TESI

What is the Traumatic Events Screening Inventory?

The Traumatic Events Screening Inventory (TESI) is a self report measure for screening children for exposure to potential traumatic events. The TESI-C interview protocol is designed for children aged 7-18, and has been formulated to minimise retraumatization to the child as they disclose their experiences.

Because of its structured interview format, TESI-C is an effective trauma screening tool for assessing a child's experience. Importantly, though, the TESI-C provides an indication or hypothesis of whether trauma is present, not a definitive identification. Only qualified mental health professionals can attempt to conduct a TESI interview.

The TESI-C is designed to detect potential traumatic events including current and previous injuries, hospitalizations, domestic violence, emotional or physical abuse, sexual abuse, loss, disasters, or witnessing community violence. Children are probed for the event onset, offset, and people involved, and traumatic events should match the criteria set out in the DSM-V.

Another version is the Traumatic Events Screening Inventory Parent Report (TESI-P or TESI-PRR). Unlike the TESI-C, the TESI-P is used for children 6 years or younger, and includes items directly assessing exposure to war or terrorism, or the suicide attempt of someone close. Our template contains only the TESI-C

How to use our TESI template

It is crucial that the TESI-C interview protocol is followed closely and responsibly to avoid damaging a child's recollection or causing further harm to their mental health. Here is how it works:

Step 1: Access the template

Open the free TESI-C protocol template by clicking "Use template," which opens it on the Carepatron app's template editor. From there, you can customize it, fill it out digitally, or print it. You can also get a ready-to-use and printable PDF by clicking "Download."

Step 2: Initial procedure

As a qualified psychologist, you should have licensure for independent practice in child assessment and psychotherapy, and supervised experience in assessment or psychotherapy with young survivors of trauma and their families. It is best if you have preexisting rapport with the child but no personal investment (to avoid skewing their reporting). If you are not familiar with the child, include a rapport building phase prior to the interview. Input key identification information for the child and about yourself, as well as the date.

Step 3: Begin the protocol

There are 16 items on the TESI-C, each of which pertains to a category of traumatic events. Ask the initial question for the first item verbatim, then follow up with open-ended probes to clarify each incident that fits within that category.

Step 4: Ask clarification questions

Next, ask the additional questions for that item verbatim, following up with open-ended probes where necessary for each of the incidents described. These questions are designed to clarify the nature of the incident and check whether the event meets A1 criteria in the DSM-V for traumatic stressors. These questions are only necessary if the child has not already provided the information in their initial explanation.

Step 5: Check DSM-V criteria

For each incident in that item, ask close-ended questions to determine if the incident qualifies as a traumatic stressor under trauma-specific A2 DSM-V criteria:

• Objective harm/threat - in the child's view, whether serious harm did or could have occurred
• Objective harm/threat - in your view as the interview, based on information provided by the child, whether the incident caused or threatened severe physical harm/death to anyone involved
• Subjective appraisal of extreme fear - whether the child felt extreme fear in or immediately following the incident
• Subjective appraisal of helplessness - whether the child felt helpless in or immediately following the incident
• Subjective appraisal of horror - whether the child felt sick, disgusted, or horrified in or immediately following the incident.

Each of these criteria should be marked yes or no separately for each incident.

Step 5: Rate the item

When you have sufficient information, rate the item as yes, no, not sure, refused, or questionable validity based on the guidelines in the template. If the incident meets both A1 and A2 criteria, ask the follow-up questions and record their answers.

Step 6: Repeat

Repeat steps 3-5 for all remaining items. If the information provided in subsequent questions indicates a need to clarify or revise the rating of any prior question, it is appropriate to do so. If at any point the child becomes distressed, pause or discontinue the assessment.

Step 7: Finish the interview

Review all the items to see if any missing information needs to be gathered or clarified. Create a clinical summary of your findings.

Scoring

Based on the information given by the child in the open and closed ended probes, indicate whether e incident meets A1 and A2 criteria (in your clinical judgement). Create a clinical summary at the conclusion of the interview to indicate what types of traumatic events the screening has detected. This is not conclusive proof that these traumas have occurred, but rather an indication.

Next steps after using the TESI-C

Here are some potential next steps after conducting the TESI-C:

Additional information

If the child has screened positive for trauma exposure, conduct further tests to confirm and clarify this. These may include the TESI-PRR, police reports, hospital records, or clinical psychological evaluations. The child should be screened for post-traumatic stress disorder (PTSD).

Psychological support

It is crucial that children who have endured trauma receive adequate support to aid their recovery. This may include recommending they are provided with a social worker or therapist if they do not already have one or if you cannot provide this service yourself. If you have any concerns about the child's current safety, consult a supervisor or child protection organization.