Battery for Health Improvement 2 (BHI™ 2)

Battery for Health Improvement 2 (BHI™ 2)


Battery for Health Improvement 2 (BHI™ 2) presents concise, coordinated assessments of the biopsychosocial issues most relevant in evaluating patients with injuries.

Battery for Health Improvement 2 (BHI™ 2) presents concise, coordinated assessments of the biopsychosocial issues most relevant in evaluating patients with injuries.


Daniel Bruns, PsyD, John Mark Disorbio, EdD


Assessment of validity, physical symptoms, psychological, character, environment, and social factors that can impact response to normal course of treatment and recovery of patients being treated for pain and injury

Age Range:

Individuals 18-65


Paper-and-pencil, computer administration

Scoring Option:

Q-global™ Web-based Administration, Scoring, and Reporting; Q Local™ Scoring and Reporting Desktop Software; Mail-in Scoring Service; Fax-in Scoring Service and PAD Scoring Service

Completion Time:

Approximately 30 minutes (217 multiple-choice)


Tips on using this test in your telepractice

Report Options:

Profile, Basic Interpretive, Enhanced Interpretive, Progress Reports, and Medical Intervention Risk Report

Publication Date:


Designed to present a concise, coordinated assessment of the biopsychosocial issues that are most relevant in evaluating patients with injuries. Because psychological and social factors that go undetected can significantly interfere with a patient’s response to treatment, the BHI 2 test can help caregivers shape an appropriate treatment plan, that may reduce treatment time and improve a patient’s quality of life.

How to Use This Test

The BHI 2 test can be used by psychologists, psychiatrists, anesthesiologists, neurologists, physical therapists, surgeons, rehabilitation specialists, and nurses to help:

  • Evaluate a patient’s readiness for medical and behavioral interventions
  • Meet evidence based medical treatment guidelines outlined for good clinical practice
  • Measure the relationship and impact of physical, environmental, and psychological factors on the patient’s treatment
  • Support evaluations involving injuries, worker’s compensation, and psychological factors
  • Evaluate treatment effectiveness and monitor clinical outcomes
  • Facilitate communication within a multidisciplinary treatment team or between physicians and psychologists

Key Features

  • Takes approximately 30 minutes to administer.
  • Objective results help reduce treatment time, improve treatment planning, and improve the patient’s quality of life.
  • Helps measure numerous outcomes, including reduction of pain, improvement in function, and satisfaction with care
  • Includes 31 Critical Items that highlight clinical concerns such as Addiction Concerns, Compensation Focus, Sleep Disorders, Satisfaction with Care, Suicidal Ideation, and Violent Tendencies.
  • Content areas within each scale help distinguish specific reasons for problems.


Validity Scales

  • Self-Disclosure
  • Defensiveness

Physical Symptom Scales

  • Somatic Complaints
  • Pain Complaints
  • Functional Complaints
  • Muscular Bracing

Affective Scales

  • Depression
  • Anxiety
  • Hostility

Character Scales

  • Borderline
  • Symptom Dependency
  • Chronic Maladjustment
  • Substance Abuse
  • Perseverance

Psychosocial Scales

  • Family Dysfunction
  • Survivor of Violence
  • Doctor Dissatisfaction
  • Job Dissatisfaction

Risk Factors (Medical Intervention Risk Report)

  • Primary
  • Presurgical
  • Rehabilitation
  • Addiction History
  • Addiction Potential

Nonadaptive Coping Styles (Medical Intervention Risk Report)

  • Catastrophizing
  • Kinesiophobia

Psychometric Information

The BHI 2 test was normed using a sample of 725 community individuals and a sample of 527 physical rehabilitation and chronic pain patients. Reports compare the patient to both norm groups and use the average physical rehabilitation patient as a benchmark for interpretations and clinical recommendations.

Reference Groups

As well as comparing the patient to the community sample and the patient sample, the BHI 2 instrument also compares the patient to individuals with a similar condition for the five reference groups listed below. These groups are based on common diagnostic categories of injuries often seen in rehabilitation settings and are used by the Pain Complaints scale.

  • Head injury/headache
  • Neck injury
  • Upper extremity injury
  • Lower extremity injury
  • Back injury

In addition, the Pain Complaints scale uses a chronic pain reference group, while the Defensiveness and Self-Disclosure scales use reference groups for symptom magnification and symptom minimization as additional benchmarks for clinical interpretation.

