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Trauma Screening Assessment Instruments

As many of you know, I'm working toward a Master's degree in Clinical Mental Health Counseling at Johns Hopkins.  This semester, I have been learning ALL about assessments and testing for counselors.  I've spent the bulk of my time reviewing and critiquing instruments meant to measure trauma in adults and children.

 

I would LOVE to hear from those of you clinicians or school mental health professionals or any others who actually USE trauma screening assessment tools in your work!  Do you use them with children?  What do you find are the limitations?  Have you found one (outside of the ACE questions) that does a great job of providing you feedback on your client's trauma experience, recovery, affect, or other measurement?  If you use trauma screening instruments, which are your "go-to" choices?  I've reviewed a few and found NONE that I would EVER give to a child although many say they are designed for children who are very young (this seems troubling to me...what's your take on that?).

 

It's not a subject I've seen covered here at ACES Connection, but I feel since we are ALL passionate about helping traumatized populations, this would be an important topic to discuss and think about.  I WISH that the ACES questionnaire were considered an actual assessment instrument, but alas, nobody I've interacted with views it that way at all (if they are aware of ACES at all)!

 

Brenda Gregory Yuen

 

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Daun and Brenda and anyone interested in ASSESSMENT TOOLS. I just went into the VA/PTSD Library website, and it's "user friendly"   Upper left has a category "Professionals", scroll down six spaces to assessments...until  a screen popped-up that a quality control survey would await me when I was done...I was trying to make an inquiry about my mother's veteran status...She had reportedly been a WW II WASP Pilot....but took her own life twelve years before President Carter signed legislation declaring the WASP and ASA/ NS..  pilots from "civilian" to "military/veteran" in 1977. and now I'm calling it a night!

 

Daun Kauffman... In my capacity as a participant in "Trauma-Informed Intentional Peer Support" we have just one question we ask one another: "What Happened To You?" rather than "What's Wrong with You?". However, just across the river, at the National Center for PTSD Executive Division (& Library) on the VA Hospital Grounds (or by Internet at:  http://www.ptsd.va.gov  , they have a physical and on-line library of assessment tools which educators, clinicians, and students can register to use at no charge-if I'm not mistaken(I just checked the User's Guide, and no password is required), and they will probably mail out a printed copy of "PILOTS [Published International Literature On Traumatic Stress] User's Guide"-As their cataloging/retrieval system is unique [not Dewey Decimal or Library of Congress Card Catalogue numbers]. My copy is a Third Edition from January 2001, but their printed e-mail newsletter, usually has a PILOTS UPDATE each quarter year (mine is Winter 2004). The PILOTS User's Guide uses Search Terms from a "controlled vocabulary" ; Under "Children" are five types: "Infants, Neonates, Preschool Age Children, School Age Children, and Preadolescents". A separate list ing for "Effects" as well as "Assessment" are "Assessment Instruments:  Anatomically Detailed Dolls, Interview Schedules, Projective Techniques, PTSD Assessment Instruments, Self Report Instruments, Trauma Assessment Instruments" followed by "Biologic Markers: Biochemical Markers, Brain Imaging, Genetic Markers, Neuroendocrine Testing, and Provocative Tests", then Cross Cultural Assessment [no items listed in that category], then "Diagnosis: Differential Diagnosis, and Medical Diagnosis"; "Forensic Evaluation lists only Disability Evaluation"; "Nosology lists only Diagnostic Validity"; "Patient History" and "Pychophysiological Assessment" are the final two categories.

The next category is "Effects" --too numerous to list at this late hour. Hope this is helpful!-Bob

Daun Kauffman... In my capacity as a participant in "Trauma-Informed Intentional Peer Support" we have just one question we ask one another: "What Happened To You?" rather than "What's Wrong with You?". However, just across the river, at the National Center for PTSD Executive Division (& Library) on the VA Hospital Grounds (or by Internet at:  http://www.ptsd.va.gov  , they have a physical and on-line library of assessment tools which educators, clinicians, and students can register to use at no charge-if I'm not mistaken(I just checked the User's Guide, and no password is required), and they will probably mail out a printed copy of "PILOTS [Published International Literature On Traumatic Stress] User's Guide"-As their cataloging/retrieval system is unique [not Dewey Decimal or Library of Congress Card Catalogue numbers]. My copy is a Third Edition from January 2001, but their printed e-mail newsletter, usually has a PILOTS UPDATE each quarter year (mine is Winter 2004). The PILOTS User's Guide uses Search Terms from a "controlled vocabulary" ; Under "Children" are five types: "Infants, Neonates, Preschool Age Children, School Age Children, and Preadolescents". A separate list ing for "Effects" as well as "Assessment" are "Assessment Instruments:  Anatomically Detailed Dolls, Interview Schedules, Projective Techniques, PTSD Assessment Instruments, Self Report Instruments, Trauma Assessment Instruments" followed by "Biologic Markers: Biochemical Markers, Brain Imaging, Genetic Markers, Neuroendocrine Testing, and Provocative Tests", then Cross Cultural Assessment [no items listed in that category], then "Diagnosis: Differential Diagnosis, and Medical Diagnosis"; "Forensic Evaluation lists only Disability Evaluation"; "Nosology lists only Diagnostic Validity"; "Patient History" and "Pychophysiological Assessment" are the final two categories.

