Appendix
1. HMIS Provider Type Flowchart
2. VCRHYP Paperwork Manual
3. Evidence-Based Assessments & Screening Tools Chart
4. Memo re: Resiliency Assessment requirements & FYSB performance measures
NO
How old is the youth? How old is the youth?
Under 12 or over 17
12-17
Is the youth in DCF custody?
Under 16 or over 21
Youth may be served by your agency or
connected with a community partner, but
should not be open in HMIS for VCRHYP
services
Youth may be served by your agency or connected with a
community partner, but should not be open in HMIS
for VCRHYP services
NO
YES
Are you providing the youth with shelter (not including
brokered housing)? YES
NO
Open in BCP Shelter
Open in BCP Prevention
18-21
Is the youth a runaway, experiencing homelessness/
housing instability, or at risk of running away/becoming homeless
due to family conflict or other crisis?
What is the youth’s main reason for accessing services?
Independent living Family reunification/stabilization
Are you providing housing to the youth
(either in agency-owned or agency-master-leased
units)?
YES
Open in TLP
HMIS PROVIDER TYPE FLOWCHART For internal use only, please do not distribute
NO
Is the youth in DCF custody?
YES
16-17
NO YES
VCRHYP Paperwork Manual, updated 2/5/2019 1
VCRHYP PAPERWORK MANUAL
Table of Contents
Intake Assessment 2
Resiliency Assessment 3
Quarterly Update 4
Exit Assessment 5
Project Reentry Form 6
Project Switch Form 7
VCRHYP Paperwork Manual, updated 2/5/2019 2
VCRHYP Intake Assessment
Use when: • A new client enters a project • A previously-served client enters a project and it has been a full month or more
since they were last exited Do not use when:
• A client is reentering the same project they exited from less than one month ago o See Project Reentry Form on pg. 6
• A client is switching between projects due to changes in circumstances, eligibility, etc.
o See Project Switch Form on pg. 7 This form:
• Includes questions you are required to ask by FYSB, as well as questions VCRHYP suggests asking
o All questions required by FYSB need to be answered completely § Check the “Data not collected” box if you did not ask a FYSB-
required question o Non-FYSB required questions are italicized
§ Check “Data not collected” if you did not ask a non-FYSB required question
• Should be sent to VCRHYP to be entered into HMIS Things to remember:
• All member agencies, except for Spectrum, will choose VT-500 Vermont Balance of State CoC for “Client Location”
• Documentation of disabilities is not required: a youth’s self-report is considered sufficient to answer “Yes”
• Dr. Dynasaur should be marked off as “Medicaid” in the Health Insurance section • Monthly income only needs to be gathered for youth in TLP • If a youth/family cannot answer the questions about current or past DCF
involvement and sign a Release of Information, you should follow-up with your DCF district office to try and get this information; if you are successful in getting it, pass it onto VCRHYP so we can update the youth’s data in HMIS
VCRHYP Paperwork Manual, updated 2/5/2019 3
VCRHYP Resiliency Assessment
Use when: • A new client enters a project • A previously-served client enters a project and it has been a full month or more
since they were last exited • Client has been served in a project for 6 months
Do not use when:
• A client is reentering the same project they exited from less than one month ago • A client is switching between projects due to changes in circumstances,
eligibility, etc. This form:
• Should be completed at entry and every six months the youth is being served • Needs to have a box checked for each statement • Can have a response written for each follow-up question • Should be used to inform Plan of Care creation and updates • Must be kept in client files, as VCRHYP no longer collects them for entry into
HMIS
VCRHYP Paperwork Manual, updated 2/5/2019 4
VCRHYP Quarterly Update
Use when: • Each three month quarter (based on federal fiscal year) is coming to end
(Quarter 1: December, Quarter 2: March, Quarter 3: June, Quarter 4: September) Do not use when:
• A client first enters a project • A client is switching between projects • A client is exiting a project
This form:
• Must have answers for the four questions in the Employment and Enrollment Status section
• Should indicate what is true for the client at the time of review • Needs to indicate a review date, as well as the quarter being reviewed • Should indicate any services provided to a client during the quarter • Should be sent to VCRHYP to be entered into HMIS
o The Disability Addendum does not need to be sent to VCRHYP unless there have been changes to a client’s disability status
Things to remember:
• You can write “No Changes” above any section on the form that remains the same for the client (except for the Employment and Enrollment Status section, which must have answers)
• VCRHYP will send a reminder to complete Quarterly Updates in the last month of each quarter, along with a list of youth who have been served during the quarter
o A Quarterly Update must be submitted for all youth served during the quarter, even those who have exited
§ However, for youth who have exited during the quarter, the only sections that need to be completed are Employment and Enrollment Status and Brokered Housing
VCRHYP Paperwork Manual, updated 2/5/2019 5
VCRHYP Exit Assessment
Use when: • A client is exiting from a project
Do not use when:
• A client is switching between projects due to changes in circumstances, eligibility, etc.
This form:
• Should include answers in the TLP Outcomes section if a client is receiving TLP services
• Includes a Services Provided section to ensure that all services provided to the client during project enrollment are entered into HMIS
• Should be sent to VCRHYP to be entered into HMIS o The Disability Addendum does not need to be sent to VCRHYP unless
there have been changes to a client’s disability status Things to remember:
• A client should be exited from a project if a full month passes without any engagement
VCRHYP Paperwork Manual, updated 2/5/2019 6
VCRHYP Project Reentry Form
Use when: • A client is reentering the same project they exited from less than one month ago
Do not use when:
• A client is entering a different project than the one they exited from, regardless of how much time has passed since the client’s exit
o See Project Switch Form on pg. 7 • A client’s circumstances have changed drastically and a full Intake Assessment
would better reflect a client’s current situation than this form
This form: • Is a shortened version of the Intake Assessment • Includes questions you are required to ask by FYSB, as well as questions VCRHYP
suggests asking o All questions required by FYSB need to be answered completely
§ Check the “Data not collected” box if you did not ask a FYSB-required question
o Non-FYSB required questions are italicized § Check “Data not collected” if you did not ask a non-FYSB required
question • Should be sent to VCRHYP to be entered into HMIS
VCRHYP Paperwork Manual, updated 2/5/2019 7
VCRHYP Project Switch Form
Use when: • A client is switching between projects due to changes in circumstances,
eligibility, etc. Do not use when:
• A client is reentering the same project they exited from less than one month ago o See Project Reentry form on pg. 6
This form: • Is a combination of the Exit Assessment and the Intake Assessment • Includes questions you are required to ask by FYSB, as well as questions VCRHYP
suggests asking o All questions required by FYSB need to be answered completely
§ Check the “Data not collected” box if you did not ask a FYSB-required question
o Non-FYSB required questions are italicized § Check “Data not collected” or leave question blank if you did not
ask a FYSB-required question • Should be sent to VCRHYP to be entered into HMIS
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 1
Evidence-BasedAssessment&ScreeningTools
TableofContentsMentalHealthandOverallWell-Being pg.2AddictionandSubstanceUse pg.12Trauma/AbuseHistory pg.13FamilyCohesion/Functioning pg.18LifeSkillsandIndependentLiving pg.19Vocational/CareerInterests pg.20AcademicSkills pg.22PermanentConnections pg.23ComprehensiveCasePlanningTools pg.23Index pg.26
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 2
Target
Population Purpose/DescriptionTimeto
AdministerCompleted
ByTraining/
QualificationsNeeded
Availability
MENTALHEALTHandOVERALLWELL-BEINGConnor-DavidsonResilienceScale–CD-RISC2ORCD-RISC-10ORCD-RISC25
Youthages10-18;Adults
2-itemOR10-itemOR25-itemscaleusedasameasureofdegreeofresilience,apredictorofoutcometotreatmentwithmedicationorpsychotherapy,stressmanagement,andresilience-building,amarkerofprogressduringtreatment,andamarkerofbiologicalchangesinthebrain
1-5min.(CD-RISC2&CD-RISC10)OR5-10min.
