Caregiver Information Questionnaire, Revised (CIQ–R)

Questions that describe the child and family. Topics covered include:

• Demographic information
• Risk factors
• Family composition
• Physical custody of the child
• Child’s mental and physical health service use
• Caregiver employment status
• Attitudes about coercion in receiving services
• Child’s presenting problem(s)
• Intake: 46 questions, with subparts, 22 minutes
• Follow-Up: 46 questions, with subparts, 17 minutes
• Caregiver and Staff as Caregiver versions

Behavioral and Emotional Rating Scale—Second Edition, Parent Rating Scale (BERS–2C)

• Identifies youth’s emotional and behavioral strengths
• Youth rate behaviors on a scale from not at all like me to very much like me
• 57 items, 8 open-ended questions, 10 minutes
• Completed at intake and follow-up
• Copyrighted instrument

Caregiver Strain Questionnaire (CGSQ)

Assesses difficulties, strains, and other negative effects related to caring for a child with emotional and behavioral problems.

• 21 questions, 10 minutes
• Completed at intake and follow-up
• Only administered to caregivers (not staff as caregivers)

Child Behavior Checklist 6–18 (CBCL 6–18)

Standardized measure of children’s symptomatology.

• Caregivers’ report of their child’s problems, disabilities, and strengths
• Caregivers say how often statements describing behaviors are true for their child
• 17 social competence items, 113 behavior problem items, 20 minutes
• Completed at intake and follow-up
• Copyrighted instrument

Columbia Impairment Scale (CIS)

Evaluates four basic areas of child’s functioning:

• Interpersonal relations
• Broad psychopathological domains
• Functioning in job or schoolwork
• Use of leisure time
• Caregivers rate how much of a problem each item is for their child
• 13 questions, 5 minutes
• Completed at intake and follow-up

Cultural Competence and Service Provision Questionnaire, Revised (CCSP–R)

Assesses:

• Importance of culture in the lives of the respondent
• Caregiver’s perspective on provider’s consideration of family’s beliefs, traditions, and practices when providing services
• 13 questions, 8 minutes
• Only completed at follow-up
• Only administered to caregivers (not staff as caregivers)

Youth Services Survey for Families (YSS–F)

Measures perceptions of service across five domains:

• Access
• Participation in treatment
• Cultural sensitivity
• Satisfaction
• Outcomes
• 27 questions, 7 minutes
• Only completed at follow-up
• Only administered to caregivers (not staff as caregivers)