The next category is "Effects" --too numerous to list at this late hour. Hope this is helpful!-Bob

The former private Family Practice clinic I used from 1998-2001, was bought out by Dartmouth-Hitchcock Medical Center/ "Family Practice Program"...and a computerized interview/assessment trauma screening tool was initiated by the "Trauma-Informed Team" headed up by Stanley Rosenberg, M.D. at (New Hampshire) Dartmouth Psychiatric Research Center (DPRC), for use in the Dartmouth Family Practice program. Myself (and an unknown [to me] quantity of others) were interviewed there by a "Dual [5 year] Residency" (Psychiatry/Internal Medicine) Physician using whatever the DPRC computerized trauma assessment was. I can not attest to its validity or how comprehensive it was, since I haven't read any reviews of it, or researched it's efficacy. I remember trying to explain a "Critical Incident Stressor" during adulthood (Aviation Crash), to a question that seemed a bit unclear to me at the time, but I don't recall whether any ACE related questions were included, or items Peter Levine mentioned in his book "Waking the Tiger: Healing Trauma", in the Emotional First Aid for Children chapter (such as having been restrained when ether/anesthesia was administered for a tonsillectomy-or even medical staff asking the parent to hold the anesthesia mask in place...and then the child didn't recognize the parent after the surgery as the anesthesia hadn't completely worn off.... I "grew up" with an "aversion/sensitivity to the smell of ether", although I can't reliably assert it was due to that occurring when my tonsils were removed, or earlier, when circumcised.

Leslie,

From everything I've read and heard, there are really NO standouts in the way of trauma assessment instruments.  I can honestly say that the two I've reviewed, I have found inadequate psychometric information and therefore cannot recommend either.  I have also found a journal article that gives a list of trauma assessment instruments used with clinicians across the country (I guess having an idea who uses what is just now gaining some traction), and was struck that basically clinicians do NOT use ANY trauma assessment instruments with children.  This was certainly true of my findings on the two I reviewed for my graduate work. 

 

I understand your point about secondary trauma.  This is another HUGE issue!  It appears that trauma instruments are just now gaining some wide attention, which I find rather sad.  It made me think "wouldn't it be GREAT if the ACE study community took that project on?  I'm not yet qualified to do the work, but I am definitely interested in finding quality instruments, with stellar psychometric data, to use with clients who have experienced significant trauma.  Now that I have learned about this, I want to see more tools available to the trauma-informed community.  Goodness knows, people are suffering and if we can track and assess trauma's impact on their lives, we can make an even stronger case for funding and attention to this issue.

 

Thanks for responding!

 

Brenda Yuen

Dear Brenda,

 

Thank you for raising this discussion.  We do use several instruments with two projects we have that are piloting trauma treatment models for caregivers of young children.  I'll pass your question on to our clinical teams.  One issue, however, that I'd like to raise is the need for organizations to recognize, acknowledge and plan for potential secondary traumatic stress (STS) as a result of implementing screening.  Too often this is overlooked and programs, in their best-intended effort to integrate a trauma informed approach, begin screening without adequate attention to STS.  Programs, clinical staff etc... need to be well prepared for the impact that employing trauma screening will have on the professionals.

Brenda if you do see something that would be helpful please let me know! I have been looking into this for a long time and everything I have found over the years I feel leaves much to be desired. I hope you find something. Thanks a bunch. Maybe we should just brainstorm and come up with something ourselves it won't be rated. And most things I have seen seem generally geared to collecting research data for academic publication. Thanks

Daun,

The National Child Traumatic Stress Network has a Measures Review Database, located at:

http://www.nctsn.org/resources...arch/measures-review

It contains MANY of the trauma assessment instruments, although the Mental Measurements Yearbook with Tests in Print is considered the BEST source for information and reviews of assessment instruments.

 

I am by no means an expert in the field!   If you wanted to see the reviews I did for my course in the Clinical Mental Health program at Johns Hopkins, I can share them offline.  But I sure don't want to mislead anyone into thinking I am any kind of an expert.

 

It seems to me there are a LOT more experts who belong to ACES Connection and I'm trying to tap into their knowledge bank!  I want to expand my expertise and knowledge, especially when it comes to trauma assessment tools.

 

I hope this helps!?  Let me know if it does not.

 

Brenda Gregory Yuen

 

I neglected to mention that there are bibliographies of children's books about coping with and surviving trauma, which might prove helpful as a prelude to children who read. "Why Daddy is like he is", and "Why Mommy is like she is" are geared to children whose parents are returning from active military duty in combat areas. I'd seen one book about tornado's, but our local children's librarian (Amy-now assistant library director) has a copy of the bibliography of children's books on Trauma. I've also seen the Canadian Solicitor General's report on the Aboriginal Schools in Canada, on the shelves in the PTSD library. The "Trauma-Informed Checklist for Family Court Judges" might offer some suitable questions, and Kathy Hentcy  of Vermont ACEs is currently working on an ACE screening questionaire to be compatable with the  proposed Vermont law (2013 session/House bill 762) requiring All Vermont health care providers to screen for aces.

 

hi Brenda. I don't currently use many screening tools, but I live right across the Connecticut River from the National Center for PTSD Library, on the grounds of the White River Junction, Vermont Veterans  Administration complex, which has, in my opinion, an awesome collection of assessment instruments - most of which are retrievable by clinicians, students, and others, on line from their website

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