Trauma Screening

Screening students for trauma is a process that needs to take careful consideration in order to be effective and supportive to both students and clinicians. There are many possible screeners available and every screener is a tool to be used in the context of a safe and trusted relationship with a provider.

When screening for risk and trauma, it is important to also screen for resilience and protective factors and take into account the student’s overall wellbeing. Additionally, it is important to include education for the student as to why screening is taking place.

Screening can be used as a tool for prevention when it is included as a part of psychoeducation and connection to building upon students’ resilience.

Considerations for Trauma Screening

Screening Tools Implemented by SBHCs

Practices for Screening Students

There are many ways to integrate screening into practice. It is important to identify the resources, staff available, and level of preparedness to help determine the best process. Below are some examples of screening protocols:

  • PC-PTSD 5 is administered as a part of the annual intake screen by the Medical Assistant at least once a year. Results are reviewed by the Medical Provider who is then expected to discuss any positive screens with the patient during the medical visit. Referral or warm handoffs can be made to behavioral health as needed.
  • With the goal of reaching the whole school, the CBITS classroom screener administered in classrooms as often as possible if there is provider availability to respond to identified needs. Students scoring positive meet individually with behavioral health providers and those who opt in to receive group services participate in a 10-session CBITS group. Students with low risk are invited to participate in a classroom presentation with the Wellness Coordinator to learn about trauma signs, symptoms and supports.
  • When students are referred for services, screen for both protective factors and trauma symptoms using the Child and Youth Resilience Measure and the PTSD-Reaction Index 12-Item.

Practice Paper: The Role of SBHCs in Addressing ACEs

School-Based Health Centers (SBHCs) are well-positioned to coordinate care for some of California’s most medically underserved youth.

However, there is limited research on trauma-informed care and Adverse Childhood Experiences (ACEs) screening implementation in SBHCs. 

ETR and the California School-Based Health Alliance, with funding from ACEs Aware, published a practice paper on emerging practices and barriers and facilitators to implementing trauma-informed care, ACE screening, and care coordination for the prevention and treatment of toxic stress in SBHCs.