suggests the individual has made significant progress in their trauma recovery journey. They frequently experience adaptive cognitions related to their trauma and demonstrate consistent self-acceptance, personal autonomy, and self-compassion.

These stages of recovery obviously mean different things for each subscale and are outlined explicitly in the Interpretation text. Refer to the ‘Stages of Trauma Recovery for the TRM’ table in the Technical Paper more details. 

Results are presented for the three subscales within the TRM:

• Validation (items 1, 4, 5, 8, 10, 13): This subscale measures a respondent’s approval and acceptance of themselves as they are, despite their experience of trauma, and assesses the development of internal value and worthiness;
• Liberation (items 2, 3, 6): This subscale measures a respondent’s ability to release or set themselves free from the control, imprisonment, and/or oppression of their trauma and to live a life in which they feel capable and confident to make positive decisions for themselves and others; and
• Positive Self (items 7, 9, 11, 12, 14, 15): This subscale measures the presence of positive cognitions that generate feelings of care, compassion, and/or comfort towards oneself.

On first administration a plot is presented showing the total and subscale clinical percentiles. The recovery stage is displayed in the background of the plot to aid in interpretation. At the end of the report a comparison plot provides information about where the respondent’s score sits in relation to the normative and clinical population samples, with the shaded areas around the means indicative of the two middle quartiles (between 25th and 75th percentile). This graph can assist in conceptualising TRM scores in comparison to the distribution of responses among clinical and non-clinical populations.

When administered on a regular basis, longitudinal plots for both the total score and the subscale percentiles provide information about the change in cognitions over time and can be used as a positive outcome measure for Trauma Recovery.

The TRM has been validated within a clinical, trauma-exposed population of individuals with the self-reported experience of traumatic life events (N = 316; Smith, 2022). The TRM has been demonstrated to have an acceptable factor structure and an adequate overall model fit (CFI = 0.95; IFI = 0.95; TLI = 0.94). The internal consistency of the TRM within the clinical sample has been demonstrated to be excellent for the TRM total scale score (α = .95), and for the three subscales of Validation (α = .93), Liberation (α = .83), and Positive Self (α = .88). The convergent validity of the TRM has been demonstrated with measures of PTSD (r = -.70), psychological distress (r = -.60), and posttrauma cognitions (r = -.77); and convergent validity has been demonstrated with a measure of self-compassion (r = .25; Smith, 2022). The construct validity of the TRM was assessed using group difference tests, with individuals reporting clinically significant PTSD symptomatology scoring significantly lower than individuals with lower or sub-threshold PTSD symptoms on the TRM (F = 220.04, Smith, 2022). The three subscales of the TRM have also been identified to be significant independent predictors of PTSD (R2 = 0.47, F(3,423) = 126.95, p < .001; f2 = 0.89; Smith, 2022).

The TRM has also been validated within a general population sample (N = 319; Morgan, 2025). Within the general population sample, there were no participants who met the clinical criteria for a likely diagnosis of PTSD. The reliability of the TRM within the general population sample was demonstrated to be excellent for the total scale score (α = .95) and the subscales of Validation (α = .93) and Positive Self (α = .88), and adequate for the subscale of Liberation (α = .79; Morgan, 2025). Convergent validity of the TRM within the non-clinical population was demonstrated with measures of PTSD (r = -.33), complex PTSD (r = -.56), and disturbances of self-organisation (r = -.68; Morgan, 2025).

Percentiles have been calculated for the clinical, trauma-exposed population with current PTSD symptoms (N = 316; M = 46.52; SD = 14.20; Smith, 2022) and a general population sample (N = 319, M = 54.73; SD = 13.73; Morgan, 2025). A normative percentile of 50 is indicative of an average score for the non-clinical population and a clinical percentile of 50 is indicative of an average score for the clinical population.

The distance from the normative mean was used to produce descriptors within the identified stages of recovery (based upon the clinical population):

• Early Stage of Recovery: < 1 SD below the mean (total scores of 31 or less)
• Middle Stage of Recovery: Total scores between 32 and 61
• Late Stage of Recovery: > 1 SD above the mean (total scores of 62 or higher)

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