Assessments (e.g., PHQ-9, GAD-7, AUDIT-C) help you track client-reported concerns to better prepare for upcoming sessions. To get started, click on the Assessments tab within the profile page of a client.
Baseline for every new adult client: Every new adult client (18 and over) receives a baseline PHQ-9 or GAD-7, however they were added to your caseload. When you add a client in Sigmund, PHQ-9 and GAD-7 appear pre-checked. Keep at least one selected. Talk therapists default to every other appointment and prescribers to every appointment. You can add up to 10 assessments and customize frequency per client.
Clients receive a dedicated assessment email 48 hours before their first appointment, if they didn't already complete it during onboarding. If it still isn't done, there's a reminder in their appointment confirmation email 24 hours before. They can also complete it in the Headway Telehealth waiting room or with you in session. For details, see Completing baseline assessments for new clients.
A few things to know:
- If you already have PHQ-8 in your library, PHQ-9 wasn't added. PHQ-8 serves the same purpose.
- Existing clients aren't sent a new baseline. The change applies to new clients going forward.
- Prescribers (including NPs and PAs) and group practice providers aren't included yet. The baseline will apply to them at a later date.
Overview
Check out our Assessments and measurement-based care guide for a closer look at what assessments are and why it's useful to incorporate measurement-based care in your practice.
We provide evidenced-based assessments that are widely used and clinically validated. Below you’ll find a brief description of each assessment, including the questions and answer choices included in each.
Keep in mind that these assessments are not a diagnostic tool on their own. A comprehensive clinical evaluation is typically still necessary for a formal diagnosis.
Sending assessments
To view and send the available assessments:
- Visit your Client list
- Click on the name of the client you'd like to send assessment(s) to
- Below the client's information box, select the Assessments tab
- Click See list of assessments
- To preview the assessment
- Click the checkbox next to the assessment(s) you'd like to view
- Next to Preview selected assessments, click View
- To send assessment(s) to your client
- Click the checkbox next to the assessment(s) you'd like to send
- Edit the Frequency
- Once complete, click Save and send
- To preview the assessment
Customizing assessments
To edit the frequency of assessments:
- Visit your Client list
- Click on the name of the client whose assessment(s) you'd like to edit
- Below the client's information box, select the Assessments tab
- Click Manage assessments
- Scroll to find the assessment you'd like to edit
- Edit Frequency as needed
- Click Save
To pause assessments for a client:
- Visit your Client list
- Click on the name of the client whose assessment(s) you'd like to edit
- Below the client's information box, select the Assessments tab
- Click Manage assessments
- Uncheck the assessment(s) you'd like to pause
- Click Save
Viewing assessment results
Assessment results will appear in the Assessments tab automatically once the client completes the assessment(s).
Annual follow-up
After the baseline, we ask for at least one completed follow-up assessment per active adult client each year. If no assessment has been completed on Headway for a client in 12 months, you'll be asked to pick a clinical reason before you confirm their next session. The session still confirms.
Filling out assessments with your client
If you prefer, you can fill out assessments with your client during their session. To fill assessments out with your client:
- Navigate to your Clients list
- Select the client you'd like to fill out an assessment with
- Click on the Assessments tab
- Click the dropdown next to Manage
- Select Fill out with client in session
- Click the checkboxes next to the assessments you'll be completing with the client
- Confirm that you're completing the assessment live with the client
- (Optional) Share your screen with the client
- Start the assessment
Once the assessment is complete, we'll remind you to stop screen sharing, if you chose to, before returning to your session.
Downloading assessments
You can download and print results to store assessment results across multiple systems, share results with your client directly, or more easily reference them in session.
To download all assessments:
- Navigate to the Clients tab
- Select a client, and click the Assessments tab
- Select Download all assessments from the menu
To download individual results:
- Navigate to the Clients tab
- Select a client, and click the Assessments tab
- Scroll to the assessment results you'd like to download, and click on it
- Click the Download PDF button
About the assessments
Brief Addiction Monitor (BAM)
Category: Substance abuse
About this assessment
The BAM is a 17-item assessment that measures substance use patterns, including alcohol, tobacco, and other drug use in terms of frequency, quantity, and consequences. It's designed for serial use — meaning it can be sent repeatedly over time to track changes in substance use during treatment.
