Brief Battery for Health Improvement 2 (BBHI™ 2)

Brief Battery for Health Improvement 2 (BBHI™ 2)

Key Information


John Mark Disorbio, EdD, Daniel Bruns, PsyD


Brief 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 years old


Paper-and-pencil, CD, computer or online administration

Scoring Option:

Q-global™ Scoring & Reporting, Q™ Local Software, Mail-in Scoring Service, Fax-in Service, or PAD

Reading Level:

6th Grade

Completion Time:

7–10 minutes (63 multiple-choice items)


Census matched community sample, physical rehabilitation/pain patient sample


Tips on using this test in your telepractice

Report Options:

Standard Report, Extended Report, Progress Report

Publication Date:


Brief Battery for Health Improvement 2 (BBHI™ 2)


A brief diagnostic tool well-suited for initial intake and outcomes measurement of patients treated for pain and injury.

Derived from the well-researched, widely used BHI™ (Battery for Health Improvement) test, the shorter BBHI 2 instrument helps practitioners quickly evaluate for a number of psychomedical factors commonly seen in patients with injuries, such as pain, somatic, and functional complaints – as well as traditional psychological concerns such as depression, anxiety and patient defensiveness.

The information provided by the BBHI 2 test can help medical professionals obtain a quick yet comprehensive overview of the patient to help in treatment planning and in determining whether the patient may need a more in-depth evaluation by a psychologist.

Key Features


Taking only 7–10 minutes to administer, the BBHI 2 test:

  • Provides a single instrument to help measure a variety of pain-related issues, including level of pain, functionality, and emotional distress.
  • Uses a nationally standardized 0–10 pain scale, which assesses multiple dimensions of the pain experience, including level of pain in 10 body areas, pain tolerance, pain range, and peak pain.
  • Efficiently assess patients to develop appropriate treatment plans and determine whether further psychological evaluation is needed.
  • Includes validity checks. The Defensiveness Scale can help detect tendencies to minimize or magnify distress, while the inclusion of a validity item helps detect random responding.
  • Helps practitioners meet assessment guidelines proposed by organizations such as the Counsel for the Accreditation of Rehabilitation Facilities (CARF) and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).


Validity Scale

  • Defensiveness

Physical Symptom Scales

  • Somatic Complaints
  • Pain Complaints
  • Functional Complaints

Affective Scales

  • Depression
  • Anxiety

Character Scales

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

Psychosocial Scales

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

Psychometric Information

Normed on a community sample of 725 individuals and a sample of 527 physical rehabilitation and chronic pain patients. The report compares the patient to both norm groups and uses the average physical rehabilitation/pain patient as a benchmark for interpretations and recommendations.

To provide further context for assessing the patient’s results, the BBHI 2 instrument also compares the patient, where appropriate, to 7 other reference groups in the reports:

  • Head injury/Headache
  • Neck injury
  • Upper extremity injury
  • Back injury
  • Lower extremity injury
  • Fake Good
  • Fake Bad


Report Options

Standard Report

Provides a concise narrative statement about the patient in the following sections: profile graph, critical items, clinical summary, and pain complaints item responses.

Extended Report

Provides more in-depth information about the patient in the following sections: profile graph, critical items, clinical summary, and pain complaints item responses. This report includes a diagnostic probabilities section as well.

Progress Report

This report enables the clinician to monitor the patient’s progress over time through repeat administrations.

The Critical Items section highlights red flag indicators of clinical concerns:

  • Suicide Ideation
  • Pain Fixation
  • Chemical Dependency
  • Sleep Disorder
  • Perceived Disability
  • Compensation Focus
  • Home Life Problems
  • Satisfaction with Care
  • Doctor Dissatisfaction
  • Psychosis
  • Vegetative Depression
  • Anxiety/Panic
  • PTSD/Dissociation
  • Death Anxiety
  • Random Responding

The Pain Complaint Item Responses capture your patient’s 0–10 pain ratings, similar to a VAS scale and also compares the patient’s reports to one of several possible reference groups.

View a sample Standard Report.

View a sample Extended Report.

View a sample Progress Report.

Scoring and/or Reporting 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 Service – Specially designed answer sheets are faxed to us for processing within 1-2 hours of receipt and 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.

  • Getting Started with the Q-global Training Series

    View these brief training modules about Q-global:

    BBHI™ 2 (Brief Battery for Health Improvement 2) Online Tutorials

    This pre-recorded 20-30 minute session allows you to learn at your leisure. All you need is access to the Internet and the sound enabled on your computer. Please keep in mind that the session may take a few minutes to load.

    These two tutorials will help you quickly gain an understanding of how to use the BBHI 2 test to efficiently assess for pain, function, depression, and other biopsychosocial issues that are commonly associated with pain and rehabilitation patients.

    BBHI 2 Brief Tutorial: A brief overview that discusses what the test measures, how you can easily incorporate it into your office protocol, and insurance reimbursement. (16 minutes)

    Attend a Session

    An In-Depth Look at the BBHI 2 Report: Thoroughly discusses the information available on the test’s results report and how you can use that information to better understand your patient’s level of pain and expectations from treatment. (10 minutes)

    Attend a session

Pre-recorded Webinars

  • Presurgical psychological evaluation for spinal cord stimulation

    Presenter: Daniel Bruns, PsyD, FAPA

    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

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


Frequently asked questions follow. Click on a question to see the response.

Test Content

  • What is the BBHI 2 assessment designed to do?


  • When is it appropriate to use the BBHI 2 assessment?

  • What are the benefits of having a test normed on rehabilitation/pain patients?

  • Can I administer just one of the BBHI 2 scales?


  • What are the BBHI 2 defaults?

  • If I score a Standard Report, can I print an Extended Report at no extra charge?

  • How are the ratings and percentiles of each scale determined on the profile report?

  • What is the benefit of using the BBHI 2 Pain Scale?