Common psychological assessment tools to use | Headway

How do I effectively use psychological assessment tools?

First, it’s important to understand the different contexts in which psychological assessment tools may be helpful. These include:

Screening: Assessment tools that are quick and easy to administer, like self-guided questionnaires, provide a great way to screen a client for a particular condition. The results may not be enough to make a formal diagnosis, but they can inform further care and analysis.
Diagnosis: Many popular assessment tools are meant to clarify which DSM-5 diagnostic criteria a client meets, making them valuable assets when determining an official diagnosis. The results of assessments are often paired with other diagnostic methods, like structured interviews.
Symptom and outcome monitoring: Many commonly used assessment tools focus on symptoms experienced during specific periods of time, like the previous two weeks or month. Repeatedly administering these tests over time can help clinicians make data-informed insights about treatment efficacy and client progress.

Here are five commonly used psychological assessment tools to consider integrating into your practice.

PHQ-9 for depression

The Patient Health Questionnaire-9, also known as the PHQ-9, is a nine-question assessment that can be used to help measure depression. Clients take the questionnaire themselves, answering prompts about how often in the last two weeks they’ve experienced symptoms of major depressive disorder, such as low mood, anhedonia, low energy, and trouble sleeping or concentrating.

Question 9 on the PHQ-9 asks about suicidal ideation. A provider is obligated to respond immediately if risk is indicated. As a therapist, you should have a plan for this if you are sending the assessment to your client virtually or outside of the session.

Once a client completes the questionnaire, their clinician scores their responses. The client is given zero points for each symptom they’ve experienced “not at all” in the last two weeks. They get one point for each symptom they’ve experienced on “several days,” two points for each symptom they’ve experienced on “more than half the days,” and three points for each symptom they’ve experienced “nearly every day.” The higher a client’s total score, the more severe their depression is thought to be.

Providers often use the PHQ-9 to assess whether a new patient has signs of depression, but it can also be used to assess a client’s progress over time.

GAD-7 for anxiety

The Generalized Anxiety Disorder-7, or GAD-7, is another self-administered questionnaire. This one is used to assess whether a client may be suffering from an anxiety disorder. Each of its seven questions relates to one of the DSM-5’s diagnostic criteria for generalized anxiety disorder, including feeling anxious, worrying, restlessness, and irritability.

Like the PHQ-9, the GAD-7 is scored based on the frequency of each symptom. A respondent gets three points for each symptom present “nearly every day” over the last two weeks, two for those present on “more than half the days,” one for those experienced on “several days,” and zero for each non-relevant symptom.

A client’s total score helps their provider understand the extent of their anxiety, making the GAD-7 a useful tool for assessing new clients. It can also be helpful for an existing client to repeatedly take the GAD-7; if their score progressively drops, that’s a good signal that treatment is working well.

Insomnia Severity Index

It’s important for clinicians to understand their clients’ sleep health. The DSM-5 lists insomnia disorder as a diagnosis of its own, and sleep difficulties are also a component of many other mental health disorders. The Insomnia Severity Index, or ISI, is a helpful tool for analyzing some of these issues.

The self-administered questionnaire includes seven questions related to the individual’s difficulty falling and staying asleep, as well as their overall satisfaction with their sleep and its effect on their life. Responses to each question are graded on a five-point scale, and a client’s total score is used to evaluate their insomnia severity. A score of 15 or above is considered clinically significant.

Providers can use the ISI to help diagnose and measure progress treating insomnia disorder, or to evaluate the extent to which sleep issues fit into other potential diagnoses.

PCL-5 for PTSD

The DSM-5 lays out 20 symptoms potentially associated with PTSD, ranging from repeated thoughts or dreams of a stressful situation to risk-taking behavior and irritability. The PCL-5 — which stands for Posttraumatic Stress Disorder Checklist for DSM-V-TR — is meant to help providers understand which symptoms from that long list a client experiences, and how troubling they are to the individual.

To meet the criteria for PTSD, it is important to note that the client must have experienced a qualifying event (noted as criteria A). While your client may show all of the correct symptoms, they won’t get a PTSD diagnosis if criteria A is not met.

The PCL-5 self-guided questionnaire asks about the extent to which a person was bothered by each of those 20 symptoms in the past month. Each response receives a score from zero to four points. Studies suggest a total score of at least 31 hints that a PTSD diagnosis is appropriate, but clinicians must supplement the PCL-5 with other diagnostic tools, like a structured interview.

The PCL-5 can also be used to measure how well a client is responding to treatment over time.

WHO-5 for wellbeing

This tool, developed by the World Health Organization, is a quick and easy questionnaire used to measure someone’s overall wellbeing. The WHO-5 is sometimes used to screen for depression — but since it provides valuable insight into a client’s daily life and overall status, it may be worth using regardless of someone’s presenting concern.

This tool consists of only five questions. Clients are asked to think about the last two weeks, then answer how often they’ve felt cheerful, calm, active, well-rested, and interested in their days. They receive five points for each answer of “all of the time,” four for “most of the time,” three for “more than half the time,” two for “less than half the time,” one for “some of the time,” and zero for “at no time.”

Since the WHO-5 relates only to a two-week period, it can be revisited to see how a patient’s overall wellbeing has changed over time.

Headway offers built-in assessment tools

Offering data-informed care is a breeze with Headway. Providers can use the Headway platform to send and administer assessments like the PHQ-9 and GAD-7, making it easier than ever to detect symptoms, make accurate diagnoses, and track client progress over time. These offerings are just one component of Headway’s mission to make therapists’ jobs simpler and more efficient, so they can focus on providing high-quality care.

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