Getting assessed for PTSD

If a frightening event still shapes your days, weeks or even years later, it may be time to get checked for PTSD (post-traumatic stress disorder). Getting assessed is not a test you pass or fail. It is a set of questions that helps you and a trained provider understand what is going on.

There is no blood test or brain scan for PTSD. Instead, providers use short questionnaires and a careful talk with you.¹ This page explains each step, what the common forms ask, and how to find care that feels safe.

Why getting checked matters

Some people live with trauma symptoms for years without knowing what they are. Others see a doctor for pain or poor sleep, and the trauma never comes up.⁹

A clear assessment can open the door to treatment that works. Trauma-focused talk therapies help many people (see trauma-focused therapies). An assessment also checks for problems that often come along with PTSD, such as depression or heavy drinking.¹

If you are not sure your reactions count as PTSD, read signs of PTSD first. You do not need to be sure before you ask for help.

Step 1: A short screen

A screen is a quick list of questions. It does not tell you whether you have PTSD. It only shows whether a fuller check makes sense.¹

The PC-PTSD-5

The most common screen in the U.S. is the Primary Care PTSD Screen for DSM-5, or PC-PTSD-5. Staff at the VA's National Center for PTSD created it. It is free for anyone to use.³

It starts by asking whether you have ever been through a very frightening or horrible event. Examples include a serious accident, an assault, war, or losing someone to murder or suicide. If the answer is no, the screen stops there.³

If the answer is yes, it asks five yes-or-no questions about the past month. In plain words, have you:³

• Had nightmares or unwanted thoughts about the event?
• Tried hard to avoid thinking about it, or stayed away from reminders?
• Felt always on guard or jumpy?
• Felt numb or cut off from people or activities?
• Felt guilty, or kept blaming yourself or others?

Each "yes" counts as one point, for a score of 0 to 5.³

What the score means

There is more than one cutoff, depending on the goal. The VA's free online self-screen treats 3 or more "yes" answers as a sign you may have PTSD and should talk with a provider.² In clinics, a score of 4 often balances catching true cases against false alarms. Clinics may use a lower cutoff for women, because a score of 4 misses many women who do have PTSD.³

Either way, the score is a starting point, not an answer. The VA/DoD guidance says no screening score should ever be the only basis for a diagnosis.⁸

If you answer "no" to the trauma question but still feel unwell, talk with a provider anyway. Depression or anxiety can also follow hard times.² Our mental health check-in and depression screening page may help.

Step 2: A fuller assessment

If a screen is positive, the next step is a more careful look by a mental health provider. This usually mixes a talk with the provider and forms you fill out yourself.¹

The PCL-5 checklist

The PTSD Checklist for DSM-5 (PCL-5) has 20 questions, one for each PTSD symptom. You rate how much each one bothered you in the past month, from 0 ("not at all") to 4 ("extremely"). Total scores run from 0 to 80. It takes about 5 to 10 minutes.⁴

A total of about 31 to 33 or higher suggests probable PTSD. But the provider still needs to talk with you to confirm it.⁴

The PCL-5 is also used to track progress. Many people fill it out before therapy sessions. A drop of about 10 points is one sign that treatment is helping.^4,8

The clinical interview

The most careful way to diagnose PTSD is a structured interview. This means the provider asks a set list of questions in order. A common one is the CAPS-5 (Clinician-Administered PTSD Scale). It has 30 items and takes about 45 to 60 minutes.⁵ A shorter interview, the PSS-I, takes about 15 to 25 minutes.⁸

A brief evaluation may take about 15 minutes. A thorough one can take 1 to 2 hours, and legal or disability assessments may take longer.¹

What the clinician will ask

Questions usually follow a set pattern. Knowing them ahead of time can make the visit less stressful.

With your permission, the provider may also want to talk with a spouse, partner or family member.¹

What a PTSD diagnosis requires

Providers in the U.S. use a guide called the DSM-5-TR. Its PTSD rules did not change in the 2022 update.⁶ To be diagnosed, an adult must have been through a qualifying event, such as facing death, serious injury or sexual violence. The person may have lived it, seen it, learned it happened to someone close, or faced gruesome details over and over at work, like a first responder.⁶

Then, for more than one month, the person must have:^6,7

• At least 1 reliving symptom
• At least 1 avoidance symptom
• At least 2 changes in thoughts and mood
• At least 2 signs of feeling on edge

The symptoms must cause real distress or trouble in daily life. They also must not be better explained by a medicine, alcohol or drugs, or another illness.⁶ That is why your provider may ask about your health and medicines.

