It’s June.  Another school year is over. The kids are at camp, in the park, or at a pool.  The Fourth of July is less than a week away. It’s vacation time.

June is also PTSD Awareness Month.  Until I began this blog, I had never heard of PTSD Awareness Month.

I have often been struck by the alternate reality that we–as clinicians–have chosen.  I am reminded of the need to balance (try to balance) patient care with self care.  Yes, it’s easier said than done!

The diagnosis of post-traumatic stress disorder (PTSD) first appeared in DSM-III (1980). DSM-5 was published in May, 2013.

Allen Frances, M.D., Chair of the DSM-IV edition, suggested using the document (e.g., DSM-IV) “cautiously, if at all”. I do not recall where I found this quote, but I liked it!

Diagnosis is a useful tool: However, people are complex. They are more than their diagnosis.

DSM-5 recognizes that preschoolers are not simply little people. It has a new diagnosis for children ages 6 and under.

The National Center for PTSD has information about how DSM-5 handles the diagnosis of post-traumatic stress disorder. Check out DSM-5 Criteria for PTSD in “adults, adolescents, and children older than 6 years”. Also check out PTSD for children 6 years and younger.

According to the International Society for Traumatic Stress Studies (ISTSS), the Clinician-Administered PTSD Scale (CAPS) is the “gold standard” for PTSD assessment worldwide. It is available in several languages (e.g., Bosnian).

Fortunately, another version of this instrument, the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA) is also available. It is designed for children, ages eight and up, and adolescents.

ISTSS mentions other assessments as well. Some are clinician-administered; some are self-report. Some are for adults; some are for children. Consistent with ISTSS’ international mission, some assessments besides the CAPS are in languages other than English.

The National Center for PTSD, by the way, is part of the United States Department of Veteran Affairs. During the past 30 years, a ton of work has been done on understanding and treating trauma. Much of this work has been a response to the problems of military men and women and their families.

People can, of course, be traumatized more than once. For example, someone who witnesses the death of a friend in Afghanistan can return home and have his/her house flooded.

A complete assessment will, therefore, ask about traumatic events throughout a person’s life. The inquiry may be part of the clinical interview. It may be part of the standardized measures used.

Have you done trauma-focused assessments? If so, have they been in private practice, in a clinic, or in a hospital?

What instruments did you administer? How useful were they? Would they be appropriate (as is or with modifications) for assessing those affected by Hurricane Sandy and other natural disasters?

Is this information helpful?  If so, check out “Resources For Clinicians (Part 2)”.

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