Professional therapists use clinical inventories as a way to assess the particular fears and dynamics underlying your child's anxiety issues. A review of the literature reveals almost as many inventories as there are therapists to administer them, and therapists vary in their skill and comfort in using these tools. As managed care has become more widespread, many insurance providers require that therapists use some sort of standardized measure of anxiety to establish a baseline of symptoms, direct treatment, and measure improvement as therapy progresses.

Anxiety and Depression

Pen-and-paper measures of depression and anxiety are among the most commonly used screening tools of therapists. Although they are not diagnostic in and of themselves, they can confirm a diagnosis of anxiety when taken together with the other information you provide. Unfortunately, simple tools for anxiety are not generally available for young children. For older children and adults, the most widely used are the Beck Depression and Anxiety Inventories. The Burns inventories of Anxiety and Depression are also commonly used. Therapists may use other tools such as a symptom checklist, given their preferences and the requirements particular to their setting. The Y-BOCS, or Yale-Brown Obsessive Compulsive Scale can be used to measure the severity of obsessions and compulsions.

Behavioral Inventories

Behavioral inventories are used for developmental screening and to identify different types of problem behavior a child might exhibit. Some inventories measure adaptive behavior, that is, the skills your child has that allow him to be independent in the world, such as self-care, problem solving, and following directions. Behavioral inventories are usually completed by parents, teachers, or trained observers. They can be used to determine which behaviors should be addressed first and can measure whether behaviors are changing over time. The Child Behavior Checklist (CBCL) is among the most common, and, again, your particular provider may have standard tools he uses to assess behavioral issues. Other useful parent-teacher rating scales include the Connors' Rating Scales and the Achenbach Inventories.

Self-Esteem

As you remember from Chapters 1 and 2, self-esteem is one of the building blocks of mental health. Self-esteem can be impaired in a number of ways, and inventories that allow your child to examine her feelings about herself, her sense of identity, and her sense of worth can build a base for change to occur in therapy. Self-esteem inventories are available to assess children at various ages. The Coopersmith Self-Esteem Inventory is one such instrument. Others include the Culture-Free Self-Esteem Inventory and the Martinek-Zaichkowsky Self-Concept Scale for Children (MZSCs).

Sentence Completion

The sentence completion technique is a useful way for a therapist to identify specific patterns of fears, worries, and areas of interest or vulnerability that may need to be addressed in therapy. The therapist will ask your child to “fill in the blank” to questions that will help in assessing behaviors, mannerisms, and areas of concern. Versions vary, but all include open-ended questions such as “When I was younger. …” Sentence completion is often used to create “talking points” for therapy, and can be presented in a playful format, which puts a child at ease.

Drawing

Therapists and evaluators use drawing exercises and inventories to analyze what a child communicates about hidden motives and struggles through his drawings, as well as to evaluate self-esteem and look for signs of trauma. Shape, size, and placement of body parts and other elements in the drawing provide clues a skilled therapist can use during therapy. It is an excellent way to establish rapport with a child and have fun as the therapist is doing his job. There are several standardized systems used to analyze and understand children's drawings. Among the most popular are the books Children in Distress, by Peterson and Hardin, and Children Draw and Tell, by Klepsch and Logie.