Using Evidence-Based Assessments to Understand Trauma and Healing among Gender-Based Violence Survivors
By Brandon Martinez, Research Associate
An innovative assessment approach successfully measures trauma and healing among families impacted by gender-based violence. Administered by a holistic and innovative program in Manhattan that provides family-focused programming, the approach helped participants better understand their healing journeys.
Clinically informed assessments are useful tools for understanding how interventions for post-traumatic stress disorder (PTSD) are supporting the healing paths of gender-based violence survivors. One program — the FamilySafe Project (FSP) — developed an innovative tool called the FamilySafe Project Assessment Tool (FSPAT) to better understand participants’ existing trauma symptoms and the impact that counseling services have on personal well-being and family functioning. Funded by the Criminal Justice Investment Initiative (CJII) - a partnership between the CUNY ISLG and the Manhattan District Attorney’s Office - the FSP is a collaboration between Sanctuary for Families (SFF) and STEPS to End Family Violence (STEPS) to develop a trauma-informed program that provides both adults and their children with family counseling services.
Recent findings from an evaluation of the FSP, conducted by the Urban Institute, found that the FSPAT measured significant improvements in participants' trauma symptomology. An analysis also revealed that the three tools that comprise the FSPAT are valid and reliable for measuring PTSD and family relationships among families affected by gender-based violence.
Three Assessments: Three Positive Healing Measures
To receive services from the FSP, families must be survivors of gender-based violence and live with children. If eligible, participants are then administered the FSPAT, which is composed of three tools, at intake and periodically thereafter to track progress and healing. These are:
PTSD Checklist for DSM-5 (PCL-5) for adults: measures PTSD symptoms. Administered every three months.
Protective Factors Instrument (PFI): measures a parent’s perception of their family’s protective factors (e.g., family functioning, social supports, parental resilience, and nurturing/attachment. Administered every three months.
Parent Report of Post-Traumatic Symptoms (PROPS) for children: measures PTSD symptoms in children. Administered every six months.
Among adult participants, PTSD scores significantly reduced as a result of the mental health services provided by the FSP. On average, adults scored 41.7 points at intake on the PCL-5, and only 30.1 at first[1] follow-up. Adults also reported that they felt more confident, compassionate, and were able to better regulate their emotions. The positive impact of the FSP is also apparent among the four PCL-5 subscales that measure different types of PTSD symptoms: re-experiencing, negative cognition and mood, avoidance, and arousal and reactivity. Average values dropped for each of the four subscales (Figure 1), indicating that the FSP has a broad impact on PTSD symptomology.
Figure 1. Average PCL-5 Score at Intake and Reassessment by Subscale
Source: Urban Institute analysis of program data.
The FSP also measured family functioning with the PFI. On average, adults scored 15.1 points at intake on the PFI, and 15.8 at follow-up — revealing that family protective factors strengthened slightly. Similar to the PCL-5, average values across the subscales of the PFI also show how the FSP had a positive impact (Figure 2). Three of the four subscales showed significant increases in: family function & resilience, social connections & support, and parental resilience. Because scores on the PFI range from one to five, small differences like the ones seen here can translate into noticeable improvements - meaning the results suggest that the FSP has a broad and positive impact on families.
Figure 2. Average PFI-5 Score at Intake and Reassessment by Subscale
Source: Urban Institute analysis of program data.
The third tool of the FSPAT - the PROPS - measured PTSD symptoms among children based on parents' perception. PROPS scores decreased 25 percent between intake and follow-up — from 21.6 points to 16.2 points (Figure 3). Moreover, parents reported that students were improving academically and could better manage their emotions. For more information on the services that children received and how they could impact their trauma symptoms, see here. These results indicate that the FSP is a valuable tool that can measure the impacts of trauma and gender-based violence among parents, families, and children.
Figure 3. Average PROPS Score at Intake and Reassessment
Source: Urban Institute analysis of program data. Note: The difference between intake and follow-up is significant at an alpha level of less than 0.001 using a paired t-test. (n = 307)
Validating the FSPAT Tool
In addition to analyzing changes in the FSPAT measures, the evaluation also examined the validity of the PCL-5 and the PFI. Although both of the measures have been validated previously, they have not been validated with survivors of gender-based violence specifically. Validating tools among different populations is important because it assesses where the tool can reliably identify symptoms of PTSD and protective factors. Using statistical analysis, both measures and their subgroups were found to be valid tools for understanding trauma and protective factors for this population overall, and for specific subgroups of participants.[1] Together, the evaluation results indicate that the FSPAT is an invaluable tool for measuring and understanding trauma and healing among families impacted by gender-based violence.
About the Program and Evaluation
The FamilySafe Project program evaluation helped families address the impacts of trauma and gender-based violence by providing adults and children with much needed counseling that reduced their trauma symptoms. As a result, the FSP improved communication within family relationships and supported educational achievement among children.
The final evaluation report, including process, outcome, and validation findings, is available here . For additional information, an earlier mid-evaluation report describing process evaluation findings in greater depth is available here.
About the Criminal Justice Investment Initiative
The Manhattan District Attorney’s Criminal Justice Investment Initiative (CJII) focuses on three investment areas—crime prevention, reentry and diversion, and supports for survivors of crime. The FamilySafe Project program is part of the CJII’s crime prevention-focused investments in Youth, Families, and Communities.
The CUNY Institute for State and Local Governance manages and provides technical assistance to CJII contractors, and conducts oversight and performance measurement throughout the lifetime of the initiative.
[1] Subgroups are based on participant characteristics: primary language (English or Spanish), birth county (United States or Any other country), and race/ethnicity (Black, Latine, Asian/Pacific Islander, and White).
Photo by Prostock-studio on Adobe Stock.