Our integrated screening and progress monitoring tools can simplify the way you provide measurement-based care. You can now automatically send scored measures like the GAD-7 and PHQ-9 to your clients on a recurring basis. When clients complete a measure, their scores will be calculated for you, and you’ll be able to view their progress over time on the Measures tab of a client’s profile.
In this guide, we’ll cover:
- Understanding scored measures
- Enabling scored measures
- Scheduling recurring measures
- Viewing scores and completed measures
- Visualizing scores over time
- FAQs
Understanding scored measures
Scored measures are self-report assessment tools that can be used to screen for mental health conditions and evaluate treatment progress. The following scored measures are available in SimplePractice:
Enabling scored measures
To add a scored measure to your account:
- Navigate to Settings > Notes & Forms > Template Library
- Select + Add next to the scored measure you’d like to add
Note: Only Account Owners, Clinicians with Administrative Access, and Practice Managers can manage templates in a group practice account. To learn more, see Team member roles and access levels.
The scored measure will be added to your My Notes & Forms page. While there’s no way to edit a scored measure, you can preview it by clicking the eye icon.
Note: A template must be enabled on the My Notes & Forms page to be available to share with clients. If you previously removed a scored measure, you can navigate to Settings > Notes & Forms > My Notes & Forms and check the box for the template you’d like to reenable.
Scheduling recurring measures
To schedule measures to be automatically sent to clients on a recurring basis:
- Navigate to the client’s Overview page
- Click Share
- Check the box next to the scored measure(s) you want to share
- Choose the Frequency
- Once
- Before every appointment
- Before every other appointment
Note: Only scored measures can be scheduled to send automatically.
- Click Continue to Email
- Follow the prompts to schedule the recurring item(s)
Note: You can edit the Recurring measure request email template at Settings > Client Portal > Emails. For an overview of the paperless intake process, see Sending intake forms and documents to clients.
If you choose Before every appointment or Before every other appointment, the measure will be automatically sent 24 hours before the client’s next appointment. If the appointment is less than 24 hours away, the first measure will be sent immediately. Clients who haven’t completed a scored measure will also receive an email 1 hour before their appointment.
To remove a scheduled recurrence:
- Navigate to the client’s Overview page
- Select the Files tab
- Locate the scheduled measure
- Select the 3 horizontal dots next to it > Delete
- Select End recurrence
To change the frequency of a recurrence, you can delete the scheduled measure and reshare it with the desired frequency.
Note: To learn more about using the Files tab, see Managing the client Files Overview page.
Viewing scores and completed measures
Measures completed by clients will be scored automatically. You can review the client's score and responses from their Overview page. To do this:
- Click All Items
- Select Scored measure from the dropdown menu
- Click the completed measure you’d like to view
Along with the client’s responses to each question, you’ll see a Score and a Scoring interpretation. You can click View scoring guide for more information:
Important: Some scored measures, like the PHQ-9, include questions about suicidality and self-harm. If a client answers affirmatively, a high-risk flag will display when you view their results. To learn more, see How is the high-risk flag generated on scored measures?
Visualizing scores over time
Routinely administering scored measures can help you track a client’s progress over time and identify patterns or trends. To view this data:
- Navigate to the client’s Overview page
- Select the Measures tab
If the client has completed a measure multiple times, each score will be displayed on the graph, along with the change since the first measure they completed (since baseline) and their most recently completed measure (since last).
FAQs
- What is the GAD-7?
- What is the PHQ-9?
- What is the source for the scoring interpretations?
- How is the high-risk flag generated on scored measures?
- Will scored measures that my clients previously completed as intake forms be scored and graphed?
- Can my client still complete a scheduled measure after an appointment?
What is the GAD-7?
