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Assessments and measurement-based care

a Headway Guide
Understanding client concerns and tracking progress can be overwhelming. Here’s how assessments make it easy.
What are assessments

Assessments are a simple tool for unlocking the benefits of measurement-based care

What are assessments?
Assessments are simple questionnaires your clients take on a regular basis, such as weekly or monthly. Each assessment focuses on a particular subject. Examples include general well-being, treatment satisfaction, or symptoms related to a specific condition, like anxiety or depression.
Assessments are a critical part of measurement-based care.

What is measurement-based care?
Measurement-based care is the practice of evaluating clients' symptoms and progress using standardized and trackable results. When you combine traditional qualitative aspects of therapy with a quantitative element like assessments, you get the holistic benefits of measurement-based care.

  • Making observations about a client’s mood, thoughts, and affect
  • Asking for client’s own comments on how they’re feeling
  • Assessing how the therapy process is going based on client’s responses and attitude
  • Numerical scores on client’s current state of mind
  • Standardized results showing progression or regression
  • Changes or spikes in client’s attitude following specific interventions
Measurement-based care
  • A comprehensive record of care, with client scores backing up your own observations
  • A timeline showing client’s overall progression and areas that still need improvement
  • Peace of mind that you’re capturing client’s thoughts and feelings both in sessions and through assessments
Assessments provide a simple and effective way to implement measurement-based care into your practice. See how Michael Heckendorn, a clinical lead at Headway, uses assessments in his practice.
Why use assessments
Assessments can increase clinical effectiveness and client satisfaction
Why incorporate measurement-based care in your practice?
As a clinician, you already engage in key aspects of assessments in your everyday practice. Through your observations and interactions with clients, you continuously assess their mental and emotional well-being. That said, adding measurement-based assessments can help make your job easier and improve your care in a variety of ways. Here’s how:
Detect issues early
By tracking changes in a client’s concerns or well-being through assessments, you can quickly see areas that need the most attention, whether it’s specific spikes in anxiety, or similar feelings that show up repeatedly on assessment results.
Assess treatment effectiveness 
Sometimes, it can be difficult to say how effective treatment has been, even after many months. Measurement-based care gives you a specific and numerical way to assess exactly how much progress your client has actually made.
Make necessary modifications
Therapy often involves a series of separate interventions, mood logs, or other approaches, where success varies from client to client. Measurement-based care can quickly tell you which ones are working and which aren’t based on how client scores change following each new type of activity.
Give client a sense of progress
Even when a client is making great progress, it’s often difficult for them to see or acknowledge it. Improving assessment scores help demonstrate progress to the client in a tangible way.
How to send assessments
How sending assessments works
Implementing assessments into your practice is as simple as choosing which ones to send to which clients, deciding on a frequency (e.g. weekly or monthly), and then tracking the results over time. Here’s a quick look at how this works for providers on Headway:

Prepare your clients
Before sending assessments, it’s often a good idea to chat with your clients in advance so they know what to expect. This might include
  • Describing what assessments are, and how they can help you tailor treatment to their specific needs
  • Explaining how assessments make clients an active participant in their own care, helping them understand how they’re progressing

Customize based on client needs
Adjusting the frequency of assessments — or pausing altogether if necessary — can help you tailor your approach to the right level for each client. For example, you might choose to send several weekly assessments to one client, and a single monthly assessment to another. Later, you might pause assessments for another client altogether.
Review results and adjust
A key part of assessments is reviewing results in advance of a session, then using notable changes or outliers as a point of discussion with your client.
Frequently asked questions

Generally speaking, it’s a good idea to send assessments that line up with each client’s particular concerns and goals. For example, the Patient Health Questionnaire 9-item (PHQ-9) measures symptoms related to depression, while the General Anxiety Disorder 7-item (GAD-7) tracks anxiety symptoms.

Some assessments, like the World Health Organization’s Five Well-Being Index (WHO-5), measure more general feelings on well-being, which makes it a good fit for a wider range of clients, regardless of their primary presenting problem.

That’s fine! You can pause or fully turn off assessments at any time — and even do this on a per client basis. You control which assessments you send and to which clients. We understand that client needs change across the course of treatment.

Your client’s individual assessment results are private and confidential. On Headway, only you and your client can see their individual results. Meanwhile, Headway and insurers can see aggregate, non-identifiable assessment results reflecting averages across a large number of providers and clients. Visit our Help Center to learn more about how Headway shares assessment results.

We intentionally launched assessments with a plan to build the tool in partnership with our providers. We want you to have a voice. That means influence over how the product improves and evolves. Please send any feedback here so we can build the best experience for your practice.

It’s understandable for clients to have questions about assessments. Consider reminding your client that assessments only take a minute or two to complete, and are a simple tool for helping tailor their treatment while giving them a sense of progress. Remind them that the individual responses to assessment questions will stay between you and them, and that they are commonly used by many providers.

If your client is still unsure, it’s okay to hold off and revisit once you’ve established a stronger relationship. Assessments should be a benefit for treatment, and not a barrier.

Assessments are a great option for teletherapy. Sometimes, clients need a bit more time to warm up or focus on the treatment plan when seeing you in a video setting. Assessments provide a great resource for kickstarting conversations about where the client has concerns, and which goals to focus on first.