MASIC-S

PARTY NARRATIVE (RECOMMENDED BUT OPTIONAL)

 (Opportunity for Interviewee to Explain their Situation in their Own Words if the Screening is Done at the Start of the Client’s Interview)

Example Script:  I will be asking you some questions today. First, I would like to ask you to tell me, in your words, what brings you to us/me?  (Note: Elicit brief narrative about why the client has come to meet with you.)

MASIC-S INTRODUCTION (REQUIRED)

Required Script: I am now going to ask you a series of questions about your relationship with [the other party], who we understand is or was a significant other or spouse of yours. These questions relate to [the other party’s name] and not other people, but let us know if any other people are doing the kinds of things we are asking about.]

Your responses to these questions will be confidential. They will NOT be shared with the court or [the other party]. Your responses will only be used to help you and us/me decide how to proceed in this case.

You may wonder about some of the questions you will now be asked, but it is helpful to think of this like a visit to the doctor’s office. There, you are often asked questions that may not seem important to you or may not seem to apply to you but are important to the doctor. 

The questions you will be asked now are important for deciding what kind of in court or out of court process would work well for you. So please answer the following questions to the best of your ability.

In answering these questions, I am asking about things that [the other party] may have done during a conflict, disagreement, fight, or in anger, or to scare you or hurt you, but NOT while joking around.

It is also important to let us/me know as you answer each question, whether [the other party] would say that you did what is being asked about to [the other party].

[Note to the screener: You or your colleague should take careful notes off the MASIC-S form of all information about what the other party will say about the client’s perpetration of abuse.]

Section 1

All questions below are REQUIRED except for some follow-up questions that are marked "Recommended but optional"

Did [the other party] ever (whether or not while living with you)...

Required Script: Please remember that all questions concern things that [the other party] ever, whether or not while living with you, may have done during a conflict, disagreement, or fight, or in anger, or to scare or hurt you, but NOT while joking around. Please also remember to let us/me know as you answer each question, whether [the other party] would say that you did what is being asked about to [the other party].

Now consider the questions you just answered, or similar kinds of things:

MASIC-S Questions - SECTION 2

If “Yes” to any of the items in Section 1 above, then Section 2 is REQUIRED.
If “No” to all questions in Section 1, then you may skip to Section 3. However, according to your clinical judgment, you may also complete Section 2.

MASIC-S Questions - SECTION 3
RECOMMENDED BUT OPTIONAL

Do you have any of the following concerns about [the other party]?

MASIC-S QUESTIONS-SECTION 4 (REQUIRED)

Required Script: Ask all parties the following question (regardless of whether Sections 2 and/or 3 were completed)