Measures Library

An inter-agency tool used in the aftermath of humanitarian crises to assess and coordinate various mental health and psychosocial response efforts. The tool is intended for use by mental health and psychosocial support agencies—NGO, governmental, and intergovernmental—rather than individuals, and is operated through an Excel spread sheet file, where various pieces of data about each participating agencies’ mental health and psychosocial activities are entered and used for evaluating response actions. Information entered into the data file comes from interviews with representatives of participating agencies, and consists of short-sentence responses, numerical values, or activity codes. The activity codes, found in the tool’s manual, reflect common activities undertaken after an emergency situation, and are divided by: community activities, activities for identified cases, and general activities. The initial use of the tool averages about two weeks in duration, and requires periodic updates.

A measurement tool that assesses the degree of war exposure in children. The tool aims to differentiate itself from others by providing an individualized objective and subjective assessment of war exposure outcomes in populations exposed to the same war. The WEQ addresses a variety of war events common to all wars, regardless of context or location, and is divided into two parts: Part One, which contains four items and asks about the frequency of exposure to various war events (i.e. physical injury and building damage), both in the respondent and anyone “very close” to the respondent (i.e. family member, neighbor, friend, etc.); Part Two, which is optional, contains six items that assess the level of perceived stress to various events resulting from a war (i.e. water shortage, electricity outages, displacement, etc.). Also in Part Two,the respondent rates his/her perception of stress to the events that he/she reported exposure to in Part One. This is rated from one (“War Event had No Effect”) to 10 (“War Event was Very Dreadful”). In Part One, up to five blank spaces are available for the respondent to answer questions about the occurrence of each event, meaning that in some respondents it is possible that they will have been exposed, and/or a “very close” person will have been exposed multiple times to an event, and will require a report on each occurrence of the same event. Each question contains its own response codes and numerical response values, allowing for independent measurements for each exposure event. The scores in Part Two are not cumulative. The entire scale is scored from 0 to 10,000, with higher numbers indicative of higher levels of exposure to war events and perceived stress resulting from these events. The WEQ should be administered by interviewers who, while not requiring a clinical or professional degree, have received detailed training on the tool prior to administration.

A tool for conducting in-depth assessments of trauma-induced psychological reactions, especially PTSD, in school-aged children and adolescents. Administration criteria for the tool are rather flexible—it can be administered in a self-report format, either individually or in a group setting, or orally by an interviewer. The tool, adapted from the Child Post-Traumatic Stress Disorder Reaction Index (CPTSD-RI) exists in three versions—Child (ages 6 to 12 years), Adolescent (13 years or older), and Parent’s Report. All three versions of the UCLA PTSD-RI are comprised of questions corresponding to the DSM-IV‘scriteria for PTSD. The Child version consists of 20 items, and the Adolescent and Adult versions contain 22 items. All versions of the questionnaire are divided into three parts: Parts I, II, and III. Part I addresses a child’s traumatic experience (Criterion A1 for PTSD from the DSM-IV). Part II, containing Yes/No response options, assesses cognitive and emotional reactions to the distressing event (Criterion A2 for PTSD from the DSM-IV). Part III delves into the frequency of PTSD symptoms in the past month, based on the classic PTSD triad of behavioral disturbances—avoidance, intrusion, and arousal (PTSD Criterion B, C, and D from the DSM-IV). Response options for items are—None of the Time (0), Some of theTime (1), Much of the Time (2), and Most of the Time (4). Two additional items address fear of recurrence and guilt related to trauma. Responses can be used to calculate a total score, and/or subscale values. The tool takes about 20-30 minutes to administer, and can be administered repeatedly.

A screening tool that measures behavior in children over the last month to six months. The SDQ is available in various versions—a One-Sided, Informant-Rated version for parents and teachers, which is completed by parents and teachers of children aged 4 to 16 years; a One-Sided, Informant-Rated Parent and Teacher version for completion by parents and teachers of children aged 3 to 4 years (identical to the parent/teacher version for 4 to 16 year-olds except for three age-modified questions); and a One-Sided, Self-Rated version for adolescents aged 11 to 16 years. Each version consists of 25 items that measure positive and negative attributes based on five sub-scales—Emotional (5 items), Conduct (5 items), Hyperactivity/Inattention (5 items), Peer Relationship Problems, and Prosocial Behavior. Double-sided SDQ versions are also available in all of the One-Sided versions. The Double-Sided SDQ versions consist of a front side containing the primary 25 questions, but also contain a back side, called an Impact Supplement, that allows for further elaboration of behavior. Additionally, there is a Follow-up version of the SDQ, which includes the original 25 items and the Impact Supplement, but also two extra questions that inquire about treatment effectiveness. Contrary to the other SDQ versions, which measure a child’s behavior over the past six months and/or the current school year, the Follow-up version only assesses behavior over the past month. Response options for the 25 items on all versions are based on a 3-point scale—Not True, Somewhat True, and Certainly True. Response options for the Impact Supplement for all versions are—Not at All (0), Only a Little (0), Quite a Lot (1), and A Great Deal (2). Impact Scores range from 0 to 10, with scores of two or more considered abnormal. The five sub-scales generate an overall SDQ score, which ranges from 0 to 40, with scores between 20 and 40 indicative of abnormal behavior. Individual scores for each of the five sub-scales can also be calculated

A screening tool designed by the World Health Organization (WHO) to assesses for common mental disorders in primary health care, and/or community settings. SRQ consists of 20 short, Yes/No questions that inquire about the presence of anxiety, depression, and psychosomatic symptoms during the past month. It originally comprised 25 questions, twenty of which assessed neurosis, four assessed psychosis, and one explored convulsions; however, it was later shortened to 20 items (SRQ-20) pertaining exclusively to neurosis. An SRQ-24 exists, which still contains the original 20 questions about neurosis and four questions about psychosis, but it is not as commonly used as the SRQ-20. The maximum total score for SRQ-20 is 20, with a “Yes” response indicating symptom presence, and “No”, the absence of a symptom. The SRQ can be self-administered, but in settings where there are high levels of illiteracy, an interviewer should administer it.

A self-report screening tool that assesses for a variety of anxiety disorders in children. The SCARED comprises 41 items that measure the severity of anxiety-related symptoms (based on DSM-IV criteria), and is scored on a 3-point scale—Not True/Hardly Ever True (0), Sometimes True(1), and True/Often True (2). The questionnaire is administered by a clinician to children and their parent(s), and requires approximately 10 minutes to administer.

