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Co-Occurring Disorders in Criminal Justice Settings

Screening for Trauma in Criminal Justice Settings

Many women and men with co-occurring disorders in the justice system have a history of trauma. Trauma histories are often not detected or addressed.

Consider the following:

Practitioners need to know a person's trauma history.

Traumatic experiences are associated with the development of substance using behavior. Detecting and addressing trauma can have beneficial effects for engaging and treating individuals with co-occurring disorders.

Trauma screening informs treatment planning.

Trauma screening helps agencies gain knowledge about an individual's exposure to trauma and any related symptoms (e.g., post-traumatic stress disorder—PTSD). This information can inform treatment planning and supervision.

The use of a standardized instrument may be more effective than taking an extensive history. Trauma screening and assessment instruments are designed to be delivered by a trained behavioral health practitioner in a safe environment. Screening should include a plan for responding to any needs that arise during the interview.

Screening instruments for trauma vary.

Screening tools vary on three factors: objective, specificity, and population of interest.

  • Objective. The objective of a trauma instrument is to identify an individual's experiences with traumatic events, such as abuse, assault, or combat. For example, a PTSD screening tool is designed to determine the likelihood of the disorder. Some PTSD screening tools also have a broader focus on related disorders.
  • Specificity. Screening instruments for trauma may vary in specificity. For trauma exposure, this means that some instruments gather in-depth information about specific events. Others focus on a single event or traumatic experiences in general. PTSD instruments may map to single or multiple traumatic experiences.
  • Population. Some instruments have been designed for specific population groups, such as combat veterans. For example, the PTSD Checklist exit disclaimer is available in three versions: civilian, military, and specific.

Remember these key points about screening for trauma.

  • Practitioners need to know about the trauma histories of justice-involved people with co-occurring disorders.
  • Trauma screening helps obtain knowledge about exposure and related symptoms, which can be addressed in treatment planning and delivery.

Resources and Links

  • Recognition of the significance and prevalence of trauma issues for individuals in the criminal justice system is growing, and systems are responding by becoming trauma-informed. In Trauma Services in Criminal Justice Settings: What, Why and How, Joan Gillece, Ph.D. presented information on what trauma is and how it can affect those involved in the criminal justice system. Flo Hepola, a mental health clinician, addressed the challenges to providing trauma services in the criminal justice setting and ways practitioners can address these challenges. The webinar concluded with a question-and-answer session with the presenters.

  • The VA National Center for PTSD web pages on assessment provide reviews of trauma exposure and post-traumatic stress disorder instruments. Separate assessment pages are directed to a general audience and to behavioral health practitioners.