title: A psychometric analysis of Project Liberty's adult enhanced services referral tool.
abstract: OBJECTIVE
  Project Liberty was the first federally funded crisis counseling program to offer evidence-informed treatments to crisis counseling recipients in need of more intensive clinical intervention. The Adult Enhanced Services Referral Tool was developed as a screening instrument for making and monitoring referrals to enhanced services. This study aimed to examine how well the tool functioned for identifying persons who would perceive a need for professional treatment.
  
  
  METHODS
  A one-page tool was created that assessed demographic characteristics, risk categories, and psychological reactions to the focal event, September 11, 2001. Psychosocial reactions were assessed by the 12-item SPRINT-E, which is an expanded version of the Short Post-Traumatic Stress Disorder Rating Interview (SPRINT). The SPRINT-E was embedded in the Adult Enhanced Services Referral Tool. Data were collected from 788 clients who received crisis counseling between June and October 2003.
  
  
  RESULTS
  The SPRINT-E is a unidimensional measure of distress and dysfunction. Internal consistency was excellent for the total sample (alpha=.93) and subsamples. Among the 543 clients offered referral, 71 percent accepted. Among those offered referral, the number of intense reactions (score of 4, quite a bit, or 5, very much) was by far the strongest predictor of referral acceptance.
  
  
  CONCLUSIONS
  The SPRINT-E was successfully integrated into the crisis counseling program and provided an apparently successful, empirical basis for referral from counseling to professional treatment. Results of the brief psychological assessment provided a stronger basis for referral to treatment than membership in a risk category (for example, family member of deceased) alone.
authors.affiliation: National Center for Post-Traumatic Stress Disorder, Veterans Affairs Medical Center, 215 North Main Street, White River Junction, VT 05009, USA. fran.norris@dartmouth.edu
authors.forename: Fran H
authors.initials: FH
authors.lastname: Norris
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Donahue
authors.forename: Chip J
authors.initials: CJ
authors.lastname: Felton
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Watson
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Hamblen
authors.forename: Randall D
authors.initials: RD
authors.lastname: Marshall
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy; D003156:Community Mental Health Services; D003419:Crisis Intervention; D005260:Female; D005610:Freedom; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D009519:New York City; D010552:Personality Assessment / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D047851:September 11 Terrorist Attacks / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D035862:Vulnerable Populations / Q000523:psychology / Q000706:statistics & numerical data