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How to use the GAD-7 for anxiety assessment

The GAD-7 can help you narrow down a diagnosis if your client is experiencing anxiety symptoms, along with allowing you to track their progress over time.

If a client presents with symptoms such as persistent worrying or restlessness, you may wonder if they’re suffering from an anxiety disorder.

A self-administered questionnaire, the GAD-7 can help you narrow down a diagnosis if your client is experiencing anxiety symptoms, along with allowing you to track their progress over time (and update their treatment plan accordingly). Below, learn more about the GAD-7 assessment, and how you can use it to better help your clients with anxiety.

What is GAD-7?

The GAD-7 is a seven-question screening tool that assesses for generalized anxiety disorder. Each of the seven questions on the assessment highlights one of the specific diagnostic criteria for GAD. Along with providing a tool for diagnosing GAD, it also assesses the severity of anxiety symptoms. 

It’s a self-report questionnaire, which means a client fills out the questions based on their own experience, and then a medical provider scores it. The questionnaire provides a quick and reliable way for healthcare professionals to assess the presence and severity of anxiety symptoms, facilitating appropriate interventions and treatment planning. 

Research has consistently shown the GAD-7 to be a valid and efficient reporting tool in primary care and therapeutic settings. Keep in mind that the GAD-7 is not a diagnostic tool on its own, and a comprehensive clinical evaluation is typically necessary for a formal diagnosis.

GAD-7 assessment

The GAD-7 questionnaire includes the following questions, and prompts clients to mark “not at all,” “several days,” “more than half the days,” or “nearly every day.”

Over the last two weeks, how often have you been bothered by the following problems? 

  1. Feeling nervous, anxious, or on edge
  2. Not being able to stop or control worrying 
  3. Worrying too much about different things 
  4. Trouble relaxing 
  5. Being so restless that it is hard to sit still 
  6. Becoming easily annoyed or irritable 
  7. Feeling afraid as if something awful might happen

GAD-7 scoring

Each of the seven questions on the GAD-7 has a four-point scoring scale, on which clients report and rate their symptoms on a scale of 0-3.

Nearly every day: 3 points

More than half the days: 2 points

Several days: 1 point

Not at all: 0 points

When each answer is assigned a point value, the total score for the GAD-7 assessment can range from 0–21, with higher scores generally indicating more severe anxiety symptoms. The scores of 5, 10, and 15 are taken as cut off points for mild, moderate, and severe anxiety.

Score 0-4: Minimal Anxiety

Score 5-9: Mild Anxiety

Score 10-14:: Moderate Anxiety

Score 15 or greater: Severe Anxiety

Monitoring changes in GAD-7

While the GAD-7 is especially helpful in screening for and diagnosing anxiety, it’s also a useful tool for monitoring a client’s progress. For example, if you diagnosed a client with GAD six months ago, you can re-issue the GAD-7 to determine the current severity of symptoms and adjust your treatment plan as needed.

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