The Holmes and Rahe Stress Scale is a rubric a health care provider can use to assess a patient's risk of stress-related illnesses. Patients can also use it as a self-assessment tool and may find it helpful for making decisions about treatment for stress. It is freely available online and through counseling offices, with both adult and non-adult versions in publication.
This tool was developed by doctors Richard Rahe and Thomas Holmes in the late 1960s. They knew that stress can contribute to the development of illness and wanted to understand how different life events can affect a person's health. They pulled together patient data as well as survey results from a variety of populations to develop a rubric that could apply to people from many different backgrounds. Initially the rubric was known as the Social Readjustment Rating Scale, but has since become generally known just as the Holmes and Rahe Stress Scale.
The scale includes a list of more than 40 life events like changing careers, a death in the family, or breaking the law. Each event is assigned a numeric value in terms of how much impact it can have on a person's health. Losing a spouse has a score of 100, the most serious impact. A jail term scores 63, while going on vacation is a 13. A patient can go down the list to determine how many of these events he has experienced in recent months, and the total can be added to determine where he falls on the Holmes and Rahe Stress Scale.
If the score is below 150, it suggests that the patient is not at very high risk for health problems related to stressful life events. Scores between 150 and 250 are a cause for concern, with an elevated risk. The patient may benefit from interventions like therapy and other forms of assistance. Scores above 250 indicate a high risk of developing illness.
The scale for non-adults focuses on life events that can occur in childhood and the teenage years, like leaving home for the first time, or a parent's job loss. This version of the Holmes and Rahe Stress Scale can be of use for guidance counselors and other professionals who work with youth. They can use the scale to identify students and clients at risk of health complications because of stressful life events. The scale can also be helpful for developing appropriate interventions.