A 10-item, self-report questionnaire that measures the level of children’s self-esteem. The RSES inquires about children’s current feelings, using “I” statements (i.e.“I feel I have a number of good qualities…”). The items consist of five positively and five negatively worded scenarios. All ten items are answered on a 4-point scale–Strongly Agree (3), Agree (2), Disagree (1), and Strongly Disagree (0). Total possible scores range from 0 to 30, with higher scores indicative of higher levels of self-esteem. A score between 15 and 25 is considered normal, and a score below 15 is suggestive of low self-esteem. If desired, the 4-point response scale can be changed to varying point allotments (i.e. 5- or 7-point scales) that provide more response options and higher overall score totals.

A 37-item, self-report tool used to measure the level and nature of generalized anxiety in children. The RCMAS, informally referred to as the ‘What I Think and Feel’ scale, was originally adapted from the Children’s Manifest Anxiety Scale (CMAS) in order to allow for a wider and more accurate measurement of anxiety. Items contained in the RCMAS—primarily “I” sentences—describe various feelings or experiences a child may have. Response options are binary—“Yes”, if the statement is applicable to a child’s current feelings or experiences; or “No”, if it is non-applicable. Twenty-eight of the items directly correlate with anxiety, and are arranged and scored based on sub-indicators of anxiety—physiological symptoms (10 items), obsessive thoughts and/or worries (11 items), and social disturbances (7 items). The final nine items, called “Lie” items, are meant to detect any incorrect reports (i.e. a child who purposefully denies a symptom of anxiety when he/she is knowingly aware of its existence). A total cumulative score can be derived for the RCMAS, as well as for the four sub-scales—Physiological Anxiety, Worry/Oversensitivity, Social Concerns/Concentration, and Lie. The higher the score received, the greater the likelihood for anxiety, or the possibility that the child has lied in his/her responses. The tool takes about 10 to 15 minutes to administer, and can be administered in individual or group settings by clinicians, teachers, and/or researchers.

A qualitative, multi-sector tool used to rapidly assess the psychosocial needs and resources of individuals, families, and populations fleeing various forms of conflict and persecution. Developed by the World Health Organization (WHO) and various partnering entities, the RAMH’s scope of practice cuts across various levels of focus and units of measurement. The tool, a combination of direct dat acollection and information gathered through discussions with governmental-and non-governmental officials, is appropriate for use in the earliest phases of an emergency. Prior to deployment into any emergency setting, RAMH assessment teams should first research affected populations, the nature of the conflict(s), and other helpful background information. Consisting of seven sections, the RAMH inquires about access to food, water, and education; the nature of the conflict and those affected by it; exposure to violence; pre- and post-conflict population characteristics; mental health resources; and recommendations for future community-based, mental health programming. Questionnaire items contain four response columns—Refugees (Yes), Refugees (No), Host Population (Yes), and Host Population (No)—in which assessors check applicable responses to questions about refugees andthe host population(s). While the RAMH is flexible in its requirements for team members’ credentials and professional backgrounds, it is important that, at a minimum, team members possess knowledge and skills in emergencies and refugee mental health. ARAMH assessment process averages 7 to 10 days.

A rapid screening tool to assess for and determine a general level of psychological distress in young children exposed to crisis situations. The PSYCa 3-6 is often administered by non-specialists, who interview a child’s parent and/or caregiver, and when indicated, refer the child to a specialist. The PSYCa 3-6, originally developed in French for use with refugees in Macedonia, contains 40 items, and has the following response options—Never/Not at All (0), Sometimes/A Few Times (1), and Often/Frequently/Always (2). The tool has a total score value of 80, with higher scores indicative of increased levels of distress. An adapted and validated PSYCa 3-6a version is available in Hausa, and contains 22-items, with a possible total score from 0 to 44. In both the original and adapted versions, items address depression, phobia, anxiety, regression, psychosomatic complaints, and post-traumatic stress disorder (PTSD).

A 30-item tool used to assess for and diagnose PTSD in children affected by various forms of trauma. The tool’s first 17 items are dedicated to PTSD (based on DSM criteria), while the remaining 13 questions focus on child-specific stress reactions to trauma that are unrelated to PTSD (i.e. hyperactivity). Moreover, the DSM-based items (1-17) are grouped according to the classic triad of diagnostic PTSD symptoms—re-experiencing (items 1-4), avoidance (items 5-11), and hyper-arousal (items 12-17). All items contain Yes (1) or No (0) response options. A diagnosis of PTSD is warranted when a child answers “Yes” to at least one item relating to re-experiencing, three avoidance items, and two items of hyper-arousal. The tool is administered via a semi-structured interview and averages approximately 30 minutes for administration. Interviewers should have experience working with children, and undergo a short training on the PTSS-C prior to conducting interviews.

A 21-item, rapid behavioral screening tool that is completed by parents and/or caregivers of children who have had recent exposure to a traumatic and/or stressful event. The tool’s items consist of 17 general behavioral questions, grouped into three domains—anxious/withdrawn, fearful, and acting out—and four questions specific to trauma exposure, and focused either on play or talk. Question responses are scored on a 4-point scale, based on symptom applicability and frequency—Almost Never (1), Sometimes (2), Often (3), and Very Often (4). The PEDS averages abouts even minutes to administer.

An assessment approach that allows communities to give voice to their psychosocial needs, and to play an active part in identifying solutions. The PRA approach, which relies heavily on oral communication for conducting needs assessments, is generally qualitative in nature, and comprises a variety of tools, techniques, and activities that facilitate community membership and participation. Prior to commencement of assessment activities, the aims, goals, and logistics of aproject, including distribution of labor, should be outlined and decided upon by implementing parties. Shortly after, sites for community assessments are chosen. Once sites are identified, specific details of PRA assessments are further discussed and finalized, including any necessary trainings, budgetary proposals, and/or applications for site approvals. With site details finalized, field assessments are conducted using selected PRA approaches. Over time, sites are continually re-visited to gather more information and complete any missing data collection activities. Findings are then shared with communities, national and international governments, and any participating agencies. Because the PRA approach allows for abundant use of creativity, improvisation, and flexibility in designing and implementing assessments, it is rare to find uniformity in its application.

