Marathon Weight Burden Scale (MWBS)

---
title: Psychosocial & Functional Impact Summary – Marathon Weight Burden Scale (MWBS)
date: 2025-12-01
client_id: [CLIENT ID]
client_name: [CLIENT NAME]
evaluator: [EVALUATOR NAME, CREDENTIALS]
context: [e.g., Clinical Evaluation / Immigration Case / Hardship Assessment]
---

# 1. Identifying Information

- **Name:** [CLIENT NAME]
- **Date of Birth:** [DOB]
- **Evaluation Date:** [DATE]
- **Evaluator:** [NAME, CREDENTIALS]
- **Context of Evaluation:** [e.g., asylum claim, VAWA petition, hardship waiver, clinical intake, ongoing treatment]

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# 2. Reason for Referral

[Brief description of why the evaluation is being conducted, e.g.:

"[CLIENT NAME] was referred for a psychosocial evaluation to assess the cumulative impact of trauma, environmental stressors, and functional impairment in the context of [immigration proceedings / mental health treatment / other]. The Marathon Weight Burden Scale (MWBS) was used as a narrative tool to help quantify and communicate the overall life burden currently carried by the client."]

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# 3. Instruments & Sources of Information

- Clinical interview
- Review of available records: [list documents, if any]
- Self-report by client
- **Marathon Weight Burden Scale (MWBS) – 100-Item Checklist (conceptual burden index, 0–1000 lbs)**
- Additional standardized measures (if applicable):
  - [BDI / BAI / PCL / HSCL-25 / TSI / ICG / other]

The MWBS is an integrative, metaphor-based tool drawing conceptually from established instruments such as:

- Beck Depression Inventory (BDI)
- Beck Anxiety Inventory (BAI)
- Clinician-Administered PTSD Scale (CAPS) / PTSD Symptom Checklist (PCL)
- Hopkins Symptom Checklist-25 (HSCL-25)
- Trauma Symptom Inventory (TSI)
- Inventory of Complicated Grief (ICG)
- Multidimensional Loss Scale (MLS)
- Migratory Grief and Loss Questionnaire (MGLQ)
- Demands of Immigration (DI) Scale
- Border Community & Immigration Stress Scale (BCISS)

The MWBS does not replace these instruments; it translates their underlying constructs (e.g., trauma, depression, anxiety, immigration-related stress, grief, loss, environmental adversity) into a single, intuitive "weight" metric.

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# 4. Description of the Marathon Weight Burden Scale (MWBS)

The MWBS conceptualizes a person's cumulative burden as the metaphorical "weight" they are carrying while running the marathon of daily life. Each of 100 checklist items corresponds to a 10-lb increment, yielding a total range of **0–1000 lbs**.

For reference, a typical adult with ordinary life challenges but no major trauma or instability is estimated to carry approximately **100 lbs** (about 10 endorsed items). Higher scores reflect:

- Greater number of life stressors and adversities
- More severe environmental instability (housing, financial, legal, safety)
- Psychological injuries (trauma, depression, anxiety, grief)
- Limited social and practical support
- Closer proximity to crisis or collapse in functioning

Domains assessed include:

1. Load & Responsibilities
2. Environment & Stability
3. Trauma & Psychological Injuries
4. Financial Strain
5. Housing & Safety
6. Social Support
7. Immigration Stress
8. Health & Medical
9. Identity, Belonging & Distance
10. Acute Crises

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# 5. MWBS Results

- **Total Items Endorsed:** [N of 100]
- **Total Estimated Burden:** **[N × 10] lbs**
- **Estimated Average Life Load for Comparison:** ≈ 100 lbs
- **Approximate Multiplier Over Average Load:** [TOTAL / 100]×
- **Overall Category:** [Normal human difficulty / Elevated load / Heavy strain / Extreme strain / Severe burden / Crisis load / Collapse territory]

## 5.1 Domain-Level Summary

| Domain                           | Items Endorsed | Estimated Pounds |
|----------------------------------|----------------|------------------|
| Load & Responsibilities          | [n]            | [n×10] lbs       |
| Environment & Stability          | [n]            | [n×10] lbs       |
| Trauma & Psychological Injuries  | [n]            | [n×10] lbs       |
| Financial Strain                 | [n]            | [n×10] lbs       |
| Housing & Safety                 | [n]            | [n×10] lbs       |
| Social Support                   | [n]            | [n×10] lbs       |
| Immigration Stress               | [n]            | [n×10] lbs       |
| Health & Medical                 | [n]            | [n×10] lbs       |
| Identity, Belonging & Distance   | [n]            | [n×10] lbs       |
| Acute Crises                     | [n]            | [n×10] lbs       |

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# 6. Interpretation of MWBS Profile

[Insert narrative synthesis, e.g.:

"[CLIENT NAME] endorsed [N] of 100 MWBS checklist items, corresponding to an estimated total of [TOTAL] lbs of burden. This places them in the category of [CATEGORY], indicating [e.g., severe burden with features of crisis-level strain]. Compared to an estimated "average" life load of approximately 100 lbs, [CLIENT NAME] is carrying roughly [FACTOR] times the typical burden.