Unknown Unknown;User’smanualprovided
Agencymustsubmitaprojectinformationformandthensignanagreement
PediatricSymptomChecklist-17(PSC-17)
Youthages4-18
17-itemquestionnairethatreflectsparents’impressionsoftheirchild’spsychosocialfunctioning;Intendedtofacilitatetherecognitionofemotional&behavioralproblemssothatappropriateinterventionscanbeinitiatedasearlyaspossible
3minutes Parent/Guardian
Refertoscreeninginstructionsbeforeusing
Free;DownloadfromMassachusettsGeneralHospital
BeckDepressionInventory-II(BDI-II)
Youthage13&up;Adults
21-iteminstrumentusedtoassesstheintensityofdepressionbasedontheDSM-IV’scriteria
5minutes ClientorYouthCareWorker
RequiresPearsonQualificationLevelB;Briefonlinetrainingvideoavailable
AgencymustpurchasedfromPearson
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 3
ReynoldsAdolescentAdjustmentScreeningInventory(RAASI)
Youthages12-19
32-itemself-reportmeasurethatprovidesindicationsoftheclinicalseverityofthemostmeaningfuldomainsofpsychologicaladjustmentproblems;Providesanadjustmenttotalscoreandscoresinfourscales
5minutes YouthCareWorker
RequiresPARQualificationLevelB;Manualprovided
AgencymustpurchasefromPAR
YouthOutcomeQuestionnaire30.2–Self-Report(Y-OQ30.2SR)ORParent/Guardian(Y-OQ30.2PR)
Youth(Agesnotspecified)
Brieftooldesignedtobeincorporatedintotherapyinanunobtrusivemanner;Allowsacliniciantotrackclients’progressandfindtheoneswhoarenotontrack
5minutes ClientorParent/Guardian
Unknown AgencymustpurchasefromOQMeasures
MassachusettsYouthScreeningInstrument–SecondVersion(MAYSI-2)
Youthages12-17
52-itembriefscreeningtoolusedtoidentifyyouthwhomayhaveimportant,pressingbehavioralneeds;Providesscoreson7scales;Usedprimarilyinjuvenileprobation,diversionprograms,andintakeinjuveniledetentionorcorrections
5-10minutes
Youth None;Manualprovided
AgencymustpurchasemanualandregisteruserwiththeMAYSI-2Project
MoodandFeelingsQuestionnaire–ShortForm(MFQ-SF)ORLongForm(MFQ)
Youthage8&up
13-itemOR33-itemquestionnairebasedonDSM-III-Rcriteriafordepression;Consistsofaseriesofdescriptivephrasesregardinghowtheyouthhasbeenfeelingoractingrecently
5minutesOR5-10min.
ClientorParent/Guardian
None Free;DownloadfromDukeUniversity
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 4
StrengthsandDifficultiesQuestionnaire(SDQ)
Youthages2-17
Mentalhealthscreeningtoolthatasksabout25psychologicalattributesandtheirimpact
5-10min. ClientorParent/Guardian
Websitesavailableasresources
Free;DownloadfromYouthinMind
ReynoldsAdolescentDepressionScale–2ndEdition(RADS-2)ORShortForm(RADS-2:SF)
Youthages11-20
30-itemself-reportscalemeasures4basicdimensionsofdepressionandprovidesanindicationoftheclinicalseverityofdepressivesymptoms(RADS-2)ORbriefscreeningmeasurethatassessesthefrequencyofsymptomsthatarepositivepsychopathologicalsignsofadepressivedisorder,alertsthatclientmayrequireimmediateclinicalattention,andquicklydeterminesthoseinneedoffurthertreatment(RADS-2:SF)
5-10min. Unknown RequiresPARQualificationLevelB;Manualprovided
AgencymustpurchasefromPAR
GlobalAppraisalofIndividualNeedsShortScreener(GAIN-SS)
Nonespecified
23-itemscreeningtooltoquicklyandaccuratelyidentifyclientswhomayneedareferraltobehavioralhealthtreatment;Screensforinternalizingdisorders,externalizingdisorders,substancedisorders,andcrime/violence
5-10min. ClientorYouthCareWorker
1hourself-pacedonlinetrainingcourse
AgencymustpurchasefromGAINCoordinatingCenter
Children’sDepressionInventory2ndEdition(CDI2)–ShortORParentORSelf-Report
Youthages7-17
12-itemOR17-itemOR28-itemcomprehensivemulti-raterassessmentofdepressivesymptoms
5minutesOR10minutesOR20minutes
ClientorParent/Guardian
RequiresMulti-HealthSystemsB-LevelQualification;Manualprovided
AgencymustpurchasefromMulti-HealthSystems
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 5
BriefSymptomInventory(BSI)
Youthage13&up;Adults
53-iteminventorythatgathersclient-reporteddatatoprovideanoverviewofpsychologicalsymptomsandintensity
8-10min. YouthCareWorker
RequiresPearsonQualificationLevelB;20-30min.onlinetrainingsessionavailable;Manualprovided
AgencymustpurchasefromPearson
SymptomAssessment-45Questionnaire(SA-45)
Youthages13&up;Adults
45-itemassessmentofsymptomatologythatcanbeusedasascreeningtool,tohelpformulatediagnoses,todeveloptreatmentplans,andtomeasureoutcomes
10minutes Client RequiresMulti-HealthSystemsB-LevelQualification;Manualprovided
AgencymustpurchasefromMulti-HealthSystems
Children’sInventoryofAnger(ChIA)
Youthages6-16
39-iteminventorythatidentifiesthekindsofsituationsthatprovokeangerinparticularyouth,aswellastheintensityoftheirangerresponse
10minutes Client Manualprovided
AgencymustpurchasefromWPS
BehavioralandEmotionalRatingScale–2ndEdition(BERS-2)
Youthages5-18
Measurespersonalstrengthsandcompetenciesfromtheperspectiveoftheyouth,theparent,andtheteacher/youthcareworker
10minutes YouthCareWorker
RequiresPARQualificationB;Manualprovided
AgencymustpurchasefromPAR
MentalHealthScreeningTool(MHST)
Youthages5-18
Rapidlyscreensyouthforareferralforamentalhealthassessmentanddeterminesurgencyofneed;Originallydesignedforyouthbeingconsideredforoutofhomeplacement
10minutes YouthCareWorker
Manualprovided
Free;DownloadfromCaliforniaInstituteforBehavioralHealthSolutions
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 6
ScreenforChildhoodAnxietyRelatedtoEmotionalDisorders(SCARED)
Youthages8-18
41-itemself-reportinstrumentusedtoscreenforchildhoodanxietydisorder,panicdisorder,andsocialphobia
10minutes ClientorParent/Guardian
Importanttounderstandthemeaningofthescoresbeforeusing
Free;DownloadfromUniversityofPittsburgh
CopingInventoryforStressfulSituations–Adolescent(CISS:Adolescent)ORAdult(CISS:Adult)
Youthages13-18ORAdults
48-itemself-reportinstrumentmeasuresthreetypesofcopingstylesineitheradolescentsoradults;Helpsdeterminethepreferredcopingstyleofaclientandcontributestoanoverallunderstandingoftherelationshipbetweenaclient’scopingstyleandtheirpersonality
10minutes Client RequiresMulti-HealthSystemsB-LevelQualification;Manualprovided
AgencymustpurchasefromMulti-HealthSystems
CopingInventoryforStressfulSituations–Situation-SpecificCoping(CISS:SSC)
Adults
21-itemself-reportinstrumentthatexaminesadesignatedevent,suchasachangeinsocialsituation,changeinrelationship,orapersonalconflict
10minutes Client RequiresMulti-HealthSystemsB-LevelQualification;Manualprovided
AgencymustpurchasefromMulti-HealthSystems
EmotionalQuotientInventory:YouthVersion(EQ-i:YV)–Short-LengthORFull-Length
Youthages7-18
30-itemOR60-itemself-reportinstrumenttoassessemotionalintelligenceinchildrenandteenagers;Short-lengthmeasures5keyareas;Full-lengthalsomeasuresgeneralmoodandinconsistencyandisrecommendedforinitialevaluationswithclients
10minutesOR30minutes
Client RequiresMulti-HealthSystemsB-LevelQualification;Manualprovided
AgencymustpurchasefromMulti-HealthSystems
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 7
SchoolSituationSurvey(SSS)
YouthinK-12thgrade
34-itemsurveytoassessayouth’sperceptionsofschool-relatedsourcesandmanifestationsofstress
10-15min. Client Manualprovided
AgencymustpurchasefromMindGarden
ChildandAdolescentFunctionalAssessmentScale(CAFAS)
Youthages5-19
Assessesfunctioningacross8areasinayouth’slife(school,home,community,behaviortowardsothers,moods,self-harm,substanceabuse,thinking)and2areasincaregiverfunctioning(materialneeds,socialsupport)
10-15min. YouthCareWorker
AgencyReferenceManualsandSelf-TrainingManualsprovided
AgencymustpurchasefromMulti-HealthSystems&payanAnnualMaintenanceFee
PsychosocialEvaluation&ThreatRiskAssessment(PETRA)
Youthages11-18
Assessespsychosocialsymptomatologyandriskofviolencethreatamongadolescents;Followingathreatofviolence,thetoolenablesyoutoanalyzethecontextofpsychosocial,ecological,andcoping/resiliencyfactorstoassistintheidentification,assessment,intervention,treatmentplanning,andbehavioralmanagementofadolescentswhoposeariskoftargetedviolencetowardothers
10-15min. YouthCareWorker
RequiresPARQualificationLevelS;Manualprovided
AgencymustpurchasesfromPAR
AdolescentCopingScale:2ndEdition(ACS-2)–ShortFormORLongForm
Youthages12-18
Designedtosupportyoungpeoplewhenexaminingtheirowncopingbehavior;Measurestheusageandhelpfulnessof20distinctcopingstrategies
10-15min.OR20-30min.