A rapid, mixed-methods (quantitative and qualitative) assessment tool that allows community members and project stakeholders to communicate their needs and to identify local resources. Data collection comes from group exercises, in which various community members are gathered in an open-forum that is systematic and controlled, and collectively asked to provide their opinions on various community needs-based questions. Information comes from one primary question (“framing question”) that is asked in a group setting by a PRM facilitator. It is imperative that questions be created to allow for detailed responses from group participants. More than one question may be asked of a group, but efforts should be made to delineate each question into separate exercises. Although participation is at the individual level, questions posed should elicit responses about the community, not the individual. Two people are required for conducting a group exercise—a note taker and a facilitator. Group activities follow a P-R-M sequencing method: P= Pile (the facilitator poses a question to the group, the group provides responses; themes are recognized and given representative objects; objects are then placed in a pile); R= Ranking (through group consensus, objects, or issues, are ranked by importance); M=Meaning (understanding of the meaning of each theme is sought throughout the exercise). One group exercise lasts roughly 30 minutes. PRM produces information that can be readily processed and analyzed. Ideally, in each community assessed, individuals chosen for group participation should be recruited and selected based on the following three broad categorical affiliations—community leaders, prominent community groups, and community groupings such as age, gender, ethnicity, etc. Depending on the setting, group exercises can occur both indoors and outdoors, although group facilitators should always be conscious of outsiders listening or peering in (especially in more public venues).

A rapid, self-report tool designed and implemented by Catholic Relief Services (CRS) to measure the perceived wellbeing of orphans and vulnerable children (OVC), and to bolster efforts and effective responses to child friendly programs. The tool, consisting of 36 statements, is administered orally, and is based on ten key domains—nutrition/food security, shelter/environment, protection, family, health, spirituality, mental health, education, economic opportunities, and community cohesion. During administration, a youth is asked to report how often each of the 36 statements applies to him/her, with the following response options: None of the Time, Some of the Time, or All of the Time. The total possible score is between 10 (low level of wellbeing) and 30 (high level of wellbeing). On average, the tool takes 15-20 minutes to complete.

A developmental screening tool to aid in the early detection of, and if needed, intervention for developmental delays in infants and children up to six years of age. Comprising one page of Yes/No questions that are completed by a child’s parent, caregiver,or health care professional, either at home or during a child wellness visit, the NDDS evaluates a child’s developmental health based on the following areas: vision, hearing, speech, language, fine and gross motor skills, cognition, social skills, emotional skills, and self-help skills. These skills are monitored and tracked at various intervals over a child’s first six years of life, with assessments occurring most frequently in the first three years of life. Each assessment interval has a corresponding one-page NDDS questionnaire, which includes various activities parents or caregivers can implement with their child to improve developmental areas. Any “No” responses are to be addressed with a child’s healthcare professional. Assessment visits also coincide with a child’s immunization schedule, which allows parents/caregivers and health care providers to coordinate both activities in one visit. The tool, which includes illustrations, activities to reinforce or augment positive developmental activities, and color-coding based on ages, is not scored.

A self-report tool used to assess for symptoms of anxiety in children. The MASC is available in two forms—MASC (the full version) and MASC-10 (the short version). The MASC consists of 39 items spread across various domains—Harm Avoidance, Social Anxiety, Physical Symptoms, Anxiety Disorders, Separation/Panic, Total Anxiety Index, and Inconsistency Index. The Inconsistency Index helps to recognize any reporting mistakes and errors, and the Total Anxiety Index identifies respondents whose anxiety scores warrant further clinical follow-up. The primary MASC scales—Harm Avoidance, Social Anxiety, Physical Symptoms, and Separation/Panic—can be further broken down into sub-scales—Somatic Symptoms, Tense Symptoms, Perfectionism, Anxious Coping, Humiliation Fears, and Performance Fears. Due to its comprehensiveness, the MASC is most appropriate for initial screenings. The MASC-10, which contains ten items exclusively measuring anxiety, allows for a rapid screening for anxiety symptoms, and is meant as a tool for monitoring progress over time. Questionnaire responses for both MASC versions are scored on a 4-point scale, ranging from “Never True About Me” (0) to “Often True About Me” (3). The tool should be administered by a clinician, or trained professional. Administration times for the MASC average about five minutes for the MASC-10 and 15 minutes for the full-version MASC

A tool that uses a structured clinical interview to assess for, and diagnose, DSM-IV Axis I mental disorders. Modeled after the Mini International Neuropsychiatry Interview (MINI), a diagnostic tool for adults, the MINI KID comprises 24 mental disorders, each containing its own set of disorder-specific questions, to which children provide Yes or No responses. Several of the disorders contain one to three initial questions that screen a child for that particular disorder. If the child answers “No” to the screening questions, the administrator can skip forward to the following disorder’s questions. The tool requires approximately 15 minutes to administer

A 33-item, self-report questionnaire that screens for symptoms of depression and loneliness (based on DSM-III-R criteriafor depression). The MFQ consists of several short phrases describing feelings or actions, to which respondents answer—True (2), Sometimes True (1), or Not True (0). A shorter, 13-item subscale, called the Short Mood and Feelings Questionnaire (SMFQ), focuses on affective and cognitive symptoms. Both the MFQ and SMFQ contain child and parent-report forms, and require approximately 5-10 minutes to administer. The parent-report form for the MFQ consists of 34 items.

A comprehensive, semi-structured interview tool used to assess and diagnose a variety of psychiatric disorders found in children. The K-SADS was developed from an adult instrument, the Schedule for Affective Disorders and Schizophrenia (SADS). In its lifetime, it has undergone several revisions in order to reflect periodic recapitulations in DSM diagnostic criteria. The original tool coincides with the K-SADS-P (Present Episode Version), which assesses current psychopathology, and comprises four sections of disorder domains—affective, anxiety, conduct, and psychosis. The K-SADS-PL (Present and Lifetime version) is the newest version and assesses for a wider range of Axis I psychiatric disorders, both current and past. It is arranged into six sections: the Introductory Interview, the Diagnostic Screening Interview, the Supplement Completion Checklist, the Diagnostic Supplements, the Summary Lifetime Diagnosis Checklist, and the Children’s Global Assessment Scale ratings. The last four sections are completed only when indicated by respondents’ answers in the Diagnostic Screening Interview. Overall scores and diagnostic decisions are determined after combining a variety of data—children’s self-reports, parents’ reports of observable behavior, and summary ratings (parent, child, school, etc.). Because of its complexity and need for clinical judgment, the tool requires administration by a clinical professional, who can re-word questions or probe for further clarification, when required. The K-SADS is administered to both children and parents, and requires about 75 minutes for administration (per respondent). Overall scores and diagnostic decisions are determined after combining a variety of data—children’s self-reports, parents’ reports of observable behavior, and summary ratings (parent, child, school, etc.).