The greatest contributors to this weight were identified in the domains of [TOP DOMAINS], suggesting that the client's functioning is heavily impacted by [e.g., environmental instability, immigration-related stress, lack of support, and recent crises]. This profile is consistent with the clinical presentation observed in interview and with the history of [trauma, losses, persecution, discrimination, etc.]."]

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# 7. Functional Impact

[Describe how this burden affects daily functioning, e.g.:

- Impact on work, school, or caregiving
- Impact on concentration, memory, and decision-making
- Impact on sleep, appetite, and physical health
- Impact on ability to manage legal and administrative tasks
- Impact on social relationships and support-seeking

Explain how the cumulative "weight" makes ordinary tasks significantly more difficult than they would be for someone carrying only an average load.]

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# 8. Clinical / Legal / Practical Implications

[For clinical contexts:]

- Need for trauma-informed care
- Importance of stabilizing environment (housing, safety, finances)
- Recommendations for frequency/intensity of treatment
- Need for coordination with community resources

[For immigration/legal contexts:]

- Degree to which removal, denial, or lack of relief would exacerbate existing burden
- Risk of psychological deterioration or decompensation under additional stress
- Role of the host environment in either mitigating or compounding existing weight
- Explanation of why functioning may appear "intact" despite crisis-level load (adaptation and survival mode)]

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# 9. Limitations

- The MWBS is a conceptual, self-report, metaphor-based measure and is not a diagnostic tool.
- Responses may be influenced by recall, insight, cultural factors, and current state.
- Results should be interpreted in combination with other clinical information and standardized instruments where available.

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# 10. Summary

[Concise 1–2 paragraph summary of the client's burden, main domains of impact, and key conclusions relevant to the referral question.]

- **Overall MWBS Weight:** [TOTAL] lbs
- **Category:** [CATEGORY]
- **Approximate Multiplier vs Average Life Load:** [FACTOR]×

[Evaluator Signature]
[Name, Credentials]
[Date]

Based on the **Marathon Weight Burden Scale (MWBS)** 100-item checklist, I endorsed **[TOTAL_ITEMS]** out of 100 possible items. This corresponds to an estimated burden of **[TOTAL_LBS] lbs** of cumulative psychological, environmental, and situational weight.

For comparison, a typical adult with normal life difficulties might endorse around **10 items (≈ 100 lbs)**. This means that right now, I am carrying approximately **[FACTOR]×** the weight of an "average" life load.

### Where the weight is coming from

The domains that contributed most to my total burden are:

- **Load & Responsibilities:** [N_LOAD items, N_LOAD×10 lbs] – [brief description in my own words]
- **Environment & Stability:** [N_ENV items, N_ENV×10 lbs] – [how unstable or unpredictable things feel]
- **Trauma & Psychological Injuries:** [N_TRAUMA items, N_TRAUMA×10 lbs] – [how my history and symptoms show up day to day]
- **Financial Strain:** [N_FINANCE items, N_FINANCE×10 lbs] – [how money stress affects my choices and nervous system]
- **Housing & Safety:** [N_HOUSING items, N_HOUSING×10 lbs] – [how safe or unsafe home feels]
- **Social Support:** [N_SUPPORT items, N_SUPPORT×10 lbs] – [who I can or cannot rely on]
- **Immigration Stress:** [N_IMM items, N_IMM×10 lbs] – [immigration-related fear, loss, and uncertainty]
- **Health & Medical:** [N_HEALTH items, N_HEALTH×10 lbs] – [how my body and health limit or drain me]
- **Identity, Belonging & Distance:** [N_ID items, N_ID×10 lbs] – [how far I feel from stability and belonging]
- **Acute Crises:** [N_CRISIS items, N_CRISIS×10 lbs] – [recent events that knocked everything else over]

### What this actually means

This score does not mean I am weak. It means I am running a marathon with **[TOTAL_LBS] lbs** on my back while many people are running with around 100 lbs on theirs.

It explains why:

- Things that look "small" from the outside can feel huge to me.
- My energy is limited, even when I look "functional."
- My nervous system is often in survival or crisis mode, not rest mode.

### Why this matters

Under this kind of load, it is not reasonable to expect myself to perform, recover, or "bounce back" like someone who is carrying only an average weight. Any support I receive (financial, emotional, legal, medical, or practical) doesn't just make life "easier" – it directly reduces the weight I am trying to carry while still moving forward.

This narrative is meant to give language and structure to my experience so that I, and the people supporting me, can better understand the scale of what I am holding and why it feels the way it does.