Symptoms often start within 3 months of the event, but not always.⁷ When the full pattern shows up 6 months or more later, it is called PTSD "with delayed expression."⁶

Who can diagnose PTSD

A mental health professional can diagnose PTSD. This includes a psychiatrist, psychologist or clinical social worker.⁷ Your family doctor may give you the short screen and then refer you. Licensed counselors and family therapists may also assess and treat PTSD, depending on state rules.¹³

Getting assessed later in life

Older adults are often less likely to bring up trauma on their own. Shame, or a wish to stay strong and quiet, can play a part. Some describe stress mainly as body problems, like pain.⁹ For that reason, the VA suggests asking everyone the short screen, rather than waiting for the person to raise it.⁹

The good news is that the PC-PTSD-5 and PCL-5 work about as well in older adults as in younger ones.⁹ Some things can make the visit go better:⁹

• Ask for forms in large, bold print.
• Bring your glasses and hearing aids. Ask the provider to speak clearly.
• Bring a family member if you like, but the provider should speak to you first.
• Ask about telehealth if getting there is hard.

Retirement, the loss of a spouse, illness or loneliness can stir up old memories. Symptoms that were mild for years may get worse in later life.⁹ If memory problems are also present, the provider may do a short memory test. Mild or moderate memory loss usually does not rule out PTSD treatment.⁹ Learn more in PTSD in older adults and veterans and the first doctor visit about memory.

Preparing for your visit

1. Write down your symptoms. Note what bothers you most, when it started, and how often it happens.
2. Take a screen first. Print or photograph your PC-PTSD-5 self-screen results to bring along.²
3. List your medicines and health problems. Include alcohol, sleep aids and supplements.
4. Decide what you are ready to share. You can say "I'd rather not go into detail yet." You control how much you tell.¹
5. Bring questions. Ask what the assessment covers, how long it takes, and how the results will be used.¹
6. Plan something calming for afterward. Talking about trauma can stir feelings. A short walk or a grounding practice may help.

Finding trauma-informed care

Trauma-informed care means a provider understands how trauma affects people. It also means they try not to cause more harm. The CDC and SAMHSA describe six guiding principles:¹⁰

• Safety, both physical and emotional
• Trustworthiness and transparency: being clear about what will happen and why
• Peer support from people with lived experience
• Collaboration: working with you as a partner
• Empowerment, voice and choice: you have a say in your care
• Respect for culture, history and gender

In practice, this means a provider explains each step, lets you pause, and does not push you to share details before you are ready.

Where to look

• Your doctor or insurance. Ask your primary care provider for a referral. Check your insurance plan's list of covered mental health providers.¹¹
• Therapy directories. The VA lists directories for therapists trained in cognitive processing therapy (CPT), prolonged exposure (PE) and EMDR, plus general directories from groups like the American Psychological Association.¹¹
• Low-cost help. Search FindTreatment.gov or call the SAMHSA National Helpline at 1-800-662-4357, any time, day or night.^14,11 Your state health department can point you to low-cost clinics.¹¹
• Veterans. You do not need to be enrolled in VA health care to get some mental health care. You can walk in or call any VA medical center. Vet Centers offer free counseling without enrollment. Not sure where to start? Call 877-222-8387.¹²

For more tips, see how to find a therapist and paying for therapy.

Medicare

Medicare Part B covers a psychiatric evaluation and diagnostic tests. It also covers visits with psychiatrists, psychologists, clinical social workers, nurse practitioners and others. Marriage and family therapists and mental health counselors are now on the list too. After the Part B deductible, you usually pay 20% of the approved amount.¹³ You can also bring up mental health changes at your yearly Annual Wellness Visit.¹³

Questions to ask a provider

• Do you have training and experience treating trauma and PTSD?¹¹
• Do you offer trauma-focused therapies such as CPT, PE or EMDR?¹¹
• Do you take my insurance? What will I pay out of pocket?¹¹

Common questions

Learn more in the PTSD and trauma overview, who develops PTSD, medicines for PTSD and coping with trauma symptoms.

When to get help right away

You can also make a safety plan or find more numbers on our help page.

Education only. This page is general information written from the sources listed. It is not medical, legal or financial advice and does not replace a doctor, therapist or lawyer who knows your situation. How we write and check pages.