Using measurement-based care in therapy
Administering assessments to diagnose and treat a client’s evolving symptoms can provide a picture of how your client is doing over time.
Learn more about the PCL-5 assessment and how you can incorporate it into your practice.
If you work with clients who have experienced significant trauma, you may be considering a diagnosis of post-traumatic stress disorder (PTSD). The DSM-5 is your best resource for considering this diagnosis, but screening tools like the PCL-5 can help you understand more about a client’s experience — and guide you in your diagnosis process.
Below, learn more about the PCL-5 assessment and how you can incorporate it into your practice.
The PCL-5 is a measurement that assesses the 20 DSM-5 symptoms of PTSD. It’s used to screen clients for PTSD, make provisional PTSD diagnosis, and monitor symptoms during treatment for the condition.
It’s a self-administered assessment, which means the client fills it out on their own, marking the symptoms they’re experienced in the last month and how frequently they’ve experienced them. Then, a medical provider scores the assessment based on the client’s answers.
The PCL-5 is a helpful supplement to use as part of a structured clinical assessment or interview, but it’s not a formal diagnostic tool on its own. As with any assessment, the PCL-5 can come with a self-reporting bias. You may consider using the results as a guide for what to assess when you meet with your client.
Previously, the PCL-5 for DSM-IV had three versions: PCL-M (military), PCL-C (civilian), and PCL-S (specific). Now, there’s only one version of the PTSD checklist in the updated DSM-5.
The PCL-5 assessment includes the following questions and prompts clients to mark “not at all,” “a little bit,” “moderately,” “quite a bit,” or “extremely.”
In the past month, how much were you bothered by:
Each measure on the assessment is measured on a four-point scale and assigned a certain number of points.
Extremely: 4 points
Quite a bit: 3 points
Moderately: 2 points
A little bit: 1 point
Not at all: 0 points
When each answer is assigned a point value, the total score for the PCL-5 assessment can range from 0–80. Some research suggests a PCL-5 score of 31-33 indicates probable PTSD, but keep in mind the results only suggest a provisional diagnosis.
While it’s often used as a tool for screening and diagnosing PTSD in new clients, the PCL-5 is also useful in re-assessing clients so you can adjust their treatment plan as needed. For example, if you diagnosed a client with post-traumatic stress disorder six months ago, you can re-issue the PCL-5 to determine the current severity of that person’s symptoms and adjust your treatment plan as needed. Assessing which questions scored higher can also inform the focus of your treatment plan and interventions provided, such as addressing nightmares specifically versus, say, beliefs of self-blame.
Administering assessments to diagnose and treat a client’s evolving symptoms can provide a picture of how your client is doing over time.
Learn more about the ADNM-8 assessment and how you can incorporate it into your practice.
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