The total score reflects substance use frequency and severity, with higher scores indicating greater use and impact. Providers can use it to identify trends, support treatment conversations, and track client progress over time.
WHO Disability Assessment Schedule 2.0 (WHODAS 2.0)
Category: Functioning
About this assessment
The WHO Disability Assessment Schedule 2.0 assesses disability and functional impairment related to health conditions over the past 30 days.
Clients will select an answer to each question using the following scale: 1 (none), 2 (mild), 3 (moderate), 4 (severe), 5 (extreme or cannot do),
Instructions: In the last 30 days, how would you rate the difficulty of the following:
- Standing for long periods such as 30 minutes?
- Taking care of your household responsibilities?
- Learning a new task, for example, learning how to get to a new place?
- How much of a problem did you have in joining in community activities in the same way as anyone else can?
- How much have you been emotionally affected by your health problems?
- Concentrating on doing something for ten minutes?
- Walking a long distance such as a kilometre?
- Washing your whole body?
- Getting dressed?
- Dealing with people you do not know?
- Maintaining a friendship?
- Your day-to-day work/school?
- Overall, in the past 30 days, how many days were these difficulties present? (Non-scorable supplementary question)
- In the past 30 days, for how many days were you totally unable to carry out your usual activities or work because of any health condition? (Non-scorable supplementary question)
- In the past 30 days, not counting the days that you were totally unable, for how many days did you cut back or reduce your usual activities or work because of any health condition? (Non-scorable supplementary question)
Clients will select an answer to each question using the following scale:
- 1: No difficulty
- 2: Mild difficulty
- 3: Moderate difficulty
- 4: Severe difficulty
- 5: Extreme difficulty or cannot do
PROMIS Global Physical Health (PROMIS GPH)
Category: Physical health
About this assessment
The PROMIS Global Physical Health 4a is a self-report measure reflecting a client's overall physical health.
- In general, how would you rate your physical health?
- To what extent are you able to carry out your everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair?
- How would you rate your fatigue on average? (In the past seven days)
- How would you rate your pain on average? (In the past seven days)
Clients will select an answer to each question using a unique scale per question:
- In general, how would you rate your physical health? (1 = Poor, 2 = Fair, 3 = Good, 4 = Very Good, 5 = Excellent)
- To what extent are you able to carry out your everyday physical activities such as walking, climbing stairs, carrying groceries, or moving a chair? (1 = Not at all, 2 = A little, 3 = Moderately, 4 = Mostly, 5 = Completely)
- How would you rate your fatigue on average? (In the past seven days) (5 = None, 4 = Mild, 3 = Moderate, 2 = Severe, 1 = Very Severe)
- How would you rate your pain on average? (In the past seven days) (11-point numerical scale with 0 = No Pain and 10 = Worst Pain Imaginable)
Eating Disorder Examination Questionnaire (EDE-Q)
Category: Eating disorders
Number of questions: 28
About this assessment
The Eating Disorder Examination Questionnaire 6.0 is a 33-item self-report measure of eating disorder symptoms over the past 28 days, scored across four sub-scales (Restraint, Eating, Shape, and Weight Concern) plus a global mean.
Clients will select an answer to each question using varying scales for different question types.
Instructions: Concerned with past 4 weeks (28 days).
- Have you been deliberately trying to limit the amount of food you eat to influence your shape or weight (whether or not you have succeeded)?
- Have you gone for long periods of time (8 or more waking hours) without eating anything in order to influence your shape or weight?
- Have you tried to exclude from your diet any foods that you like in order to influence your shape or weight (whether or not you have succeeded)?
- Have you tried to follow definite rules regarding your eating (for example, a calorie limit) in order to influence your shape or weight (whether or not you have succeeded)?
- Have you wanted your stomach to be empty?
- Has thinking about food, eating or calories made it very difficult to concentrate on things you are interested in (for example, working, following a conversation, or reading)?
- Has thinking about shape or weight made it very difficult to concentrate on things you are interested in (for example, working, following a conversation, or reading)?
- Have you had a definite fear of losing control over eating?