Report Options

Medical Intervention Risk Report (NEW!)
A half-page graphical profile succinctly summarizes patient scores on 5 Psychosocial Risk Factors, and 2 Nonadaptive Coping Styles.  Interpretive statements are offered for all scores and a final section provides recommended interventions to reduce risk and highlights patient strengths.

View a sample Medical Intervention Risk Report

Progress Report
This concise graphical report enables the clinician to monitor the patient’s progress over time; provided at no additional charge.

View a sample Progress Report.

Profile Report
Provides a patient profile that includes a graphical representation of the patient’s raw and T scores in comparison to both the patient and community norms, as well as the patient’s rating and percentile. The report also includes a section on Validity Issues, Critical Items, Content Areas, Omitted Items, and Item Responses.

View a sample Profile Report.

Basic Interpretive Report
Provides a concise interpretation of test results, including a profile graph and scale summary. The report also includes brief scale category narratives including validity issues, Pain Complaints Item Responses, Content Areas, Critical Items, Omitted Items, Item Responses, Treatment Recommendation, and a Patient Summary.

View a sample Basic Interpretive Report.

Enhanced Interpretive Report
Provides a more extensive interpretation of the patient’s test results, including in-depth scale category narratives. In additional to all the components of the Basic Interpretive Report , this report also includes section on Somatic Complaints, Item Responses, and Diagnostic Probabilities.

View a sample Enhanced Interpretive Report.

View a sample annotated Enhanced Interpretive Report.

Scoring Options

Q-global™ Web-based Administration, Scoring, and Reporting – Enables you to quickly assess and efficiently organize examinee information, generate scores, and produce accurate comprehensive reports all via the Web.

Q Local™ Scoring and Reporting Desktop Software – Enables you to score assessments, report results, and store and export data on your computer.

Mail-in Scoring Service – Specially designed answer sheets are mailed to Pearson for processing within 24–48 hours of receipt; results returned via regular mail.

Fax-in Scoring Service – A Fax-in form is completed and included with your fax-in answer sheets. Pearson processes these within 24 hours of receipt; results returned via fax.

PAD (Patient Assessment Device) Hand-held Electronic Device – Administer the test on a portable, hand-held device. The PAD is placed on a docking station connected to a printer and a results report is printed immediately


Using Psychological Evaluations to Improve Patient Care and Outcomes


Assessment and Treatment of Chronic Pain: A Physician’s Guide


BBHI 2 Bibliography


Medical Intervention Risk Report

Pre-recorded Webinars

  • Presurgical psychological evaluation for spinal cord stimulation

    Presenter: Daniel Bruns, PsyD, FAPA

    The current opioid crisis has led to increased interest in alternative forms of pain treatment. One of these is spinal cord stimulation (SCS), which is an electrical treatment for pain. Research studies on SCS have shown that while there is evidence that it can alleviate pain, there is also a significant risk of complications. Studies have also shown that SCS outcome can be predicted by psychological assessment methods.

    This webinar will include:

    • A brief review of the nature of spinal cord simulation and related treatments, and how they are used to treat pain and other conditions;
    • A brief review of medical treatment guidelines for chronic pain, and why the majority of them require presurgical psychological assessment for spinal cords stimulators;
    • Theoretical paradigms of chronic pain and delayed recovery that have been adopted by guidelines;
    • Biopsychosocial risk factors for poor SCS outcome that have been identified by empirical and clinical consensus methods; and
    • Extensive supplementary materials will also be provided.
    • The use of the BHI 2 Medical Intervention Risk Report will also be discussed in this context.

    Date: Oct 25, 2017

    pdf PDF: Presurgical psychological evaluation for spinal cord stimulation

    link Video: Presurgical psychological evaluation for spinal cord stimulation

    pdf PDF: Follow­-up Questions and Answers from Presurgical Psychological Evaluation for Spinal Cord Stimulation Webinar

  • Medical Intervention Risk Report Explained – Part 1

    Presenter: Daniel Bruns, PsyD FAPA

    The Medical Intervention Risk Report is a standardized measure intended for the biopsychosocial assessment of medical patients suffering from pain or injury. The MIR is published by Pearson Assessments

    Date: Jan 11, 2017

    pdf PDF: MIR Explained – Part 1

    link Video: MIR Explained – Part 1

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