Frequently in the world of mental health, we find ourselves using many terms that can become confusing, even for those that work within our systems. As Benchmarks continues to expand projects across North Carolina, we find that the terms “screening” and “assessment” have become a regular part of this confusion. The interchangeable use of these terms has contributed to mix-ups surrounding the terms’ actual meanings, leading professionals to inadvertently refer children and families to services prematurely or inadequately.
Screenings should be brief, with targeted questions about events or symptoms that may have affected an individual. For trauma screenings, such as the Project Broadcast Screening Tool, there are questions about a person’s potentially traumatic experiences and associated symptomology. This one-page screening tool allows for professionals to ask brief, targeted questions without delving into details regarding the events or symptoms. If a person screens “positive” for trauma, they can be referred for further assessment. Many other systems use similar screening tools to assess for risk, needs, or trauma-related issues. Screening tools can be used quickly to determine whether further mental health assessment is called for at that point in time. Many screening tools also have quick and easy training available so that those who want to use the screenings for clients can do so efficiently.
However, many professionals still raise questions about implementing use of such screeners, asking questions like, “What happens when a person does screen positive for trauma?” or “What next?” These questions are raised because often, the helping professional administering the tool may not have the necessary training to further assess potential reactions to events or symptoms the person reported during the screening process. Therefore, many screening tools have sections that help professionals decide next steps and referral options. If the decision is made to send the individual for further assessment, the screening tool can be a helpful device to share with the assessor as a starting point during the assessment process with the person.
Administering assessments is longer process that could require more than one meeting with the individual and their supports. Assessments can include clinical interviews, behavioral observations, and administering standardized measures. Holistic trauma-informed assessments, such as the Benchmarks’ Trauma-intensive Comprehensive Clinical Assessment (TiCCA), which has been tested in various projects across North Carolina, take an in-depth look at how trauma has shaped the person, considering the impact it may have had on every area of a person’s life from their development to their general well-being. To gather robust information about each area of an individual’s functioning, assessors conduct interviews with clients as well as pertinent collateral contacts. For children, this often includes parents or caregivers, school personnel, and medical professionals. Clinicians then synthesize all the information to make recommendations for clients that extend beyond typical behavioral and mental health services. Recommendations made during these assessments aim to respond to how the person can be best supported in all areas of their life. As a result, these assessments can serve as a map and be shared with other professionals to guide them in helping the person flourish. Finding ways to collaborate across systems to follow through with trauma-informed assessments and their recommendations can have an influence on whether a person is able to thrive post-assessment.
Again, screenings are short lists of questions asked of someone about their experiences and can lead to a referral for further mental health assessment. Typically, screenings occur before an assessment is done. Many of our helping systems have embedded screening tools in their day-to-day work that help professionals decide whether people need to be referred for more in-depth mental health assessment. Understanding the difference between these two terms helps to ensure that the right tools are being used at the right time to help youth be referred to the right services. Additional information can be found regarding screening and assessment differences via the National Child Traumatic Stress Network website at www.nctsn.org.
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