IMPACT OF TRAFFICKING: CHECKLIST OF SYMPTOMS & PROBLEMS

Each of these below ‘symptoms’ or ‘complaints’ can be rated for severity on a 5 point rating
scale from 1 to 5 as follows. The rating is carried out based on self-report by the child as well as
observation of her by the Shelter staff, counselor or a family member. Probing questions can be
used wherever needed to explore further.

1 – Not at all
2 – A little
3 – Moderately
4 – Significantly
5 – Extremely

This rating will enable counselors to assess the problem area in terms of severity that can serve
as a baseline assessment prior to Counselling as well as help in formulating the Counselling
goals, and post intervention assessment.

Note: Only current problems and symptoms should be included for rating.

Impact Areas

I. Health/Physical

1. Fractures 1 2 3 4 5
2. Cuts, bruises, injuries 1 2 3 4 5
3. Chronic infection from poor hygiene 1 2 3 4 5
4. T.B./Respiratory 1 2 3 4 5
5. S.T.D’s, HIV 1 2 3 4 5
6. Malnourishment 1 2 3 4 5
7. Pregnancy 1 2 3 4 5
8. Aches and Pains 1 2 3 4 5
9. Others …………………… 1 2 3 4 5

Counselling Interventions for Children Affected by Trauma, Abuse and Neglect

II. Sexual

1. Sexual misconceptions 1 2 3 4 5
2. Sexual aversion 1 2 3 4 5
3. Hypersexual behaviors – 1 2 3 4 5
4. Sexual disorders/ dysfunctions 1 2 3 4 5
5. Sexual manipulation 1 2 3 4 5
6. Confuses love and sex 1 2 3 4 5
7. Others …………………. 1 2 3 4 5

III. Emotional

1. Guilt and shame 1 2 3 4 5

2. Fear 1 2 3 4 5
3. Low self-esteem 1 2 3 4 5
4. Lack of confidence/ Overconfidence 1 2 3 4 5
5. Unworthiness/Self-disgust 1 2 3 4 5
6. Feeling degraded 1 2 3 4 5
7. Hopeless, Powerless 1 2 3 4 5
8. Sad/depressed 1 2 3 4 5
9. Lack of trust, Betrayal 1 2 3 4 5
10. Hostile, Anger 1 2 3 4 5
11. Moody, Sulky 1 2 3 4 5
12. Intrusive memories 1 2 3 4 5
13. Others ……………… 1 2 3 4 5

Counselling Interventions for Children Affected by Trauma, Abuse and Neglect

IV. Behavioral

1. Numbness, shock 1 2 3 4 5
2. Disoriented/confused 1 2 3 4 5
3. Low concentration 1 2 3 4 5
4. Helplessness 1 2 3 4 5
5. Aggressive, violent, abusive 1 2 3 4 5
6. Risky behaviors, Impulsiveness 1 2 3 4 5
7. Self-harm, suicidal attempts 1 2 3 4 5
8. Rebellious, defiant 1 2 3 4 5
9. Sleeplessness 1 2 3 4 5
10. Substance abuse 1 2 3 4 5
11. Truancy, Running away 1 2 3 4 5
12. Suspiciousness 1 2 3 4 5
13. Stealing 1 2 3 4 5
14. Lying 1 2 3 4 5
15. Others …………………… 1 2 3 4 5

V Social
1. Feeling isolated, cut off from the society 1 2 3 4 5
2. Feeling unaccepted by society 1 2 3 4 5
3. Rejection by family, friends 1 2 3 4 5
4. Difficulty in forming relationships 1 2 3 4 5
5. Difficulty to conform to societal norms 1 2 3 4 5
6. Loss of earlier achievements 1 2 3 4 5
7. Others ………………… 1 2 3 4 5

VI Legal
1. Inability to give testimony 1 2 3 4 5
2. Unable to go through court/legal procedures 1 2 3 4 5
3. Turning hostile 1 2 3 4 5
4. Trouble with law 1 2 3 4 5
5. Others ………………… 1 2 3 4 5

Counselling Interventions for Children Affected by Trauma, Abuse and Neglect