Assessment Issues Relevant To Violence Against Women

There are two major assessment issues relevant to violence against women: trauma specification and impact. First, given the complex trauma histories reported by many clients, it is obviously important to consider a woman’s prior history of adverse events when treating her for psychological distress or a disorder. Unfortunately, research indicates that clinicians often do not screen for prior abuse or detect current or historic victimization in their clinical caseloads, although numerous studies show that women will respond if asked about victimization. Furthermore even when a given form of victimization such as a rape or partner battering has been identified in a given client, it is common for clinicians to overlook the possibility of other

So, the next most critical component of an assessment is identification of psychological distress and symptoms leading to referrals for specialized therapeutic services and the development of treatment plans. Current recommendations in the area of violence against women include conducting brief, but comprehensive, assessments of psychological functioning with the use of clinical interviews and/or psychological tests (Briere & Jordan, 2004). Clinicians routinely use interviews or tests to explore a range of symptoms typically reported by mental health clients as well as symptoms that are typical of trauma survivors, such as posttraumatic stress and dissociation. There are a number of concise screening tools that function as generic measures of psychological symptoms and require a minimal amount of time to administer and hand score. Some examples include the Brief Symptom Inventory (BSI), the Beck Depression Inventory (BDI-III), the Beck Anxiety Inventory (BAI), and the Alcohol Use Disorders Identification Test (AUDIT). The BSI is a 53-item measure that provides nine symptom scales and three global scales of distress. The widely used BDI is a 21-item survey that assesses the intensity of depression among distressed and non-distressed groups. The BAI is a

Unfortunately because syndrome-based models ranging from PTSD to DESNOS, are not especially informative regarding any given assault survivors’ psychological state, clinicians must turn to individualized assessments to determine the specific targets of treatment. In many cases, this will mean administering psychological tests or conducting clinical interviews that cover the general areas of potential dysfunction and distress. Such tests or interviews should ideally include generic measures that review a range of symptoms commonly seen in mental health clients, like the Minnesota Multiphasic Personality Inventory (MMPI-2) or Symptom Checklist-90-R. They should also include more trauma-specific instruments that evaluate posttraumatic stress, dissociation, and other symptoms relevant to psychological trauma like the Trauma Symptom Inventory (TSI) or Posttraumatic Stress Diagnostic Scale (PDS). By avoiding assumptions regarding what symptoms a given victim ought to have and instead using standardized instruments to determine what a survivor of assault is actually experiencing, treatment is likely to be more specific and effective. Thus far, we know that certain therapies are relatively effective for the posttraumatic stress, cognitive disturbance, and negative mood