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Subjective Units of Disturbance/Distress Scale

 

 This can be a useful method of quantifying, to some extent anyway, any gains a client gets in session. Of course it is wholly subjective, but it should work out fairly well when the client is only really keeping score for herself. It's not like there is a status game to be played, or there are bonuses for getting a good score. If a client routinely keeps track of her topics, and how they change in relation to whatever session actions she takes, then after a while she should have a pretty good idea of which session modules work well for her and which ones don't.

It is also useful to keep a simple record of the fact that changes have occurred. It is sometimes easy to forget how distressing some particular topic was when it is no longer in view and hasn't been for ages. But if one consults a journal that six months ago says, "Another sleepless night worrying about ___. That one has really been a SUDS 7 or 8 for months" and compares it with an entry three months ago that says, "Jane gently asked me about ____ at lunch today, and was shocked to see me burst out laughing about it and tell her it was no longer a worry at all. I think she decided I had been lying to her about the prior severity of it."

So the session modules here will probably all have SUDS before and after screens, giving the client a chance to rate their topic at the start and end of session each time. The Rogerian one already has it.

Taken from Wikipedia at http://en.wikipedia.org/wiki/SUDS:

SUDS = Subjective Units of Disturbance/Distress Scale
There is no hard and fast rule by which a patient can self assign a SUDS rating to his or her disturbance or distress, hence the name subjective.

Two guidelines are that the intensity recorded must be as it is experienced now. And constriction or congestion or tensing of body parts indicates a higher SUDS than that reported.

Here is one version of the scale:

10 = Feels unbearably bad, beside yourself, out of control as in a nervous breakdown, overwhelmed, at the end of your rope. You may feel so upset that you don't want to talk because you can't imagine how anyone could possibly understand your agitation.

9 = Feeling desperate. What most people call a 10 is actually a 9. Feeling extremely freaked out to the point that it almost feels unbearable and you are getting scared of what you might do. Feeling very, very bad, losing control of your emotions.

8 = Freaking out. The beginning of alienation.

7 = Starting to freak out, on the edge of some definitely bad feelings. You can maintain control with difficulty.

6 = Feeling bad to the point that you begin to think something ought to be done about the way you feel.

5 = Moderately upset, uncomfortable. Unpleasant feelings are still manageable with some effort.

4 = Somewhat upset to the point that you cannot easily ignore an unpleasant thought. You can handle it OK but don't feel good.

3 = Mildly upset. Worried, bothered to the point that you notice it.

2 = A little bit upset, but not noticeable unless you took care to pay attention to your feelings and then realize, "yes" there is something bothering me.

1 = No acute distress and feeling basically good. If you took special effort you might feel something unpleasant but not much.

0 = Peace, serenity, total relief. No more anxiety of any kind about any particular issue.