YouthCareWorker
DegreeinPsychologyorSocialWorkrequired;Assessment-specifictraining
AgencymustpurchasefromtheAustralianCouncilforEducationalResearch
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 8
SocialSkillsImprovementSystemRatingScales(SSIS)
Youthages3-18
Enablestargetedassessmentofindividualsandsmallgroupstoevaluatesocialskills,problembehaviors,andacademiccompetence;Formsavailableforteacher,parent,andyouth
10-25min. Unknown RequiresPearsonQualificationLevelB;Manualprovided
AgencymustpurchasefromPearson
ChildHealthQuestionnaire–ChildSelf-ReportedVersion(CHQ-CF87)
Youthages10-18
87-itempediatricqualityoflifesurveythatmeasures14uniquephysicalandpsychosocialconcepts
15minutes Client Unknown AgencymustreceivepermissionandpurchasefromHealthActCHQ
ResiliencyScalesforChildren&Adolescents–AProfileofPersonalStrengths(RSCA)
Youthages9-18
Threestand-alonescales(SenseofMastery,SenseofRelatedness,EmotionalReactivity)of20-24questionseachthatmeasuresthepersonalattributesoftheyouththatarecriticalforresiliency
15minutes(5minutesperscale)
Unknown RequiresPearsonQualificationLevelB;Manualprovided
AgencymustpurchasefromPearson
PersonalityInventoryforYouth(PIY)–ScreenerORFullScale
Youthages9-19
80-itemOR270-iteminstrumentcovering9clinicalscalesthatmeasureemotional&behavioraladjustment,familyinteraction,andacademicfunctioning
15minutesOR45minutes
Client RequiresWPSQualificationC;Manualprovided
AgencymustpurchasefromWPS
State-TraitAnxietyInventoryforChildren(STAI-CH)
Youthinupperelementary&juniorhighschool
40-iteminstrumentmeasuresanxietyinchildren;Distinguishesbetweenageneralpronenesstoanxiousbehaviorrootedinpersonalityandanxietyasafleetingemotionalstate
20minutes Client Manualprovided
AgencymustpurchasefromMindGarden
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 9
JuvenileInventoryforFunctioning(JIFF)
Youthages5-19
Hands-on,interactive,computerizedinterviewthatcovers10lifedomains(school/work,home,familyenvironment,peerinfluence,communitybehavior,feelings,self-harmpotential,substanceuse,healthrelatedneeds,rationalthinking)
15-30min. ClientorParent/Guardian
None AgencymustpurchasefromMulti-HealthSystems&payanAnnualMaintenanceFee
Child&AdolescentRisk/NeedsEvaluation(CARE-2)
Youthages6-19
A57-itemassessmentthatmeasuresriskfactorsassociatedwithyouthviolence,aswellasprotectivefactors;ScoredassessmentisusedtocompletetheCaseManagementPlanningFormthathelpscliniciansgaugetheintensityofpotentialbehaviorproblemsandidentifytheappropriatelevelandtypesofinterventionsneeded
15-30min. YouthCareWorker
Unknown AgencymustpurchasefromCare2Systems
Mayer-Salovey-CarusoEmotionalIntelligenceTest(MSCEIT)
Notspecified
Evaluatesemotionalintelligence;Testsabilitytoperceive,use,understand,andregulateemotions;Measureshowwellpeopleperformtasksandsolveemotionalproblems
30-45min. Client RequiresMulti-HealthSystemsB-LevelQualification
AgencymustpurchasefromMulti-HealthSystems
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 10
LifeStressorsandSocialResourcesInventory–Youth(LISRES-Y)ORAdult(LISRES-A)
Youthages12-18ORAdults
Structuredinterviewthatmonitorsongoinglifestressors&socialresources;Covers8majorareasoflifeexperience
30-60min. YouthCareWorker
RequiresPARQualificationB;Manualprovided
AgencymustpurchasefromPAR
ChildandAdolescentPsychiatricAssessment:V4.2(CAPA)–ChildORParent
Youthages9-18
Interviewer-basedstructureddiagnosticinterviewwithversionstousewithchildrenORparents;Assessessymptomsandpotentialareasofincapacity
1.5hours YouthCareWorker
Formaltrainingisrequiredandmustberequested
AgencymustreceivepermissionandpurchasefromDukeUniversity
YoungAdultPsychiatricAssessment(YAPA)
Youth(Agesnotspecified)
AmodificationoftheCAPA(above)thatissuitableforusewithyoungadults;Providesafocusondiagnoses,livingsituations,relationships,andareasoffunctioningrelevanttotheyoungadultagegroup
Unknown Unknown Formaltrainingisrequiredandmustberequested
Free;AgencymustreceivepermissionfromDukeUniversity
FunctionalAssessmentRatingScale–Children(CFARS)ORAdult(FARS)
Youth(Agesnotspecified)ORAdults
Assessescognitive,social,androlefunctioning
Unknown YouthCareWorker
CertificationrequiredthroughtheFLDCFTraining&CertificationSystemforCFARSORFARS
Free;DownloadfromtheUniversityofSouthFlorida
OptumSFHealthSurvey–SF-12v2ORSF-36v2
Adults 12-itemOR36-itemquestionnairetomeasurefunctionalhealthandwell-beingfromtheclient’spointofviewacross8domains
Unknown ClientorYouthCareWorker
Unknown AgencymustrequestsurveylicensefromOptum
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 11
YouthOutcomeQuestionnaire-Y-OQ2.01ORTherapeuticAlliance(Y-OQ2.01TA)
Youthages4-17
64-itemOR68-itemparentreportmeasurestreatmentprogressforyouthreceivingmentalhealthintervention;Designedtoreflectthetotalamountofdistressayouthisexperiencing;Indicatesthosewhomayneedimmediateinterventionbeyondstandardoutpatienttreatment;TherapeuticAllianceversionalsoassessesyouth’sperceptionoftherelationshipbetweenthemselvesandtheprovider
Unknown Parent/Guardian
Unknown AgencymustpurchasefromOQMeasures
YouthOutcomeQuestionnaire–SelfReport(Y-OQSR2.0)ORTherapeuticAlliance(Y-OQSRTA2.0)
Youth(Agesnotspecified)
64-itemOR69-itemself-reportversionoftheYouthOutcomeQuestionnaire(above)designedtocapturetheyouth’svoice;Canbeusedintrackingtreatmentprogressforyouthreceivingtherapyorcounseling;Indicatesthosewhomayneedimmediateinterventionbeyondstandardoutpatienttreatment;TherapeuticAllianceversionalsoassessesyouth’sperceptionoftherelationshipbetweenthemselvesandtheprovider
Unknown Client Unknown AgencymustpurchasefromOQMeasures
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 12
