Assessment Using PCL-5 and ACEs

How Does PCL-5 Work?

The PCL-5 features 20 questions related to the PTSD symptoms and diagnostic criteria outlined in the DSM-V. The following are some examples of questions found on the PCL-5.

‘In the past month, how much were you been bothered by:

“Repeated, disturbing, and unwanted memories of the stressful experience?’

‘Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reliving it)?’

‘Avoiding memories, thoughts, or feelings related to the stressful experience?’

Answers range from 0 (not at all) to 4 (extremely) on a five-point Likert scale.

The results of the PCL-5 must be interpreted by a mental health professional. It is important to consider other factors in the client’s life outside of their answered PCL questions. Interpretation should align with assessment goals. If there is a clear need for a higher level of care despite a lower score on the checklist, treatment will be tailored accordingly. Similarly, suppose there is a higher score on the checklist, but a more appropriate type of care is agreed upon. In that case, a program can be made that accommodates this.

We understand that clients’ lives are inherently more complicated in real life than they are on paper. Still, the PCL lets us know about the severity of one’s symptoms. It allows us to gain insight into how those symptoms may influence one’s willingness to engage in treatment. Knowing one’s PCL score can help us increase the likelihood of positive therapeutic outcomes.

ACE Assessment

Adverse Childhood Experiences is a term that refers to difficult and overwhelming traumatic events in childhood. Children who have been abused, witnessed domestic violence, been neglected, or grew up in a home with unresolved mental illness or alcohol or drug abuse. ACEs impact millions of children and adults across the country. Many cases of physical and mental health illness, substance use, and cross-generational abuse (parents who were abused in childhood abusing their own children) can be traced back to the experience of multiple ACEs in childhood.

The following are some examples of questions used in the ACE assessment.

‘Did a parent or other adult in the household often or very often…

a) Swear at you, insult you, put you down, or humiliate you? or
b) Act in a way that made you afraid that you might be physically hurt?’

‘Did a parent or other adult in the household often or very often…

a) Push, grab, slap, or throw something at you? or
b) Ever hit you so hard that you had marks or were injured?’

‘Was a household member depressed or mentally ill, or did a household member attempt suicide?’

Questions are answered with ‘Yes’ or ‘No’.

The ACE assessment is a way of identifying the presence of ACEs in a client’s history. The higher a person scores on an ACE assessment, the greater their chance of other health issues, such as cancer, diabetes, and heart disease. Children who have been abused or have been through stressful childhoods are often under chronic stress. This has a lasting damaging impact on their physical and mental health well-being.

Without the safety and support of a nurturing, attuned caregiver, ACEs can disrupt healthy development. They lead to a toxic stress response that hinders brain development, immune system function, hormonal balance, and self-regulation. One or more ACEs also jeopardize social, educational, and legal well-being.

Assessments at the New York Center for Living

We offer adolescent and young adult mental health services and programs here at the New York Center for Living. Our adolescent programs, for those aged 12-17, and our young adult programs (18-29), serve to help clients overcome or manage their mental health conditions. We provide evidence-based, expert-led treatment for co-occurring mental health and substance use disorders. Substance Use Disorder (SUD) impacts the development and treatment of other health conditions. Treatment must be delivered by professionals who understand the complex nature of co-occurring disorders.

Client care is at the core of our values. We work with each client from the standpoint that, as individuals, we are ultimately responsible for our own healing. We help clients feel safe and stable through therapy, medical assistance, and many other types of support. Once a client is stable, we begin to work on developing strength and resilience. We believe that by placing clients in the center-focus of their recovery, real healing can take place.

Contact us today to arrange for an assessment, or to find out more about the programs and services we offer.