A self-report tool that measures stress reactions to a traumatic life event. IES consists of 15 items, which are grouped and scored based on two sub-categories—intrusion and avoidance. When filling out the questionnaire, a child is directed tofirst write at the top of the page the specific life event to be used for questionnaire responses, and the date of its occurrence. The child is then asked to recall whether or not he/she experienced each of the 15 items in the last week. If the child is able to recall an item, the frequency —Rarely, Sometimes, and Often—and intensity—Mild, Moderate, or Severe—are measured. A revised IES scale, called IES-R, was developed shortly after the introduction of the IES, and is similar to the IES but contains 22 items (8 avoidance and 8 intrusion items) and an additional hyper-arousal sub-category (6 items). In both scales, the following response options are used: Not at All (0), A Little Bit (1), Moderately (2), Quite a Bit(3), and Extremely (4). IES yields a total score from 0 to 60, and IES-R a score from 0 to 88. Higher scores are more indicative of increased stress reactions. It is also possible to calculate sub-scale scores for intrusion, avoidance, and hyper-arousal. Although IES was not originally designed as a tool for children, it has been used successfully on several occasions with children. The Children’s Impact of Event Scale 8 (CRIES-8, and also called IES-8), containing eight of the most child-pertinent items from the IES, was developed to reflect differences between adults and children in responding to trauma. Modeled after the IES, CRIES-8 consists of four items measuring intrusion and four items measuring avoidance. Another child-specific IES scale that expands on the CRIES-8 is the Children’s Impact of Event Scale 13 (CRIES-13). In CRIES-13, the same eight items relating to intrusion and avoidance from CRIES-8 are present, plus five items measuring arousal. CRIES-8 and-13 are measured and scored by the following responses: Not at All (0), Rarely (1), Sometimes (3), and Often (5). All ofthe scales can be administered in group settings.

A manual comprising various population-level psychosocial assessment tools used globally by the International Organization for Migration (IOM). In its methodological approach, the IOM tools incorporate aspects of other psychosocial assessment measures, namely the Rapid Appraisal Procedure (RAP), which relies on a variety of measurement strategies— literature reviews, informant interviews, focus group interviews, field-level observations, and individual and family interviews—to glean insight into populations’ needs. The IOM tools consist of two distinct questionnaires—a Questionnaire for International and National Stakeholders, which identifies psychosocial needs and responses by key international and national organizations; and a Questionnaire for Local Stakeholders and Key Members of the Displaced Population, which queries the needs expressed by affected populations and their coping strategies, and/or desired postemergency services. In addition to the two questionnaires, there are other tools: a Qualitative Household Questionnaire, which focuses on an emergency’s psychosocial effect on households, particularly children; A Scheme for Psychosocial Wellbeing, which studies the emotional experiences of displacement in terms of housing, employment, school, and social life; and Distress Indicators, which aim to identify common psychosocial-related symptoms and/or areas of dysfunction seen in affected families and communities. For all IOM tools, a conversational approach to interviewing is emphasized, rather than asking direct questions. Additionally, non-verbal communication and body language, both from the respondent and people in his/her family, are valuable pieces for analyses. A minimum of 30 interviews should be completed to have enough data to derive meaningful information.

A toolkit produced by War Child Holland, which provides modules and interactive training exercises to use with children (aged 11-15) and youth (aged 16-20) in conflict settings as a way to improve their life skills and resiliency. The six thematic modules include: 1) Identity and Assessment, 2) Dealing with Emotions, 3) Peer Relations, 4) Relationships with Adults, 5) Conflict and Peace, and 6) The Future. Each module consists of between two to five 90-minute sessions that are designed to build upon one another. Sessions within each module engage in a combination of different activities including drama, visual arts, games and group discussions. These are designed so that participants can explore important issues in their current lives and learn how to better cope with these. Home assignments are integrated into the sessions encouraging participants to practice new skills and strategies outside of the program. Sessions should be facilitated by two trained facilitators and conducted with a group of children who can participate in the modules together. The I DEAL curriculum is also developing additional modules tailored at specific groups. These are: BIG DEAL (addresses gender relations, rights and responsibilities, and leadership with young people aged 16-20), PARENTS DEAL (aims to establish supportive environment for parents and caregivers to address the challenges they face in raising children), TEACHERS DEAL (assists teachers in creating a safe school environment), and SHE DEALS (addresses concerns of girls and young mothers under 20 years old).

A 26-item tool used to rapidly assess perceived serious needs of populations affected by large-scale humanitarian emergencies. Developed by the World Health Organization (WHO), the HESPER combines elements of survey research (i.e. sampling) and participatory methods for assessing needs. Respondents for surveys are first chosen either through convenience sampling (anyone who is accessible to the interviewer) or representative sampling (a random selection of people from a sampled population who accurately reflect the entire make-up of that population). Although representative sampling is the preferred sampling method for HESPER, it is not always a feasible option (especially in emergency contexts), in which case, convenience sampling is appropriate. Once a sampling method and sample size are decided upon, respondents can be recruited and interviewed. The 26 “need” items are read by the interviewer and answered by the respondent with the following rating options: Serious Problem (1)—identified as a serious problem by the respondent; No Serious Problem (0)–not identified as a serious problem by the respondent; or No Answer (9)—no answer provided, answer declined, not applicable, etc. After answering the 26 items, a respondent is then asked to list his/her three most serious perceived needs, as well as identify any other perceived needs not covered in the 26 items. Use of the tool does not require extensive training, as much of the general information can be learned through reading its user’s manual; however, it is important that interviewers have a few days of formal training and, at a minimum, have 12 years of education, familiarity with the local culture and context, and comfort interacting with diverse groups of people. Although children are not directly included in interviews (HESPAR respondents should be at least 18 years old), adult respondents can provide valuable information about children living in their homes or communities. The tool allows for considerable flexibility and adaptations to local and cultural contexts, and requires about 15-30 minutes (per interview) to administer.

A screening tool that assesses mental wellbeing based on five symptom dimensions—somatization, obsessive-compulsion, interpersonal sensitivity, anxiety, and depression. It is comprised of various versions, ranging from 90 to 10 items (i.e. HSCL-90, -71, -64, -58, -35, -31, -25, -20, and -10), and scaled based on four categories of responses: Not at All (1), A Little (2), Quite a Bit (3), and Extremely (4). Originally developed as a self-report tool, over time and in contexts where illiteracy predominates, HSC has been adapted for use as an interviewer administered tool. HSCL can be used for various purposes: research; epidemiological studies; clinical screening in medical and psychiatric patients, and in “healthy” populations; to measure clinical change; and to monitor and evaluate effectiveness of interventions. The HSCL25 consists of 25 items that are broken down into two sub-scales: 10 items for assessment of anxiety and 15 items that screen for depression.

