Counselor Quick Reference

Trauma/PTSD assessment, suicide risk assessment, nonsuicidal self-injury (NSSI), violence risk to others, mandated reporting, and substance use disorder assessment — five clinical domains from Textbook Ch. 11. No matching lecture module exists yet, so this is textbook-only.

Ch. 11 — Trauma, Harm & Substance Abuse Assessments pp. 247–271

Trauma, Harm, and Substance Abuse Assessments

Trauma/PTSD · suicide risk · NSSI · violence risk to others · mandated reporting · substance use disorder

Glossary

SUD scale: Subjective Units of Distress — client's in-the-moment anxiety, rated 0–10 (Wolpe; a 0–100 version is also common).
Crisis: When coping mechanisms fail and internal confusion/anxiety result without support (WHO).
NSSI: Nonsuicidal self-injury — intentional self-inflicted tissue damage without suicidal intent; distinct from a suicide attempt, though it can still be a suicide risk factor.
Thwarted belongingness / perceived burdensomeness: IPTS's two core feelings ("I am alone" / "I am a burden") that combine with acquired capability to predict suicidal behavior.
Static risk factor: Fixed historical fact (e.g., prior violence) that doesn't change with treatment.
Dynamic risk factor: Changeable factor (peer relationships, impulse control, substance use) that is the main target of intervention.
Compassion fatigue: The emotional residue of trauma-exposure work specifically — distinct from burnout, which relates to the workplace itself.
Structured Professional Judgment (SPJ): Combines evidence-based structured tools with practitioner judgment — more flexible/personalized than a purely actuarial (ARAI) approach.

Frameworks & models

Stress → trauma continuum (Fig. 11.1)

Stress/stressful event
Posttraumatic stress
Acute stress disorder
Posttraumatic Stress Disorder (PTSD)

Trauma/PTSD instruments

LEC-5 — 17 items, 16 categories; identifies traumatic events
ACE Questionnaire — 10 items; scores 4–6 moderate, 7+ high risk
CAPS-5 — "gold standard" structured interview; for symptom tracking, not sole diagnosis
ProQOL-5 — 30 items; compassion satisfaction, burnout, secondary traumatic stress
PTGI — 21 items, 5 factors of posttraumatic growth

Suicide risk assessment

SAD PERSONS — Sex, Age, Depression, Previous attempt, Ethanol abuse, Rational thinking loss, Social supports lacking, Organized plan, No significant other, Sickness
MSPS — weighted version; 6–8 → probable psychiatric consultation, >8 → probable hospital admission
SPS — 36 items; hostility, negative self-eval, ideation, hopelessness
C-SSRS — FDA's "gold standard"; 4-part severity/behavior assessment
SAFE-T — 5-step SAMHSA triage protocol, pairs with C-SSRS

NSSI assessment

IPTS (Joiner) — thwarted belongingness + burdensomeness + acquired capability
HIRE — History, Interest in change, Reasons, Exposure to risk
SOARS — Suicidal ideation, Onset/frequency/methods, Aftercare, Reasons/readiness, Stage of change
DSHI — 17 items; NSSI-AT — 12 modules/39 items, adaptive/web-based
Table 11.3: ISAS, FASM, SHI, SITBI, SHBQ, SIQ (SIQ = adolescents only)

Violence risk to others

ARAI (actuarial) vs. SPJ (structured professional judgment)
Static-99 — adult male sex offenders, most common
VRAG-R, LSI-R — recidivism/case-planning tools
HCR-20, START, SAVRY — SPJ tools (SAVRY = youth-specific)
History's 4 components: recentness, severity, frequency, pattern

Substance use disorder assessment

DSM-5-TR: Use, Intoxication, Withdrawal
CAGE — Cut down, Annoyance, Guilty, Eye-opener; CAGE-AID extends to drugs
AWARE — 28 items, relapse-risk prediction
SASSI-4 — 105 items/11 scales, detects defensive responding
URICA/TTM — precontemplation → contemplation → preparation → action → maintenance → termination
Table 11.5: ASSIST, AUDIT-C, SOAPP

Clinical checkpoints

Keep NSSI, suicide attempt, and suicidal behavior conceptually distinct — NSSI is a risk factor for suicide, not the same thing as it
Remember the "gold standard" label (CAPS-5, C-SSRS) doesn't mean "use alone" — CAPS-5 specifically is for tracking, not sole diagnosis
Distinguish static (fixed, historical) from dynamic (changeable, treatment-targetable) risk factors for violence
The chapter calls an explicit or implied statement of intent to harm the single most reliable predictor of future violence (the broader forensic literature most often cites past violence) — either way, document it accordingly
Child/elder abuse reporting is mandated in all 50 states; duty to warn/protect for danger to others varies by state (mandatory in many, permissive in others) — know Colorado's specific rule
Distinguish compassion fatigue (trauma-exposure specific) from burnout (workplace-general) when assessing your own or a colleague's functioning

No lecture pairing yet. Like the Ch. 8–10 pages, there's no class-notes module for this chapter yet — everything here is textbook-only. If a matching lecture module shows up later, this page should get a matching update the way the M4 page did for Ch. 4.

This sheet is for fast recall, not citations. This chapter names ~39 instruments/models across five clinical domains; this page groups rather than exhaustively lists every one. Check the full quiz (42 questions, 100% heading/exam-flag coverage) or the textbook chapter directly before quoting any specific instrument fact, scoring cutoff, or citation year in graded work.