The Generalized Anxiety Disorder 7-item scale, or GAD-7, is a tool designed to measure the presence and severity of anxiety. It includes the following questions:
| Over the last 2 weeks, how often have you been bothered by the following problems? | ||||
| 1. Feeling nervous, anxious, or on edge | Not at all (0) | Several days (1) | Over half the days (2) | Nearly every day (3) |
| 2. Not being able to stop or control worrying | Not at all (0) | Several days (1) | Over half the days (2) | Nearly every day (3) |
| 3. Worrying too much about different things | Not at all (0) | Several days (1) | Over half the days (2) | Nearly every day (3) |
| 4. Trouble relaxing | Not at all (0) | Several days (1) | Over half the days (2) | Nearly every day (3) |
| 5. Being so restless that it’s hard to sit still | Not at all (0) | Several days (1) | Over half the days (2) | Nearly every day (3) |
| 6. Becoming easily annoyed or irritable | Not at all (0) | Several days (1) | Over half the days (2) | Nearly every day (3) |
| 7. Feeling afraid as if something awful might happen | Not at all (0) | Several days (1) | Over half the days (2) | Nearly every day (3) |
| If you checked off any problems, how difficult have these made it for you to do your work, take care of things at home, or get along with other people? | Not difficult at all | Somewhat difficult | Very difficult | Extremely difficult |
The GAD-7 is calculated by assigning a score of 0, 1, 2, or 3 to the answers to questions 1-7, and the total score ranges from 0 to 21.
| Score | Anxiety severity |
| 0-4 | None-minimal |
| 5-9 | Mild |
| 10-14 | Moderate |
| 15-21 | Severe |
This tool was developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke, and colleagues.
What is the PHQ-9?
The Patient Health Questionnaire-9, or PHQ-9, is a tool designed to measure the presence and severity of depression. It includes the following questions:
| Over the last 2 weeks, how often have you been bothered by any of the following? | ||||
| 1. Little interest or pleasure in doing things | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| 2. Feeling down, depressed, or hopeless | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| 3. Trouble falling or staying asleep, or sleeping too much | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| 4. Feeling tired or having little energy | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| 5. Poor appetite or overeating | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| 6. Feeling bad about yourself—or that you are a failure or have let yourself or your family down | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| 7. Trouble concentrating on things, such as reading the newspaper or watching television | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| 8. Moving or speaking so slowly that other people could have noticed? Or the opposite—being so fidgety or restless that you have been moving around a lot more than usual | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| 9. Thoughts that you would be better off dead or of hurting yourself in some way | Not at all (0) | Several days (1) | More than half the days (2) | Nearly every day (3) |
| If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people? | Not difficult at all | Somewhat difficult | Very difficult | Extremely difficult |
The PHQ-9 is calculated by assigning scores of 0, 1, 2, or 3 to answers for questions 1-9, and the total score ranges from 0 to 27.
| Score | Depression severity |
| 0-4 | None-minimal |
| 5-9 | Mild |
| 10-14 | Moderate |
| 15-19 | Moderately Severe |
| 20-27 | Severe |
This tool was developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke, and colleagues.
What is the source for the scoring interpretations?
Each measure and the corresponding scoring information are reproduced directly from source material and supporting literature. You can view the Sources on the scoring guide, as well as at the bottom of each completed measure:
How is the high-risk flag generated on scored measures?
Some measures, like the PHQ-9, include questions related to suicidal ideation. If a client reports that they’ve had thoughts of suicide or self-harm Several days, More than half the days, or Nearly every day, this will be indicated by a high-risk flag when you view their results.
If a client respond affirmatively to a suicidal ideation question, they’ll see the following modal upon submitting the measure:
Will scored measures that my clients previously completed as intake forms be scored and graphed?
GAD-7 or PHQ-9 intake forms that have been previously completed by clients won't be scored or graphed on the client's Measures tab. To view all completed GAD-7 or PHQ-9 questionnaires:
- Navigate to the client’s Overview page
- Select All Items > Scored measure
Can my client still complete a scheduled measure after an appointment?
If a client didn’t complete a measure before their appointment, they can still do so afterwards. For scheduled measures, clients receive an automated email 24 hours before their next appointment, as well as 1 hour before their appointment if the measure hasn't yet been completed.
Note: You can also manually send clients a reminder to complete Pending documents at any time. For more information, see Sending a reminder for pending forms, documents, or uploaded files.