A questionnaire that explores traumatic events and symptoms associated with traumatic events. HTQ contains four parts, each part focusing on different aspects of a person’s relationship with trauma. In the original version of HTQ, available in Vietnamese, Cambodian, and Laotian, questions address trauma specific to Southeast Asian refugees. Part I consists of 17 possible traumatic events, to which respondents are to answer with one or more of the following—Experienced, Witnessed, Heard about it, or No. In the later version of the HTQ, available in Japanese, Bosnian, and Croatian, Part I contains 46 to 82 traumatic event scenarios, with available response choices reduced to Yes/No only. In both versions of the HTQ, Part II asks respondents to provide a subjective, open-ended narrative of the most traumatic event ever experienced. Part III inquires about head injuries, with the question further expanded upon in the Bosnian and Croatian versions, and eliminated from the Japanese version. Part IV of the original version explores trauma symptoms, with the first 16 items drawn from the DSM IIIR/DSM-IV criteria for post-traumatic stress disorder (PTSD) and the remaining 14 developed by the Harvard Program in Refugee Trauma to reflect symptoms specific to refugee trauma. In later versions of HTQ, Part IV of the Japanese version contains the original 30 items, in addition to seven items specific to Japanese culture and language. The Bosnian and Croatian versions for Part IV preserve the original 16 items from the DSM IIIR/DSM-IV for PTSD, but contain 24 items that inquire about one’s perception of and/or ability to function on a day-to-day basis.

A global assessment tool that measures impairments in psychosocial functioning due to an underlying psychiatric disorder. The GAPD is based on Axis VI of the ICD-10, which addresses deficits in functioning at home, school, work (if employed), and with peers due to a psychiatric disorder, or a disorder of psychological origin, and/or mental retardation. The GAPD does not assess individual symptoms, but instead, evaluates a child’s overall psychological, social, and occupational levels of functioning. The overall score for GAPD is between 0 and 8, with a higher score reflective of a higher degree of disability. The composite score values and corresponding psychosocial functioning levels are as follows: Superior/Good Social Functioning (0), Moderate Social Functioning (1), Slight Social Disability (2), Moderate Social Disability (3), Serious Social Disability (4), Serious and Pervasive Social Disability (5), Unable to Function in Most Areas (6), Gross and Pervasive Social Disability (7), and Profound and Pervasive Social Disability (8). In general, a score of two is commonly used as the cut-off between clinical cases and non-cases (i.e. scores of 2 to 8= cases, and 0-2= non-cases).

A self-report screening tool used to assess for a variety of current mental disturbances. The questionnaire was originally developed as a 60-item tool (GHQ-60), but has since been revised into shorter versions—GHQ-30, GHQ-28, GHQ-20, and GHQ-12. All versions of the questionnaire ask about a respondent’s current behavior and functioning abilities, and if there have been any recent changes in either. The GHQ-60 contains all original questions, which focus on both physical and mental disturbances; the GHQ-30 excludes questions about somatic symptoms; the GHQ-28 inquires about severe depression (7 items), somatic symptoms (7 items), social dysfunction (7 items), and anxiety/insomnia (7 items); and the shortest version, the GHQ-12, facilitates a rapid screening (about 2 minutes) for various mental disturbances. The GHQ-28 allows for scoring of each domain of disturbance, as well as an overall score. The GHQ-60, GHQ-28 and GHQ-12 only produce total scores. The questionnaires’ response options are on a 4-point scale—Better/Healthier than Normal, Same as Usual, Worse/More than Usual, Much Worse/More than Usual—and can be scored according to a variety of scale values—GHQ (0-0-1-1), Likert (0-1-2-3), Modified Likert (0-0-1-2), and C-GHQ (0-0-1-1 or 0-1-1-1). The tool takes from 2-10 minutes to administer, depending on the version chosen.

A scale that measures an adolescent’s sense of family connectedness, defined by his/her perception of interpersonal relations with, closeness to, and respect from family. Adapted from previous research undertaken by social scientists in the U.S. pertaining to family and school connectedness in youth, the FCS follows the premise that enhanced social supports and positive perceptions of family relationships in adolescents are protective against various psychosocial risk factors, including emotional distress, depression, and suicidality. The tool consists of 12 items and is scored on a 3-point scale—Very/Often, Somewhat/Sometimes, Not at all/Almost Never. Higher scores indicate increased family connectedness, and lower scores are indicative of decreased family connectedness.

A tool that consists of a structured interview to assess for and diagnose a broad spectrum of psychiatric disorders in children. The DISC has been revised on numerous occasions to reflect new research on psychiatric pathology, and to coincide with updates to the DSM and ICD classification systems. Trained, non-clinicians can administer older versions— DISC-I, DISC-R, DISC-2.1, and DISC-2.3—as well as the newest version—DISC-IV. All versions contain two different forms, DISC-Y, for administration to children aged 9 to 17 years; and DISC-P, for administration to parents and/or caretakers of children aged 6 to 17 years. The DISC-P contains a few more questions than the DISC-Y; otherwise, the two forms are similar in composition. The original version of the tool, DISC-I, followed DSM-III criteria and focused largely on environmental (i.e. school and home), rather than pathological, domains. The subsequent version, DISC-R, minimized the use of open-ended questions and disorders requiring observations for diagnoses, and added a section to chart time. Shortly after, the DISC-2.1 was introduced, which included more robust psychometrics—assessments of treatment history, age at initial onset of symptoms, and impairments precipitated by a current episode. This was followed by the DISC-2.3, which reduced the length and complexity of questions, and permitted diagnoses of disorders based on symptom criteria. The latest version, DISC-IV, follows DSM-IV and ICD-10 criteria, contains over 30 psychiatric diagnoses commonly seen in youth, allows for information discrimination of initial and present onset of symptoms, inquires about impairments related to symptoms and/or disorders, uses more concisely-worded questions, and has all but eliminated open-ended questions. Answer responses to the DISC-IV are: Yes, No, Somewhat, and Sometimes. The questionnaire is arranged into different modules, which query demographic information, as well as information specific to various disorders—Anxiety, Mood, Disruptive, Substance use, Schizophrenia, and Miscellaneous disorders. The DISC-IV consists of 2,930 items (some of which are asked of all respondents and others only asked of respondents who provide clinically significant responses), and takes about 70 minutes to administer to parents/caregivers, and 90 to 120 minutes to administer to children.

