Evidence-Based Assessment of Childhood Trauma and Bereavement: An Integrative Developmentally Informed Approach

We draw upon principles of both evidence-based assessment and evidence-based clinical psychological assessment to propose a basic 4-step assessment method consisting of (1) Preparation, (2) Routine Evaluation, (3) In-Depth Assessment, and (4) Assessment During Active Treatment and Follow-up. The method uses an iterative, hypothesis-testing “detective” approach by generating hypotheses, gathering and evaluating data, then revising and re-evaluating hypotheses until key questions are addressed. The method relies on the best available research and assessment measures to triangulate phenomena across multiple sources and methods, reduce multiple types of measurement error, and build a clinically useful conceptual framework and treatment plan. We list measures to assess traumatic stress, posttraumatic stress disorder (PTSD), complex PTSD, bereavement, and prolonged grief disorder. We hypothesize pathways through which individual PTSD symptoms can cause functional impairment in developmentally important life domains, and propose measures to evaluate hypothesized impairment. We feature clinical reasoning tools (Stakeholder Model, Assessment Planning Grid, Eco-Check Heuristic) to support each assessment step and apply them to a running case example.