OhioScalesforYouth
Youthages12-18
Briefmeasureofoutcomesforyouthreceivingmentalhealthservices;Youthandparentscalesinclude20-itemproblemseverityscale,20-itemfunctioningscale,satisfactionwithtreatmentscale,andhopefulnessscale;Youthcareworkerscaleincludes20-itemfunctioningscaleandrestrictivenessoflivingenvironmentscale
Unknown ClientorParent/GuardianorYouthCareWorker
Onlinetrainingaidsavailable
AgencymustpurchasefromBrighamYoungUniversity
YouthAssessmentandScreeningInstrument(YASI)
Youthages10-25
Pre-screenorfullassessmenttoolmeasuresbothriskandstrengthsinjuvenilepopulationsorotherhighriskyouth;Includescaseplanningcomponent;Covers10domains
Unknown Unknown Unknown AgencymustpurchasefromOrbisPartners
ADDICTIONandSUBSTANCEUSECAGE–AdaptedtoIncludeDrugs(CAGE-AID)
Nonespecified
4-itemscreeningquestionnairetoindicateaneedforfurtherdrug/alcoholassessments
1minute ClientorYouthCareWorker
Instructionsappearonform
Free;DownloadfromSBIRT
PersonalExperienceScreeningQuestionnaire(PESQ)
Youthages12-18
40-itemquestionnairetoscreenyouthforsubstanceabuse;Identifiesyouthwhoshouldbereferredforacompletechemicaldependencyevaluation;Measuresproblemseverity,psychosocialitems,anddrugusehistory
10minutes YouthCareWorker
RequiresWPSQualificationB;Manualprovided
AgencymustpurchasefromWPS
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 13
SubstanceAbuseSubtleScreeningInventory–Adolescent(SASSI-A2)ORAdult(SASSI-4)
Youthages12-18ORAdults
Identifieshigh/lowprobabilityofsubstanceusedisorders;Measureslevelofdefensiveness;SASSI-A2providesclinicalinsightintofamily&socialriskfactors;SASSI-4includesprescriptiondrugscaleandprovidesameasureofwillingnesstoacknowledgeexperiencedconsequencesofsubstanceuse
15minutes YouthCareWorker
MustmeetTheSASSIInstitute'sQualificationsforTestPurchase
AgencymustpurchasefromTheSASSIInstitute
PersonalExperienceInventory(PEI)
Youthages12-18
Self-reportinventoryhelpsidentify,refer,andtreatyouthwithdrug&alcoholprograms;Coversallformsofsubstanceabuse,assessesbothchemicalinvolvementandpsychosocialproblems,anddocumentstheneedfortreatment;Identifiespersonalriskfactorsthatmayprecipitateorsustainsubstanceabuse
45minutes YouthCareWorker
RequiresWPSQualificationC;Manualprovided
AgencymustpurchasefromWPS
TRAUMA/ABUSEHISTORYChildhoodTraumaQuestionnaire:ARetrospectiveSelf-Report(CTQ)
Youthages12&up
28-itemquestionnaireforahistoryofchildabuse&neglect(physical/sexual/emotionalabuse&emotionalneglect);Includesaminimization/denialscalefordetectingindividualswhomaybeunderreportingtraumaticevents
5minutes Client RequiresPearsonQualificationLevelB;Manualprovided
AgencymustpurchasefromPearson
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 14
ReportofPost-TraumaticSymptoms–Child(CROPS)ORParent(PROPS)
Youthages7-17OR6-17
26-itemscalethatassessesposttraumaticsymptoms;Acceptableforusewithyouthwhodonothaveanidentifiedtraumaticevent;Canbeusedtomonitorchangesinsymptomsovertime
5minutes Client,YouthCareWorker,orParent/Guardian
Psychologistsorthoseunderthesupervisionofpsychologists
AgencymustpurchasefromChildTraumaInstitute
JuvenileVictimizationQuestionnaire2ndRevision(JVQ-R2)-ReducedItemORScreenerSum
Youthages8-17;Adults
Screenerforchildhoodvictimizationexperiences(conventionalcrime,childmaltreatment,peer/siblingvictimization,sexualvictimization,witness/indirectvictimization);Formsavailableforyouth,caregivers,oradults;Versionsavailabletoaskaboutlifetimeexperiencesorexperiencesinthepastyear
5-10min.OR10-15min.
ClientorParent/Guardian
Traininginpsychological&epidemiologicalassessment;Para-professionalsmayadministerundersupervision
Free;DownloadfromCrimesAgainstChildrenResearchCenter;Citationmustbeused
RevisedConflictTacticsScales(CTS2)
Adults 78-itemtooltoassesspartnerviolenceacross5dimensions
10minutes ClientorYouthCareWorker
Handbookprovided
AgencymustpurchasefromWPS
ConflictTacticsScales:Parent-ChildVersion(CTSPC)
Parents/caregiversofyouth(Agesnotspecified)
35-itemtooltoassesschildmaltreatmentandparent-to-childviolence;Scores6dimensions(nonviolentdiscipline,psychologicalaggression,physicalassault,weeklydiscipline,neglect,sexualabuse)
10minutes Parent/GuardianorYouthCareWorker
Handbookprovided
AgencymustpurchasefromWPS
AbuseRiskInventoryforWomen(ARI)
Adultwomen
25-itemscreeningdevicetohelpidentifywomenwhohavebeen,orareatriskofbeing,abused
10-15min. Client Manualprovided
AgencymustpurchasefromMindGarden
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 15
ChildPTSDSymptomScale(CPSS)–Self-ReportORInterview
Youthages8-18
24-itemmeasuretoassessforthepresenceandfrequencyofPTSDsymptomsduringthepastmonthinyouthwhohaveexperiencedatraumaticevent
10-15min.OR20minutes
ClientORYouthCareWorker
Mentalhealthprofessionalwithclinicaltraininganddiagnosticassessmentexperience
Free;[email protected]
AdolescentDissociativeExperiencesScale(A-DES)
Youthages11-17
30-itemself-reportmeasureofnormative&pathologicaldissociation;Ascreeningtooldesignedtoidentifyyouthinneedoffurtherassessment
10-15min. Client None Unknown;[email protected]
LosAngelesSymptomsChecklist(LASC)
Youth(Agesnotspecified);Adults
43-itemmeasureofPTSDsymptomsandgeneralpsychologicaldistress;GeneraldistressitemsweredevelopedtoreflectsymptomsthatareoftenassociatedwithPTSD
10-20min. Youthcareworker
Qualifiedmentalhealthprofessionals
Free;[email protected]
TraumaEventsScreeningInventory–Self-Report(TESI-SRR)
Youthages8-18
Briefmeasuretoscreenforlifetimeexposuretopotentiallytraumaticevents;Maybeadministeredaseitheraquestionnaire(26items,10-30min.)orasasemi-structuredclinicalinterview(15items,20-30min.)
