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Initial Validation of a Subtle Trauma Symptom Screening Scale Embedded in a Needs Assessment Given to Women Entering Drug Treatment

Trauma-informed treatment suggests that all women entering alcohol and other drug treatment be screened for past exposure to violence and current trauma symptoms, but sometimes clients are reluctant to reveal this information. The purpose of this study was to validate a subgroup of items from a needs assessment given to women upon admission to residential substance use disorder treatment. These items are similar to those found on other trauma symptom measures. At intake, 368 clients were given a 69-item general needs assessment scale, “What I Want From Treatment,” along with an interview regarding history of violence. Items reflective of trauma symptoms on the needs assessment were selected for factor analysis. Principal components analysis using varimax rotation found 6 items with high loadings and good internal consistency. An index of prior abuse history correlated with the scale, indicating concurrent validity. More than half of the sample reported prior physical and sexual abuse but did not want to address it in treatment. This measure can provide a Subtle Trauma Symptom Screening Scale to help alert clinicians to possible trauma symptoms in clients who are reticent to disclose them.