The following multimodal evaluation procedure is recommended for Carlos:

Semi-Structured Clinical Interview

The foremost component of an informal evaluation of traumatized individuals entails semi-structured interviewing, in which the following details of the patient ought to be garnered:

• Demographic facts

• Employment history

• Medical history

• Educational history

• Social history and • Several specific facts.

Such an interview must be closely founded on minor and major trauma disorder facets (James, 2008). Particular questions to be posed to Carlos are linked to:

• Trauma nature and level of exposure

• Definite trauma integral to PTS (post-traumatic stress) symptoms

• Intrusive thoughts, recollections, emotions, imagery, responsiveness/awareness freezing, avoidance response and other similar symptoms

• Related elements of anxiety, depression, drug/alcohol abuse, anger or violent behavior

• Pre-morbid family and social life, and adjustment

• Familial history of psychological ailments. Essentially, therapists must seek comprehensive information on individual PTS symptomatology elements, identifying the nature, seriousness, content, rate, concise explanation and duration of symptoms.

The above-mentioned evaluation method is crucial as the information procured via interviewing of patients may be utilized as the base of client diagnosis and examination. With increased knowledge of Carlos's particular symptoms, PTSD (post-traumatic stress disorder) path and subtypes, the assessor's likelihood of validly and correctly assessing the ailment increases. Such a fundamental system may be implemented for individual kinds of traumatic stressors and distinct reactions. Further, one can extend it to encompass more in-depth information and secondary aspects (Peterson, Prout & Schwarz, 1991).

Screening Post-Traumatic Stress

Trauma and trauma-inducing event-connected questions are vital to pose before clients from evaluation as well as intervention perspectives. Key questions to be posed to Carlos include:

Which life experience of yours would you deem as most traumatic?

How did this experience affect your life?

Did you believe, for any period of time in the course of such an experience, that your life or safety was seriously in jeopardy (i.e., that you would be physically harmed or killed)? What are your thoughts and feelings with regard to that particular experience? (Peterson, Prout & Schwarz, 1991)

Have you ever experienced an excessively disturbing, terrifying or awful situation in the course of your life, because of which, within the course of the last month, you:

• Always remained alert, vigilant, cautious or quick-to-startle?

• Had nightmares or unwelcome recollections of the incident?

• Experienced numbness or detachment from your surroundings, other people or activities?

• Strove hard to ensure thoughts about the incident don't enter your mind or evaded scenarios which call to mind the incident? (Wallace & Cooper, 2015).

The above questions are highly generic, but effectively assume that an individual has experienced some traumatic event in life and urge him/her to identify the worst. For answering the above questions, the patient (in this case, Carlos) needs to undertake a comparison and contrast of several distressing scenarios he has faced, which will potentially glean various associations. It is vital to pose such questions as the one aspect with the highest correlation to trauma is victims' cognitive assessment that their life or personal physical wellbeing was gravely jeopardized. Hence, the significance of the question pertaining to whether the victim sensed a likelihood of being killed or physically injured (Peterson, Prout & Schwarz, 1991).

In spite of such questions' significance, therapists need to carefully seek details on traumatic events from clients. It is a common, wrong assumption made by professionals and non-professionals alike that evaluation of a patient's trauma history entails an indifferent attempt at bringing to the surface detailed memories of possible traumatic events. Therefore, prior to interviewing the client (in this case, Carlos), he ought to explicitly know that there is no compulsion on him to reveal facts too uncomfortable or distressing to reveal. Therapists must ensure they don't use complex academic jargon or colloquial language, which might cause anxiety in the patient or cause him to interpret it differently. Further, he must be therapeutically guided when revealing possibly traumatic experiences to ensure the assessment process doesn't end up leaving him mentally overwhelmed or pressurized or stigmatized (Rosen & Freuh, 2010).