10-30min. ClientorYouthCareWorker
Licensedforindependentpracticeinchildassessment&psychotherapyw/childtraumasurvivors/family
Free;[email protected]
TraumaEventsScreeningInventory–Parent-Report(TESI-PRR)
Parents/caregiversofyouthages4-7
26-itemquestionnairetoscreenforachild’slifetimeexposuretopotentiallytraumaticeventsasreportedbytheirparentorguardian
10-30min. Parent/Guardian
Sameasabove(forTESI-SRR)
Free;[email protected]
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 16
JuvenileVictimizationQuestionnaire2ndRevision(JVQ-R2)-AbbreviatedInterviewORFullInterview
Youthages8-17;Adults
Comprehensiveevaluationofchildhoodvictimizationexperiences(conventionalcrime,childmaltreatment,peer/siblingvictimization,sexualvictimization,witness/indirectvictimization);Formsavailableforyouth,caregivers,oradults;Versionsavailabletoaskaboutlifetimeexperiencesorexperiencesinthepastyear(Abb.);Supplementsavailabletoevaluateexposuretofamilyviolence,neglect,andrelationalvictimization(Full)
15-20min.OR20-30min.
YouthCareWorker
Traininginpsychological&epidemiologicalassessment;Para-professionalsmayadministerundersupervision
Free;DownloadfromCrimesAgainstChildrenResearchCenter;Citationmustbeused
TraumaSymptomChecklistforChildren(TSCC)
Youthages8-16
54-itemself-reporttoolmeasuresposttraumaticstressandrelatedpsychologicalsymptomatologyinyouthwhohaveexperiencedtraumaticevents(physical/sexualabuse,majorloss,naturaldisasters,witnesstoviolence);Usefulinassessingsymptomsrelatedtoacute,single-eventtraumasaswellasrepeatedorchronictraumaexposure;Canbeusedtomonitorsymptomchangesovertime/treatment
15-20min. Unknown RequiresPARQualificationB;Manualprovided
AgencymustpurchasefromPAR
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 17
UCLAPosttraumaticStressDisorderReactionIndex(UCLAPTSD-RI)
Youthages7-18
Self-reportmeasuretoassessayouth’shistoryofexposuretopotentiallytraumaticeventsandscreenforfrequencyofDSM-IVPTSDsymptoms;Child(7-12),adolescent(13-18),andparent-reportversionsavailable
15-30min. ClientorYouthcareworker
Qualifiedmentalhealthprofessionalsorgraduatestudentunderthesupervisionofalicensedmasterslevelclinician
Free;[email protected]@mednet.ucla.edu
TraumaSymptomInventory-2(TSI-2)
Adults 136-itemassessmentevaluatesposttraumaticstressandotherpsychologicalsequelaeoftraumaticevents(sexual/physicalassault,intimatepartnerviolence,combat,torture,motorvehicleaccidents,masscasualtyevents,medicaltrauma,traumaticlosses,childhoodabuse/neglect)
20minutes Unknown RequiresPARQualificationB;Manualprovided
AgencymustpurchasefromPAR
Clinician-AdministeredPTSDScaleforDSM-5–Child/AdolescentVersion(CAPS-CA-5)
Youthages7&up
30-itemscaleassessesthe20DSM-5PTSDsymptoms;Questionstargetonset&durationofsymptoms,subjectivedistress,impactonsocialfunctioning,developmentimpairment,overallresponsevalidity,overallPTSDseverity,improvementofsymptoms,andspecificationsfordissociativesubtype
Unknown Youthcareworker
Master’sdegreeinclinicaldiscipline;4.5houronlinetraining;TechnicalmanualsavailablefromWPS
AgencymustcompleteanAssessmentRequestFormorpurchasefromWPS
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 18
FAMILYCOHESION/FUNCTIONINGEybergChildBehaviorInventory(ECBI)
Youthages2-16
7-pointintensityscaleandayes-or-noproblemscalethatassessesthecurrentfrequency&severityofdisruptivebehaviorsinthehomesettingandtheextenttowhichparentsfindthebehaviortroublesome
5minutes Parent/Guardian
RequiresPARQualificationB;Manualprovided
AgencymustpurchasefromPAR
ProtectiveFactorsSurvey(PFS)
Youth(Agesnotspecified)
20-itemsurveyassessestheperceivedpresenceof5protectivefactorsagainstchildabuseandneglect(familyfunctioning/resiliency,socialsupport,concretesupport,childdevelopment/knowledgeofparenting,nurturing&attachment)
10-15min. Parent/Guardian
Trainingprotocolsareprovidedinthemanual
Free:DownloadfromFRIENDSNationalResourceCenter
FamilyEnvironmentScale(FES)
Youthage11&upandtheirfamilymembers
90-itemassessmentthatevaluatesthesocialenvironmentofthefamilyunitthrough3dimensionsand3perceptions:real,ideal,expected
15-20minutes
Clientandtheirfamilymembers
Manualprovided
AgencymustpurchasefromMindGarden
CaregiverWishList(CWL)
Youthages3-19
Computerizedinterviewthatallowsparents/caregiverstoreportontheirchildrenandtheirownparentingbehaviorsacross6keyareas
30minutes Parent/Guardian
None AgencymustpurchasefromMulti-HealthSystems&payanAnnualMaintenanceFee
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 19
NorthCarolinaFamilyAssessment(NCFAS)
Familymembersofallages
Designedtoexaminefamilyfunctioningin5domains;Conductingassessmentatthebeginningofservice,at90-dayintervals,andattheendofserviceprovidesworkerswiththeopportunitytoprioritizegoalsandservices;Obtainingsufficientinformationmayrequireanumberofhoursofface-to-facecontactwiththefamilyandcollateralsources
30-40min. YouthCareWorker
Self-administeredtrainingrequiresseveralhourstocomplete;Trainingmaybecompletedindividuallyoringroups
AgencymustreceivepermissionandpurchasefromNationalFamilyPreservationNetwork
LIFESKILLSandINDEPENDENTLIVINGVinelandAdaptiveBehaviorScales,SecondEdition(Vineland-II)–SurveyInterviewFormORParent/CaregiverRatingFormORExpandedInterviewForm
Youthagesbirth&up;Adults
TargetedassessmentORratingscaleORin-depthexpandedassessmentthatsupportsdiagnosisofintellectualanddevelopmentaldisabilities,autism,anddevelopmentaldelays;Helpstodetermineeligibility/qualificationforspecialservices,planrehabilitationorinterventionprograms,andtrack&reportprogress
20-60min.(Survey&Rating)OR25-90min.