A self-report, questionnaire consisting of 58 items that measure “developmental assets”, a set of skills, experiences, relationships, and behaviors found to facilitate formative growth and development in youth, and that are indicative of later success in adulthood. It has been found that the more developmental assets youth have, or acquire, the more likely their chances for success in school, and in leading happy, healthy and productive lives. DAP assesses eight internal and external categories of developmental assets: support (how caring parents, teachers, and neighbors are in a youth’s life); empowerment (a youth’s perceived sense of safety, value and appreciation at school and home); boundaries and expectations (a youth’s perception of how much he/she must abide by boundaries set at home, school and in the community); constructive use of time (the level of extra-curricular involvement partaken by a youth); commitment to learning (how motivated a youth is in completing school work and in seeking new information and/or skills); positive values (the level of personal and community responsibility exercised by a youth); social competencies (how well a youth engages in social relationships, adapts to change, and expresses himself/herself to others); and positive identity (a youth’s sense of self-worth). In addition, DAP includes five contextual areas—personal, social, school, family, and community. The tool contains the following four response options: Not at All or Rarely; Somewhat or Sometimes; Very or Often; Extremely or Almost Always. On average, the DAP takes approximately ten minutes to complete. When used in combination with data on school attendance, achievement and other measurable factors, DAP can provide a more complete picture of youths’ well-being, as well as inform strategies and programs to prepare them for later successes in such spheres as higher education, professional careers, and civic duties.

The DIME model is a process developed and used by the Applied Mental Health Research Group at Johns Hopkins University since 2000. The model seeks to combine evidence-based programming with rigorous monitoring and impact evaluation. It demonstrates the potential of using qualitative, participative research to inform the development of quantitative measures of mental health and psychosocial well-being. A manual is available which specifies the key steps specified by the DIME model. These steps are: (1) Qualitative assessment to identify and describe priority mental health and psychosocial problems; (2) Development of draft instruments to assess priority mental health and psychosocial problems; (3) Validation of draft instrument(s); (4) Conduct baseline prevalence surveys; (5) Program planning; (6) Development of interventions to address the identified mental health and psychosocial problems; (7) Implementation and monitoring; (8) Intervention evaluation. DIME is thus an approach to program development not just an approach to assessment and evaluation. However, there is potential to use aspects of the approach without committing to the whole DIME cycle.

An 18-item, self-rating tool to screen for depressive symptoms and exposure to environmental stressors. Children  shouldcomplete the questionnaire independently, but if a child demonstrates or expresses difficulty in reading the items, a clinician may assist by reading items aloud. All items in the tool contain positive and negative “I” statements (i.e. “I feel like crying”), to which children answer with one of three responses—Mostly, Sometimes, or Never—depending on their personal experiences and feelings relating to the scenarios described. When items describe positive, non-depressive scenarios, (i.e. “I look forward to things as much as I used to”), responses are scored—Mostly (0), Sometimes (1), and Never (2). When items depict depressive symptoms (i.e. “I have bad dreams”), responses are scored—Mostly (2), Sometimes (1), and Never (0). The total possible score on the questionnaire is 36, with a total of 15 or more indicative of mental stress and/or disorder, and the need for diagnostic follow-up. The tool takes about five minutes to complete.

A comprehensive tool designed by the World Health Organization (WHO) to assess for psychiatric disorders (as defined in ICD-10 and DSM-IV) and associated risk factors, consequences, and treatment interventions. The CIDI consists of a series of structured modules that screen for somatoform disorders, anxiety, depression, mania, schizophrenia, eating disorders, impairments in cognition, and substance use disorders. The CIDI is a highly complex tool that requires advanced knowledge, both in its administration procedures and its scope of clinical pathologies; however, with proper training, it can be administered by interviewers who are non-clinicians. The CIDI allows for great variability in its administration. The questionnaire begins with a series of screening questions about the child’s general health, before delving into disorderspecific questions. Depending on the scope and aims of an assessment, the CIDI can be administered in its entirety, or broken up and given in sections (i.e. the screening section and the depression module, etc.). However, it is important that the screening section always be included in any administration of the CIDI. The CIDI consists of a Short and a Long version. The Short version, averaging 45 minutes in administration time, helps to significantly reduce unnecessary financial and time costs compared with the Long version, which averages two hours in administration time. The Long version must be given to those who meet criteria for a mental disorder; it is up to the study organizer to determine whether or not to administer the Long version to those not meeting criteria for a mental disorder. The CIDI questionnaire and scoring algorithm are available in paper (PAPI) and computerized (CAPI) formats, and are updated regularly due to continual revisions in ICD and DSM criteria. Worldwide, CIDI training centers are available to provide expert training and technical assistance with the tool. Trainings last from 3-5 days and are available in Arabic, Chinese, Dutch, English, and Spanish.

A self-report questionnaire that contains six items measuring a child’s self-perception and level of belief about personal goal-attainment. The tool is based on two fundamental components of hope—agency and pathways. Agency refers to a child’s ability to initiate and sustain goal-directed activities, and pathways indicate a child’s capacity to carry out goals. The premise is that with more positive emotions come higher levels of hope, self-esteem, and goal-directed behavior; whereas, more negative emotional states tend to indicate reduced levels of hope, self-esteem, and goal-directed behavior. Question responses are scored from one through six—None of the Time (1), A Little of the Time (2), Some of the Time (3), A Lot of the Time (4), Most of the Time (5), and All of the Time (6). The higher the score, the higher the child’s level of hope and goal-directed behavior. The questionnaire takes, on average, four minutes to complete. There is also a modified parent-report version available for use.

A 27-item, self-report tool used to assess symptoms and severity of depression in children. The CDI questionnaire, which can be administered individually or in a group setting, poses various statements relating to mood, interpersonal problems, ineffectiveness, lack of energy, and negative symptoms, to which respondents are to select three that best describe their thoughts and feelings over the past two weeks. Apart from the primary CDI, administered directly to children, the CDI exists in other versions—CDI-S, a 10-item, condensed version of the tool that allows for rapid screening; the CDI-P, for administration to parents, and based on behavior observed at home; and CDI-T, given to teachers, who report on observed behaviors at school and in social settings. The tool is scored from 0 to 54, with scores above 19 indicative of depression. The CDI, which takes about 15 minutes to administer (10 minutes for CDI-S), is available both in paper and computerized-formats.