Mental Status Examination

Formal evaluation of Carlos's mental health status within the assessment process to establish whether or not he has PTSD entails a standard procedure, which involves interviewing the patient on: orientation, motor functioning, sensory experiences, mathematical ability, moods and feelings, delusional behavior, judgment, proverbs, spatial-visual abilities and visual and aural memory. The facts gathered in mental wellbeing assessments... SCID's PTSD module (Spitzer, Gibbon, & Williams, 1996) represents the most frequently employed clinical interview for various types of trauma patients.
• IES or Impact of Event Scale is a fifteen-item scale that may be utilized for indexing avoidance and intrusive signs as well, in acute PTSD patients. This tool has strong psychometric properties and correlates with PTSD (Zilberg, Weiss, & Horowitz, 1982).

Any facts that were ignored or went unnoticed in the mental status assessment and structured interview stages may be garnered through formal assessments. Numerous formal assessments for trauma-connected ailments are available (Bryant & Harvey, 2000)

Psychophysiological Assessment

Clinicians and researchers are increasingly focusing on psychophysiological measures for complementing psychometric instruments and clinical interviews when assessing trauma patients. Key psychophysiological indices include blood pressure, heart rate, muscle tension, peripheral temperature, and skin conductance response and level. This evaluation technique proves beneficial, owing to its lower likelihood of response bias as well as its ability to identify processes potentially unidentifiable using other methods. A majority of PTSD related research works have indexed numerous psychophysiological activities as a reaction to trauma signs. Researchers concur with the fact that such reactions can help distinguish between traumatized and non-traumatized patients (Bryant & Harvey, 2000)

Current Issues Faced by Client- A Provisional Diagnosis

The patient, Carlos, is, at present, undergoing behavioral and emotional disturbances, owing to the traumatic abuse incident he was subjected to yet uncommon in his everyday life. He experiences apprehension, worry, edginess, and dread. He is constantly uneasy and expects something worse to happen to him since he was unable to identify his abuser for detention and the man still runs free. He suffers from crying spells, eye-contact difficulties, trembling hands, severe hyper-vigilance, and physiological arousal. He also exhibits withdrawal and avoidance signs, as evidenced by his statement that he is mortified to have been found in such a state by his parents and has taken to avoiding their company. It is possible that intrusive recollections of the incident frequent his mind as well. The above symptoms and the injury he sustained at the hands of the abuser are hindering his professional life as well (Dattilio & Freeman, 2000). Bearing in mind the above client history and symptomatology, a provisional PTSD diagnosis (referring to the DSM V) may be made (American Psychiatric Association, 2013). PTSD is marked by behavioral and psychological signs brought on by sexual abuse, near-death experiences or severe injuries. Carlos's symptoms resemble PTSD's DSM-V conditions:

• Experiencing traumatic stressors (condition A)

• Emergence of a distinct condition entailing reliving, numbness, hyper-arousal and avoidance symptoms (conditions B. to D)

• Duration of no less than 30 days (condition E)

• Clinically significant professional/social functioning impairment or difficulties (condition F).

But comprehensive patient evaluation is necessary for complete diagnostic confirmation.

Multidisciplinary Referrals for Client

Individuals often experience trauma both mentally and physically. It is a very effective idea to treat the body combined with psychotherapy. Hence, multidisciplinary PTSD treatment strategies are recommended. Educating traumatized individuals on fear psychobiology and natural ways to decrease stress proves beneficial as well. PTSD surfaces in individuals who are physically, psychologically and mentally overcome by feelings of dread, which are manifested and experienced in their body. The human mind cannot process chronic dread and ends up thinking irrationally. Such a state renders the individual's social, physical and professional functioning unfeasible. Carlos will have higher chances at a smooth, swift and complete recovery if his mind as well as body gets treated. This multidisciplinary PTSD treatment plan can drastically reduce symptoms and psychiatric drug consumption necessity. It is also promising in that it may accelerate healing and typically does away with the need to refer the patient for other psychosocial or psychological services (e.g., constant case management). The multidisciplinary evaluation will ideally incorporate psychologists, counselors, social workers, occupational therapists and nurses (Wallace & Cooper, 2015 Hence, in Carlos's case, certain multidisciplinary referrals would prove highly effectual in satisfying client requirements, including:

• Identification of a PTSD-trained mental healthcare professional capable of offering consultation, guidance, diagnostic and educational services, which is the foremost step. PTSD therapists may belong to diverse disciplinary backgrounds such as trauma therapy, clinical psychology, eidetic imagery and…