Parent/Guardian
RequiresPearsonQualificationLevelB;Onlinewebinarsavailable;Manualprovided
AgencymustpurchasefromPearson
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 20
CaseyLifeSkillsAssessment(CLSA)
Youthages14-21
Assessesthebehaviorsandcompetenciesyouthneedtoachievetheirlongtermgoals;Designedtobeusedinacollaborativeconversationbetweenacaseworkerandyouth;Additionalsupplementsavailable;Appropriateforallyouthregardlessofwhethertheyareinfostercare,livewiththeirbiologicalparents,orresideinagrouphome
30-40min. Client PractitionersGuideandotherresourcesavailablefromCaseyFamilyPrograms
Free;SignuptoadministerthroughCaseyFamilyPrograms
DanielMemorialInstituteIndependentLivingAssessmentforLifeSkills–ShortORLong
Youthages15&up
A90-itemOR231-iteminterviewassessmentcovering14OR16independentlivingcategories;Designedforadministrationinone-on-onesituations
Unknown YouthCareWorker
None AgencymustpurchasefromDanielMemorialInstitute
VOCATIONAL/CAREERINTERESTSPictureInterestCareerSurvey–SecondEdition(PICS)
Youthages10&up;Adults
36setsofpicturesofpeopleatworkhelpyouthidentifyoccupationalinterests;Createsaprofileoftheyouththatleadsdirectlytocareerinformationandpotentialjobmatches;Designedforthosewithlimitedreadingability,specialneeds,orwhomightstrugglewithtext-basedassessments
10-15min. Client Manualprovided
AgencymustpurchasefromJIST
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 21
AdjectiveCheckList–SuccessFactorsatWorkReport(ACL-SFW)
Youthinhighschoolorolder;Adults
Checklistof300adjectivesandadjectivalphrasescommonlyusedtodescribeaperson’spersonality;Generatesareportpresentingresultson30scalestoassess6worksuccessfactors
10-15min. Client Manualprovided
AgencymustpurchasefromMindGarden
CareerInterests,Preferences,andStrengthsInventory(CIPSI)
Youthages11-22
Careerexplorationtoolthatidentifiesinterests,strengths,generalpreferences,andfavoredcareers;Youth’schoicesarealignedwiththeU.S.DepartmentofEducation16CareerClusters
15-30min. Client UserManualprovided
AgencymustpurchasefromProEd
CareerBeliefsInventory(CBI)
Youth(Agesnotspecified);Adults
96-itemtoolthatmeasuresayouth’sassumptions,generalizations,andbeliefsaboutthemselvesandtheworldofwork;Idealtouseatthebeginningofthecareercounselingprocess
25-30min. Client None;Manualprovided
AgencymustpurchasefromMindGarden
CareerAssessmentInventory–TheVocationalVersion(CAI)
Youthage15&upplanningtoentercareersrightafterHSortoattendcommunitycollege/techschool
305-itemassessmentthatcomparesanindividual’svocationalintereststothoseofindividualsin91specificcareers(includingskilledtradesandtechnicalandserviceprofessions)thatrequire2yearsorlessofpost-secondarytraining;Inventorycanbeusedtohelpclientsdevelopcareerandstudyplans
35-40min. Client RequiresPearsonQualificationLevelB;Manualprovided
AgencymustpurchasefromPearson
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 22
CareerAssessmentInventory–TheEnhancedVersion(CAI)
Youthages15andup;College-boundornon-collegebound
370-itemassessmentthatcomparesanindividual’soccupationalintereststothoseofindividualsin111specificcareersthatreflectabroadrangeoftechnicalandprofessionalpositions;Inventorycanbeusedtohelpclientsdevelopcareerandstudyplans
40minutes Client RequiresPearsonQualificationLevelB;Manualprovided
AgencymustpurchasefromPearson
ACADEMICSKILLSWideRangeAchievementTest4(WRAT4)
Youthages5&up;Adults
Academicskillsassessmentthatmeasuresreadingskills,mathskills,spelling,andcomprehension
35-45min. Client RequiresPearsonQualificationLevelB;Manualprovided
AgencymustpurchasefromPearson
TestsofAdultBasicEducation9&10(TABE9&10)–SurveyORCompleteBattery
Youthages14&up;Adults
100-itemOR195-itemassessmentofbasicskillsinreading,mathematics,language,vocabulary,mechanics,andspelling;Focusedonkeyfactorsrequiredforvocationaltrainingprogramsandmostoftendemandedbyemployers;Comesin4testlevelsfromEasytoAdvanced(Survey)OR5testlevelsfromLimitedliteracytoAdvanced(CompleteBattery);Pre-andpost-testsallowgrowthtobemeasured;Widerangeofaccommodationmaterialsavailabletohelpevaluatetheskillsofadultswithspecialneeds
1.5hoursOR2.5hours
Client CanbeadministeredbyadulteducatorswhohaveageneralknowledgeofmeasurementprinciplesandarewillingtoabidebytheassessmentstandardsoftheAmericanPsychologicalAssociation
AgencymustpurchasefromDataRecognitionCorporation
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 23
PERMANENTCONNECTIONSInventoryofSociallySupportiveBehaviors(ISSB)–ShortForm
Nonespecified
19-itemself-reportmeasuredesignedtoassesshowoftenindividualsreceivedvariousformsofassistance(e.g.advice,encouragement,etc.)duringtheprecedingmonth
Unknown Client Informationaboutscoringcanbefoundhere
Free;PDFavailablehere
YouthConnectionsScale
Youth(Agesnotspecified)
Tooltomeasurepermanent,supportiveconnectionsforyouthinfostercareandtoguidecaseplanningaroundstrengtheningyouthconnectionstocaringadults
Unknown YouthCareWorker
Minimal;½hourtrainingmoduleavailablefromtheCenterforAdvancedStudiesinChildWelfare
Free;DownloadtoolandImplementation&ScoringGuidefromtheCenterforAdvanceStudiesinChildWelfare
COMPREHENSIVECASEPLANNINGTOOLSGlobalAppraisalofIndividualNeedsQ3Standard(GAIN-Q3)
Youth(Agesnotspecified);Adults
Consistsofninescreeners(background,schoolproblems,workproblems,physicalhealth,sourcesofstress,riskbehaviors&infectiousdiseases,mentalhealth,substanceabuse,andcrime&violence);Computesameasureofparticipants’qualityoflifeandcollectsinformationonfrequencyofserviceutilizationandbehaviorduringthepast90days
25-35min. YouthCareWorker
7hoursofself-pacedonlinetrainingrequiredtogaincertification
AgencymustpurchasefromGAINCoordinatingCenter
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 24
GlobalAppraisalofIndividualNeedsInitial(GAIN-I)
Nonespecified
Acomprehensivebio-psychosocialassessmentdesignedtosupportclinicaldiagnosis,placement,andtreatmentplanning;Containsover100scalesandsubscales;Sectionscoverbackground,substanceuse,physicalhealth,riskbehaviors&diseaseprevention,mental&emotionalhealth,environment&livingsituation,legal,andvocationalneeds
1.5-2.5hours
YouthCareWorker
7hoursofself-pacedonlinetrainingrequiredtogaincertification
AgencymustpurchasefromGAINCoordinatingCenter
Self-SufficiencyMatrix
Nonespecified
Acustomizablecasemanagementtool(withupto25keyoutcomeareas)thatdocumentstheprogressormaintenanceofclientskillsandabilitiesbyprovidingaclearillustrationofwhereaclienthasstrengths,aswellaswheretofocusadditionalenergytogenerateimprovement
Unknown Youthcareworker
Instructionsavailablehere
Free;Contenttocustomizeyourowntoolisavailablehere;AsampleofacustomizedtoolcanbefoundontheHUDExchange
ChildandAdolescentNeedsandStrengthsComprehensiveMultisystemAssessment(CANS-Comprehensive)
Youthages5-22
Acomprehensiveassessmenttohelpprovidersgettoknowyouth&families,learnaboutissuestheyarefacing,anddiscovertheirhopes/goalsfortreatmentand/orservices