A tool used to assess children’s war-related experiences. It has two versions—CWTQ-C (for children) and CWTQ-A (for parents and caretakers). Both versions can either be self-administered or administered by an interviewer, although data reliability is greater when administered by an interviewer. The CWTQ contains 25 items and comprises two sections: Section One inquires about demographic details such as age, gender, and place of residency; Section Two asks detailed questions relating to a child’s direct and indirect experiences and exposures to war. Section Two asks about 45 different types of war-related traumas, separated according to the following categorizations—Separation, Victim of Violent Acts, Involvement in Hostilities, Displacement, Bereavement, Exposure to Shelling or Combat, Witness Violent Acts, Physical Injuries, Emigration, and Extreme Depravation.

An assessment tool that aids in preliminary detection and determination of the level of psychosocial distress, and any potential need for specialized services and/or treatment, in children. CPDS uses broad, non-specific questions relating to one of three factors—distress, resilience, and school—and can be administered by non-specialists. It contains seven items, the first four of which are answered by the child, and the final three by a teacher of the child. Possible response options include: Never/Not at all/Irregular, Sometimes/A little/Some absence, and Often/A lot/Regular. Pictorial representations of empty, half-full, and full-glasses are used to help children with providing correctly intended responses to each question. Each question response is worth 0-2 points (14 total possible points for the entire CPDS), with higher overall scores indicative of higher levels of psychosocial distress in the past month. For three of the items, ‘probes’, relating to the child’s own experiences and memories of past events, are used. Information for probes is gleaned through focus group discussions held with parents, teachers, and children prior to administration of questionnaires. In these focus group discussions, participants are queried about local and/or personal examples of aversive events (Question 1.1 on CPDS) and manifestation(s) of distress and other worrisome behaviors (Questions 1.3 and 2.1). Responses are listed and ranked, with the most frequently mentioned responses selected for use as probes. In addition to the pre-administration focus groups, it is strongly encouraged to conduct pre-administration briefings with parents, teachers, and children to discuss screening procedures, project objectives, and the consent process. Also, it is acceptable for the questionnaire to be administered orally to illiterate children.

Allows for a rapid, inter-agency assessment of Child Protection needs and existing local resources following the onset of an emergency. It is recommended for use within three to four weeks following the onset of an emergency. When possible, it should be used in conjunction with other coordinated Protection Rapid Assessments. Works best when conducted as a collaborative and coordinated effort among all Child Protection members, including governments. When possible, a lead organization should be selected to organize and spearhead group efforts, and a Child Protection Rapid Assessment Task Force (CPRATF) formed to manage the assessment process. Different communities are chosen through a structured purposive sampling—a sampling process in which information is collected in select communities to estimate the needs of an entire population. The CPRA covers all major child protection issues, including psychosocial distress, but does not explore then in depth. It allows for a broad estimate of the situation to guide quick planning and action. Desk review, key informant interviews, and direct observations are used for collecting data. Information collected from each community is compiled into a single ‘site report’ which forms the basis of the analysis. The accompanying excel-based data management tool allows for timely analysis of data, using descriptive analysis techniques, and produces basic graphs and tables. As part of the methodology, it is recommended that an interpretation workshop is organized upon initial analysis of the data, involving child protection actors. There is potential for extracting questions addressing psychosocial concerns for use within other surveys.

A 24-item tool used to assess for, and/or diagnose, Post-Traumatic Stress Disorder in children. Adapted from the adult screening tool, the Posttraumatic Diagnostic Scale (PDS), the CPSS comprises two parts—Part One, patterned after DSMIV criteria; and Part Two, assesses functional impairments resulting from symptoms recognized in Part One. Part One, consisting of 17 items, addresses symptom frequency—how often a child has been bothered by a particular problem over the past two weeks. Response options for this section include: Not at All (0), Once a Week or Less/Once in a While (1), Two to Four Times a Week/Half the Time (2), and Five or More Times a Week/Almost Always (3). The total score for this section ranges from 0 to 51, with higher scores indicative of PTSD. In Part Two, children are asked seven questions about functional impairment due to symptoms discussed in Part One. Response options for this section are: Absent (0) or Present (1). The total score for this section ranges from 0 to 7, with higher scores indicative of greater functional impairment. If desired, it is also possible to calculate sub scale scores for re-experiencing, avoidance, and hyper-arousal. The CPSS, which can be self-administered or administered by an interviewer, takes about 10-20 minutes to administer.

A multi-step, participatory process in which children develop their own culturally grounded concepts on psychosocial wellbeing, desired outcomes, and indicators as a way of monitoring psychosocial programming outcomes. Developed by the Transcultural Psychosocial Organization (TPO) Nepal, the process is centered on empowering children to be actively involved in finding solutions to their own problems, largely as a way of engendering local buy-in and sustainability. While the process of involving local children is specific to each context, the general areas in which their participation is valuable are not—providing specific insights and experiences about their lived experiences; offering insight into what constitutes wellbeing within their socio-cultural contexts; and their knowledge of resources available to them in their communities. From these areas of knowledge and insight, psychosocial programming can occur. With psychosocial programming comes the development of program indicators, which are also informed by participating children. The multi-step process begins with a drawing exercise, in which selected children are asked to draw their heartmind, a Nepali symbol for emotion and memory, in which children are to depict both their positive and negative feelings. In subgroups, children are then asked by a facilitator to choose the most pressing issues confronting their lives today (sometimes gleaned from looking at their heartminds), and collectively share their answers with the group. Next, children are asked to think through (or draw) the cause and effect analysis of their main psychosocial problem— how the problem affects their lives, both now and in the future. This is followed by an analysis of objectives, in which children can positively describe their future situation, as though their main problem has been resolved. In this activity, children are asked to turn their ‘problems’ into positive ‘objectives’ that are both realistic and achievable. Afterwards, children are involved in resource mapping, in which they identify resources that will be both beneficial to their wellbeing and available in their communities. Children then list activities that they think will help them achieve their desired objectives. Finally, children design indicators that will help them measure their success in fulfilling originally determined objectives, and which will serve as indicators for program monitoring and evaluation.

