Why screen ~ and what these don't do.
Screenings are clinical instruments, not diagnoses. Their job is to surface signal you might otherwise miss ~ dissociation, complex PTSD, sensory sensitivity, attachment style ~ so you can plan treatment accordingly. None of them replaces a structured clinical interview, and none of them substitutes for a relationship.
C-SSRS ~ Columbia-Suicide Severity Rating Scale (Posner et al., 2011).
A six-question screening that quantifies suicidal ideation and behavior along a severity gradient ~ from passive wish to be dead through active ideation with plan and intent. The Columbia Protocol is the most widely adopted suicide risk screening in emergency, military, and outpatient settings. It belongs in every trauma clinician's intake because complex trauma clients carry elevated suicide risk that standard PTSD screenings do not capture.
Published with permission.
On using the C-SSRS in trauma practice
The Screen Version (Recent) is the one-page version you hand a client or read aloud. Questions 1–2 gate the rest: if both are "No," skip to Question 6 (behavior). If either is "Yes," continue through 3–5 to establish severity. The color coding ~ yellow (low), orange (moderate), red (high) ~ gives you an immediate visual triage.
This is not a diagnostic instrument. It's a conversation structure that documents risk level and guides your next clinical decision ~ safety planning, consultation, or referral. Use it at intake, at any point a client's presentation shifts, and before and after memory processing with clients who have a history of suicidal ideation.
Reference: Posner, K., Brown, G. K., Stanley, B., et al. (2011). The Columbia-Suicide Severity Rating Scale: Initial validity and internal consistency findings from three multisite studies with adolescents and adults. American Journal of Psychiatry, 168(12), 1266–1277. Columbia Lighthouse Project
DES-II ~ Dissociative Experiences Scale (Carlson & Putnam, 1993).
A 28-item self-report measure of dissociative experiences in daily life. The most widely used dissociation screening in trauma practice. Higher scores warrant follow-up with a structured interview (e.g., MID, SCID-D).
On scoring
The conventional cutoff (DES-II mean ≥ 30) flags possible dissociative disorder. Treat the cutoff as a conversation prompt, not a verdict. Many clients with significant dissociation score under 30; some clients who score over 30 do not have a dissociative disorder. Use the instrument to open the assessment.
A score above 30 should prompt a structured diagnostic instrument ~ the DDIS (Dissociative Disorders Interview Schedule) or the MID (Multidimensional Inventory of Dissociation) ~ to move from screening signal to diagnostic clarity.
ITQ ~ International Trauma Questionnaire (Cloitre et al., 2018).
A self-report measure aligned with ICD-11 PTSD and Complex PTSD. Distinguishes the core PTSD symptom cluster from the additional disturbances in self-organization (DSO) that mark CPTSD.
Sensitivity screening.
A short screening for sensory and emotional sensitivity. Useful for treatment planning around choice of ABLS form (tactile is the primary modality I use; some highly sensitive clients tolerate tones poorly, and others find eye movement activating), pacing, and the intensity of in-session interweaves.
Attachment screening.
A pre-session screening for attachment style. The result shapes how you build the alliance, how you offer resourcing (particularly nurturer/protector imaginal work), and which interweaves are likely to land or to activate attachment defenses.
BLS Tools.
A practical reference list for in-person tapping devices and online tools that simulate alternating bilateral stimulation for telehealth. Brand-agnostic ~ included for clinician convenience, not endorsement.