Unknown YouthCareWorker
Some;Providersmustbecomecertifiedbycompletinganonlineorin-persontrainingprogram&passinganexam
$12tobecomecertified;InformationavailablefromVermontAHS:IntegratingFamilyServices
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 25
YouthOutcomeQuestionnaireTreatmentSupportMeasure(Y-OQTSM)
Youth(Agesnotspecified)
TooldesignedtoworkinconjunctionwiththeY-OQ2.01,Y-OQSR2.0,orY-OQ30.2(seeMentalHealth&OverallWell-BeingSection);Designedasatreatmentplanningtooltoassisttherapistsworkingwithchildren,youth,andtheirparentsorguardiansandasaclinicalsupporttooltoprovidetherapistswithactionablefeedbackwhenyoutharenotmakingexpectedprogressintreatment;Resultsobtainedatthebeginningoftreatmentcanbeusedtoidentifyclientstrengthsandweaknesseswhichcanbeusedintreatmentplanning
Unknown Unknown Unknown AgencymustpurchasefromOQMeasures
PartnersforChangeOutcomeManagementSystem(PCOMS)
Nonespecified
Twosimpleclinicaltools(OutcomeRatingScale,SessionRatingScale)providedatathatisintegratedintoclinicalpracticethroughFeedback-InformedTreatment(amethodforusingclientfeedbackregardingthetherapeuticallianceandoutcomeofcaretoinform,tailor,andimproveservicedelivery)
Unknown Client Unknown Agencymustpurchase
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 26
Index
Abuseand/orneglect(emotional/physical/sexual)
ChildhoodTraumaQuestionnaire:ARetrospectiveSelf-Report,pg.13JuvenileVictimizationQuestionnaire–ReducedItemorScreenerSum,pg.14ConflictTacticsScales:Parent-ChildVersion,pg.14RevisedConflictTacticsScales,pg.14AbuseRickInventoryforWomen,pg.14TraumaEventsScreeningInventory–SelfReport,pg.14TraumaEventsScreeningInventory–Parent-Report,pg.14JuvenileVictimizationQuestionnaire–AbbreviatedorFullInterview,pg.16TraumaSymptomChecklistforChildren,pg.16TraumaSymptomInventory-2,pg.17ProtectiveFactorsSurvey,pg.18
Academiccompetence/functioning/skills
SocialSkillsImprovementSystemRatingScales,pg.8PersonalityInventoryforYouth,pg.8WideRangeAchievementTest4,pg.22TestofAdultBasicEducation9&10,pg.22GlobalAppraisalofIndividualNeedsQ3Standard,pg.23
AnxietyMassachusettsYouthScreeningInstrument,pg.3ScreenforChildhoodAnxietyRelatedtoEmotionalDisorders,pg.6State-TraitAnxietyInventoryforChildren,pg.8
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 27
Angercontrol/management/responseMassachusettsYouthScreeningInstrument,pg.3Children’sInventoryofAnger,pg.5
Behavioralproblems/disorders PediatricSymptomChecklist-17,pg.2
MassachusettsYouthScreeningInstrument,pg.3GlobalAppraisalofIndividualNeedsShortScreener,pg.4BehavioralandEmotionalRatingScale,pg.5ChildandAdolescentFunctionalAssessmentScale,pg.7SocialSkillsImprovementSystemRatingScales,pg.8PersonalityInventoryforYouth,pg.8Child&AdolescentRisk/NeedsEvaluation,pg.9YouthAssessmentandScreeningInstrument,pg.12EybergChildBehaviorInventory,pg.18
CareerInterests
PictureInterestCareerSurvey,pg.20CareerInterest,Preferences,andStrengthsInventory,pg.21CareerBeliefsInventory,pg.21CareerAssessmentInventory–TheVocationalVersion,pg.21CareerAssessmentInventory–TheEnhancedVersion,pg.22
Copingstyles/behavior CopingInventoryforStressfulSituations,pg.6
CopingInventoryforStressfulSituations–Situation-SpecificCoping,pg.6PsychosocialEvaluation&ThreatRiskAssessment,pg.7AdolescentCopingScale,pg.7
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 28
Depression/depressivedisorder/depressivesymptoms BeckDepressionInventory-II,pg.2
MoodandFeelingsQuestionnaire,pg.3MassachusettsYouthScreeningInstrument,pg.3ReynoldsAdolescentDepressionScale,pg.4Children’sDepressionInventory2ndEdition,pg.4
Disabilities(intellectual/developmental/autism/developmentdelays) VinelandAdaptiveBehaviorScales,pg.19Dissociation AdolescentDissociativeExperiencesScale,pg.15Domesticviolence/partnerviolence RevisedConflictTacticsScales,pg.14
AbuseRickInventoryforWomen,pg.14TraumaSymptomInventory-2,pg.17
Emotionalintelligence EmotionalQuotientInventory,pg.6 Mayer-Salovey-CarusoEmotionalIntelligenceTest,pg.9Emotionalproblems/disorders/distress
PediatricSymptomChecklist-17,pg.2BehavioralandEmotionalRatingScale,pg.5ScreenforChildhoodAnxietyRelatedtoEmotionalDisorders,pg.6PersonalityInventoryforYouth,pg.8GlobalAppraisalofIndividualNeedsInitial,pg.24
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 29
Functioning(caregiver)ChildandAdolescentFunctionalAssessmentScale,pg.7OhioScalesforYouth,pg.12CaregiverWishList,pg.18
Functioning(client)
ChildandAdolescentFunctionalAssessmentScale,pg.7JuvenileInventoryforFunctioning,pg.9LifeStressorsandSocialResourcesInventory,pg.10YoungAdultPsychiatricAssessment,pg.10FunctionalAssessmentRatingScale,pg.10OptumSFHealthSurvey,pg.10OhioScalesforYouth,pg.12Self-SufficiencyMatrix,pg.24ChildandAdolescentNeedsandStrengthsComprehensiveMultisystemAssessment,pg.24
Functioning(family)
ChildandAdolescentFunctionalAssessmentScale,pg.7PersonalityInventoryforYouth,pg.8JuvenileInventoryforFunctioning,pg.9EybergChildBehaviorInventory,pg.18ProtectiveFactorsSurvey,pg.18FamilyEnvironmentScale,pg.18NorthCarolinaFamilyAssessment,pg.19ChildandAdolescentNeedsandStrengthsComprehensiveMultisystemAssessment,pg.24
JobReadiness AdjectiveCheckList–SuccessFactorsatWorkReport,pg.21
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 30
LifeSkillsVinelandAdaptiveBehaviorScales,pg.19CaseyLifeSkillsAssessment,pg.20DanielMemorialInstituteIndependentLivingAssessmentforLifeSkills,pg.20Self-SufficiencyMatrix,pg.24
PanicdisorderScreenforChildhoodAnxietyRelatedtoEmotionalDisorders,pg.6
Peerinteractions/relationships
JuvenileInventoryforFunctioning,pg.9YoungAdultPsychiatricAssessment,pg.10YouthAssessmentandScreeningInstrument,pg.12
Psychologicaladjustment/attributes/symptoms ReynoldsAdolescentAdjustmentScreeningInventory,pg.3 StrengthsandDifficultiesQuestionnaire,pg.4 BriefSymptomInventory,pg.5
SymptomAssessment-45Questionnaire,pg.5MentalHealthScreeningTool,pg.5ChildandAdolescentPsychiatricAssessment,pg.10YoungAdultPsychiatricAssessment,pg.10YouthOutcomeQuestionnaire2.01,pg.11YouthOutcomeQuestionnaire2.0,pg.11OhioScalesforYouth,pg.12YouthAssessmentandScreeningInstrument,pg.12LosAngelesSymptomsChecklist,pg.15GlobalAppraisalofIndividualNeedsQ3Standard,pg.23GlobalAppraisalofIndividualNeedsInitial,pg.24
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 31
Psychosocialfunctioning/symptoms PediatricSymptomChecklist-17,pg.2
PsychosocialEvaluation&ThreatRiskAssessment,pg.7ChildHealthQuestionnaire,pg.8PersonalExperienceScreeningQuestionnaire,pg.12PersonalExperienceInventory,pg.13GlobalAppraisalofIndividualNeedsInitial,pg.24
PTSDsymptoms ReportofPost-TraumaticSymptoms,pg.14 ChildPTSDSymptomScale,pg.15
LosAngelesSymptomsChecklist,pg.15TraumaSymptomChecklistforChildren,pg.16UCLAPosttraumaticStressDisorderReactionIndex,pg.17TraumaSymptomInventory-2,pg.17Clinician-AdministeredPTSDScaleforDSM5,pg.17