A culturally adaptable assessment tool that measures daily functioning levels of children living in low- and middle-income countries. Due to both a lack of mental health resources, and a dearth of appropriate psychometric tools specific to low and middle-income countries (LAMIC), the Child Functioning Impairment Rating Scale was developed as a tool that could be easily adapted for use across various LAMIC contexts. The pilot scale, designed and implemented in Indonesia, consists of 11-items that assess various social and ecological indicators of functional impairment in Indonesian children—individual activities (4 items), family activities (2 items), peer activities (2 items), school functioning (2 items), and one open item. Questions were developed following a series of mixed-methods data collection efforts that consisted of participant observations, two-week diary entries of daily activities by a sample of school children, and focus group discussions. The finalized questionnaire, scaled on a 4-point scale—None (1), A Little (2), Moderate (3), and Often Can’t do Activity (4)—was scored from 0 to 44, with higher scores indicative of higher levels of impairment. The pilot tool provides a foundational basis on which to develop similar, context-specific impairment rating scales.

A 42-item, behavioral screening tool that measures children’s behavioral symptoms and adaptations. Modified from numerous other child behavioral measurements, the CBI is available in two versions—CBI-A (for parents and/or caretakers) and CBI-C (for children). Both versions can either be self-administered or administered as a structured interview; however, CBI-C can only be administered to children between the ages of 10 and 16, while the CBI-A can be administered to parents and caretakers of children between the ages of 5 and 16. When possible, administration in an interview format is advisable, especially when administering the questionnaire directly to children, as this method tends to yield better results. The questionnaire contains 25 items that inquire about behavioral symptoms—aggression (9 items), depression (10 items), and anxiety (6 items)—and 17 items measuring behavioral adaptations—prosocial behavior (9 items) and planful behavior (8 items). The CBI response options are based on a 4-point scale: Never (0), Rarely (1), Sometimes (2), and Always (3). Sub-scale scores are first tallied (i.e. a score for aggression, depression, anxiety, prosocial behavior, and planful behavior) and added together to derive an overall CBI score.

A tool used to screen for abnormal behavior and emotions in children. Part of the Achenbach System of Empirically Based Assessment—a comprehensive approach to studying children’s behavior—the CBCL comprises two versions—the Preschool Checklist (CBCL/1½-5), for use with children between the ages of 18 months and 5 years; and the School-age Checklist (CBCL/6-18), for children aged 6 to 18 years. It also contains two forms—the Teacher’s Report Form (TRF), administered to a child’s teachers; and the Youth Self Report (YSR), completed by children aged 11 to 18. Apart from the TRF and YSR, a child’s parent, family member, or caregiver completes both the Preschool and School-age Checklists. The Preschool Checklist contains 100 items, and the School-Age Checklist contains 120 items. In both checklists, statements about a child’s behaviors are provided, with response options scored on a three point scale—Not true (0), Somewhat or Sometimes true (1), Very true or Often true (2). Two open-ended items are included at the end of a questionnaire for a respondent to report any other worrisome behavior. A total score can be derived for the tool, as well as for various behavioral syndromes—Anxious/Depressed, Withdrawn/Depressed, Somatic Complaints, Social Problem, Thought Problems, Attention Problems, Rule-Breaking Behavior, and Aggressive Behavior; and DSM IV categories—Affective Problems, Anxiety Problems, Somatic Problems, Attention Deficit/Hyperactivity Problems, Oppositional Defiant Problems, and Conduct Problem. Although the CBCL does not require administration by a clinician, someone with at least a graduate-level degree—that included coursework in standardized assessments—should administer it. The tool requires approximately 15 minutes for administration.

An assessment approach that uses brief semi-structured interviews to develop locally relevant indicators. In a semistructured interview, a central question is asked and discussed, from which themes and assessment data are derived. Following interviews, data is sorted, given thematic names, and eventually molded into assessment indicators by a group of researchers. Once a set of indicators is developed, it will need to first be piloted to test for accuracy in assessing intended areas of MHPSS. Although Brief Ethnographic Interviews can be used singularly, they are encouraged to be used in conjunction with other assessment approaches, such as focus groups and key informant interviews. Each interview takes about 15 minutes to complete.

A set of qualitative, participatory evaluation tools for monitoring and measuring the impact of psychosocial support programs for children. The tools consist of a series of leader-facilitated group activities (approximately one to two hours in duration) that are based on the following indicators: emotional self-awareness, independence, self-regard/self-worth, social networks, empathy, integration into the community, flexibility, problem-solving, contribution to own basic needs, normalization, skills and knowledge, happiness vs. depression, and optimism and future orientation. Program staff must first decide which of the pre-defined indicators it wishes to measure and then select tools/activities that match selected indicator(s). Each indicator contains three to eight activities, many of which involve group discussions and/or asking the children to draw. Selected children are invited to participate, given an explanation of the purpose of the activities, and then asked for informed consent. Activity groups consist of six to ten children, who should be divided by age groups (i.e. ages 6-10, 11-13, and 14-18). The activities both help children to recognize, understand and express their feelings, and assist staff of psychosocial programs in determining if programs are meeting pre-determined objectives.

A 21-item tool used to assess common mental health disorders in children aged 10-14  years. The tool is usually administered through a structured questionnaire by a trained interviewer. The scale has a recall period of one-week and ranges from scores of 21 to 63, with a higher score suggestive of poorer mental health. Possible responses include: Rarely, Sometimes, and Always.

Created by sociologist Robert Sampson and colleagues (1997), the 10-item Collective Efficacy Scale measures how well communities work together to make things happen. The scale has two parts. The informal social controlsection assesses how likely neighbors are to intervene when there is trouble, and the social cohesion and trustsection assesses how likely neighbors are to support each other in times of need.

The Brief-COPE is a 28 item self-report questionnaire designed to measure effective and ineffective ways to cope with a stressful life event. “Coping” is defined broadly as an effort used to minimise distress associated with negative life experiences.

The scale is often used in health-care settings to ascertain how patients are emotionally responding to a serious circumstance. It can be be used to measure how someone is coping with a wide range of adversity, including a cancer diagnosis, heart failure, injuries, assaults, natural disasters, financial stress or mental illness. The scale is useful in counselling settings for formulating the helpful and unhelpful ways someone responds to stressors.

The scale can determine someone’s primary coping styles with scores on the following three subscalse:

• Problem-Focused Coping
• Emotion-Focused Coping
• Avoidant Coping

In addition, the following facets of coping are reported: Self-distraction, Denial, Substance Use, Behavioural disengagement, Emotional Support, Venting, Humour, Acceptance, Self-Blame, Religion, Active Coping, Use of Instrumental Support, Positive Reframing, and Planning.