As discussed in previous articles, the TJC Behavioral Health standards have a specific standard in the Care, Treatment, and Services chapter on trauma assessment. It is standard CTS.02.02.05 (added in 2011): “The organization identifies individuals served who may have experienced trauma, abuse, neglect, or exploitation.”  Specific requirements are as follows:

• The organization must educate staff about trauma, abuse, neglect and exploitation.
• The organization must have a mechanism for identifying individuals who have experienced trauma, abuse, neglect, or exploitation.
• Staff must be able to screen for trauma, abuse, neglect and exploitation (as indicated by the setting and services.)
• The organization must assess the individual who has experienced trauma, abuse, neglect or exploitation or refer the individual for this assessment.

Over the past year, we have seen several BH organizations cited for not including the full range of trauma issues in their assessment (beyond physical and sexual abuse.)

We recently came across a tool that may be helpful to organizations seeking to strengthen their capacity for conducting a thorough trauma assessment. It is the Life Events Checklist for DSM-5 (LEC-5), (PDF, 36KB). The LEC-5 is a self-report measure designed to screen for potentially traumatic events in a client’s lifetime. It gathers information about exposure to 16 events known to potentially result in PTSD or distress. It also includes one additional item assessing any other highly stressful event not captured in the first 16 items. The client is asked to respond to the 16 stressful life events by indicating one of the following:

• It happened to me personally.
• I witnessed it happen to someone else.
• I learned about it happening to a close family member or close friend.
• I was exposed to it as part of my job.
• I’m not sure if it fits.
• It doesn’t apply to me.

The LEC-5 is a self-report tool and, as such, is essentially used for information gathering. The information obtained from the tool needs to be evaluated by a clinician to assess the impact of the trauma and the implications for treatment. Many clinicians report that the use of a structured tool to gather trauma history prompts clients to report more information on these types of experiences than they would in a typical interview process.

It should be noted that a specific standard on trauma assessment does not exist in the TJC Hospital manual under which psychiatric hospitals are surveyed. However, the need to assess for trauma history is equally as important in those settings.

Looking for additional resources on trauma assessment and treatment?

SAMHSA’s National Center for Trauma-Informed Care

A technical assistance center with a wealth of resources on various models of trauma-informed care, staff training, and best practices.

International Society for Traumatic Stress Studies

An international collection of studies, research, and education on trauma; publishes the Journal of Traumatic Stress.

If you are looking for assistance with the stressful life events checklist, get in touch with our experts consultants today.