Resilience Connor-DavidsonResilienceScale,pg.2
PsychosocialEvaluation&ThreatRiskAssessment,pg.7ResiliencyScalesforChildren&Adolescents,pg.8YouthAssessmentandScreeningInstrument,pg.12ProtectiveFactorsSurvey,pg.18
Self-harm
MassachusettsYouthScreeningInstrument,pg.3ChildandAdolescentFunctionalAssessmentScale,pg.7JuvenileInventoryforFunctioning,pg.9
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 32
Socialskills/phobiaScreenforChildhoodAnxietyRelatedtoEmotionalDisorders,pg.6
SocialSkillsImprovementSystemRatingScales,pg.8Socialsupport/resources
ChildandAdolescentFunctionalAssessmentScale,pg.7LifeStressorsandSocialResourcesInventory,pg.10ProtectiveFactorsSurvey,pg.18InventoryofSociallySupportiveBehaviors,pg.23YouthConnectionsScale,pg.23
Strengths/competencies BehavioralandEmotionalRatingScale,pg.5
YouthAssessmentandScreeningInstrument,pg.12Stress/stressmanagement
Connor-DavidsonResilienceScale,pg.2CopingInventoryforStressfulSituations,pg.6CopingInventoryforStressfulSituations–Situation-SpecificCoping,pg.6SchoolSituationSurvey,pg.7LifeStressorsandSocialResourcesInventory,pg.10GlobalAppraisalofIndividualNeedsQ3Standard,pg.23
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 33
Substancedisorders/use/abuse/riskfactorsMassachusettsYouthScreeningInstrument,pg.3GlobalAppraisalofIndividualNeedsShortScreener,pg.4ChildandAdolescentFunctionalAssessmentScale,pg.7JuvenileInventoryforFunctioning,pg.9CAGE–AdaptedtoIncludeDrugs,pg.12PersonalExperienceScreeningQuestionnaire,pg.12YouthAssessmentandScreeningInstrument,pg.12SubstanceAbuseSubtleScreeningInventory,pg.13PersonalExperienceInventory,pg.13GlobalAppraisalofIndividualNeedsQ3Standard,pg.23GlobalAppraisalofIndividualNeedsInitial,pg.24
Trauma/traumaticevents(exposureto)
ChildhoodTraumaQuestionnaire:ARetrospectiveSelf-Report,pg.13ReportofPost-TraumaticSymptoms,pg.14JuvenileVictimizationQuestionnaire–ReducedItemorScreenerSum,pg.14ConflictTacticsScales:Parent-ChildVersion,pg.14RevisedConflictTacticsScales,pg.14AbuseRickInventoryforWomen,pg.14TraumaEventsScreeningInventory–SelfReport,pg.14TraumaEventsScreeningInventory–Parent-Report,pg.14ChildPTSDSymptomScale,pg.15LosAngelesSymptomsChecklist,pg.15JuvenileVictimizationQuestionnaire–AbbreviatedorFullInterview,pg.16TraumaSymptomChecklistforChildren,pg.16UCLAPosttraumaticStressDisorderReactionIndex,pg.17TraumaSymptomInventory-2,pg.17
VCRHYPOrientationManual:Evidence-BasedAssessment&ScreeningTools 34
Treatment(progress)Connor-DavidsonResilienceScale,pg.2YouthOutcomeQuestionnaire30.2,pg.3YouthOutcomeQuestionnaire2.01,pg.11YouthOutcomeQuestionnaire2.0,pg.11YouthOutcomeQuestionnaireTreatmentSupportMeasure,pg.25PartnersforChangeOutcomeManagementSystem,pg.25
Treatment(satisfaction/therapeuticalliance)
YouthOutcomeQuestionnaire2.01,pg.11YouthOutcomeQuestionnaire2.0,pg.11OhioScalesforYouth,pg.12
Victimization(peer/sibling/sexual/indirect)
JuvenileVictimizationQuestionnaire–ReducedItemorScreenerSum,pg.14JuvenileVictimizationQuestionnaire–AbbreviatedorFullInterview,pg.16
Violence/aggression(towardsothers)
GlobalAppraisalofIndividualNeedsShortScreener,pg.4PsychosocialEvaluation&ThreatRiskAssessment,pg.7Child&AdolescentRisk/NeedsEvaluation,pg.9YouthAssessmentandScreeningInstrument,pg.12GlobalAppraisalofIndividualNeedsQ3Standard,pg.23
MEMORe:ResiliencyAssessmentrequirements&FYSBperformancemeasureAugust31st,2018InresponsetoongoingbarriersinourstatewidedatabasethatpreventusfromusingResiliencyAssessmentdatatoreportonperformancemeasures,VCRHYPisupdatingbothourResiliencyAssessmentrequirementsandourFYSB(federal)performancemeasuresforBCPandTLP.TheResiliencyAssessmentisstillanecessarycomponentofayouth’sPlanofCaredevelopmentandisexpectedtocontinuetobeusedforthispurpose.ResiliencyAssessmentshavehistoricallyservedtwopurposes:tosupportPlanofCaredevelopmentandtoreportonperformancemeasures.Thechangesoutlinedinthismemorelateonlytotheirusetoreportonperformancemeasures.Allchanges,whichgointoeffectimmediately,aresummarizedbelowandwillbereflectedinupdatestoVCRHYP’sOrientationManualandPaperworkManual.ResiliencyAssessmentRequirements
1) CompletedResiliencyAssessmentswillnolongerbesenttoVCRHYPforentryintoHMIS.Allcompletedassessmentsmustbestored,eitherinhardcopyorelectronically,inclientfilesatyouragency.• Note:VCRHYPwillcontinuetolookforResiliencyAssessmentsduringour
annualfilereviewstoensuretheyarebeingconsistentlyusedtoinformPlanofCaredevelopment.
2) ResiliencyAssessmentswillnolongerneedtobecompletedatprogramexit.
• Note:ResiliencyAssessmentsshouldcontinuetobecompletedaspartofPlanofCaredevelopment,soarerequiredtobecompletedeachtimeaPlanofCareiswrittenorupdated,startingatintakeandoccurringatleasteverysixmonthsoriftheyouth’scircumstancesandgoalschangedramatically.
PerformanceMeasuresProxymeasureshavebeenidentifiedtoreplaceallperformancemeasuresrelatedtotheResiliencyAssessment.DatatoreportontheseproxymeasuresisalreadybeingcollectedusingtheVCRHYPExitAssessmentandwillrequirenoadditionalquestionsbeasked.Thefollowingchartprovidesacrosswalkfromourcurrentperformancemeasurestotheirproxymeasures.BeginningwithourOctober2018biannualreportforFYSB,VCRHYPwillreportontheseproxymeasures.
Currentmeasure(s) Currenttarget Grant ProxyMeasure(s) New
target%ofyouthwhoreportfeelingsafeintheircommunityatexit 85% TLP
%ofyouththatconsidertheirexitdestinationtobesafe 80%%ofyouthwhoreportanincreaseinoneormore
indicatorsrelatedtosafetyatexit(Examplesinclude:“IfeelsafewhereIliveand/orstay.”“Ifeelsafeinmycommunity.”)
80% BCP
%ofyouthwhoreportfeelingcomfortableaccessingcommunityresourcesatexit 90% TLP %ofyouththathavepermanentpositive
communityconnectionsoutsideoftheprogram 80%
%ofyouthwhoreportanincreaseinoneormoreindicatorsrelatedtowell-beingatexit(Examplesinclude:“Idoatleastonethingtobehealthy.”“Ihavehealthywaystomanagestressorstressfulsituations.”)
80% TLP&BCP
%ofexitingyouthwhohavehadanannualcheck-upwithadoctorwithinthelastyear 75%
%ofyouthwithhealthinsuranceatexit 90%%ofexitingyouthwhoreporttheirmentalhealthstatusis“excellent,”“verygood,”or“good” 75%
%ofyouthwhoreportanincreaseinoneormoreindicatorsrelatedtopermanentconnectionsatexit(Examplesinclude:“Ihaveoneormoresupportivefriendships.”“Ihavesupportiverelationshipswithoneormorenon-familyadults.”)
80% BCP
%ofexitingyouthwithpermanentpositiveadultconnectionsoutsideoftheprogram 80%
%ofexitingyouthwithpermanentpositivepeerconnectionsoutsideoftheprogram 80%
%ofyouthwillreportanincreaseinoneormoreindicatorsrelatedtoself-sufficiencyatexit(Examplesinclude:“Ihaveaplanforthefuture.”“Iknowwhatcommunityresourcesareavailabletome.”
80% BCP
%ofexitingyouthwhoareattendingschoolregularlyorhavereceivedtheirdiplomaorequivalency
90%
%ofexitingyouthwithpermanentpositivecommunityconnectionsoutsideoftheprogram 80%