- Have you felt fat?
- Have you had a strong desire to lose weight?
- In the past four weeks, have you eaten what other people would regard as an unusually large amount of food (given the circumstances)?
- On the occasions when you ate an unusually large amount, did you have a sense of having lost control over your eating (at the time)?
- How many times have you done any of the following as a means of controlling your shape or weight: Made yourself sick (vomited)?
- How many times have you taken laxatives as a means of controlling shape or weight?
- How many times have you exercised in a driven or compulsive way as a means of controlling your weight, shape or amount of fat, or to burn off calories?
- How many times have you taken diuretics (water tablets) as a means of controlling your shape or weight?
- How many times have you taken diet pills or other medication as a means of controlling your shape or weight?
- How many times have you eaten in secret (not counting binges)?
- On what proportion of the times that you have eaten have you felt guilty (felt that you've done wrong) afterwards?
- In the past four weeks, has your weight influenced how you think about (judge) yourself as a person?
- Has your shape influenced how you think about (judge) yourself as a person?
- How dissatisfied have you been with your weight?
- How dissatisfied have you been with your shape?
- How uncomfortable have you felt seeing your body (for example, seeing your shape in the mirror, or your reflection in a shop window)?
- How uncomfortable have you felt about others seeing your shape or figure (for example, in communal changing rooms, when swimming, or wearing tight-fitting clothes)?
- How fat do you feel?
- How much do you want to be thin?
- How much do you want to lose weight?
- What is your current weight?
- What is your current height?
- Have you had a menstrual period in the last four months?
- If yes, how many periods have you had in the last four months?
- Are you currently taking the contraceptive pill?
- Questions 1–12 and 19 use days-based scale.
- Questions 13, 14, 16-18 use a "Count of times" score of 0-50 with a 50+ bucket.
- Question 15 is a count of days score of 0-28.
- Questions 21-28 are a 0-6 scaled answer with 0 = Not at all and 6 = Markedly.
- Questions 30-33 are non-scored optional demographics.
Accountable Health Communities Health-Related Social Needs Screening Tool (AHC HRSN)
Category: Social needs
About this assessment
The Accountable Health Communities Health-Related Social Needs Screening Tool is a CMS-developed screener for unmet social needs across core domains (housing, food, transportation, utilities, safety) and supplemental domains.
- What is your living situation today? (I have a steady place to live (0), I have a place to live today but I am worried about losing it in the future (1), I do not have a steady place to live (2))
- Think about the place you live. Do you have problems with any of the following? Choose all that apply. (Pests such as bugs/ants/mice (0), Mold (1), Lead paint or pipes (2), Lack of heat (3), Oven or stove not working (4), Smoke detectors missing or not working (5), Water leaks (6), None of the above (7))
- Within the past 12 months, you worried that your food would run out before you got money to buy more. (Never true (0), Sometimes true (1), Often true (2))
- Within the past 12 months, the food you bought just didn't last and you didn't have money to get more. (Never true (0), Sometimes true (1), Often true (2))
- In the past 12 months, has lack of reliable transportation kept you from medical appointments, meetings, work or from getting things needed for daily living? (No (0), Yes (1))
- In the past 12 months has the electric, gas, oil, or water company threatened to shut off services in your home? (No (0), Yes (1), Already shut off (3))
- How often does anyone, including family and friends, physically hurt you? (Never (1), Rarely (2), Sometimes (3), Fairly often (4), Frequently (5))
- How often does anyone, including family and friends, insult or talk down to you? (Never (1), Rarely (2), Sometimes (3), Fairly often (4), Frequently (5))
- How often does anyone, including family and friends, threaten you with harm? (Never (1), Rarely (2), Sometimes (3), Fairly often (4), Frequently (5))
- How often does anyone, including family and friends, scream or curse at you? (Never (1), Rarely (2), Sometimes (3), Fairly often (4), Frequently (5))
- How hard is it for you to pay for the very basics like food, housing, medical care, and heating? (Not hard at all (0), Somewhat hard (1), Very hard (2))
- Do you want help finding or keeping work or a job? (I do not need or want help (0), Yes help finding work (1), Yes help keeping work (2))
- If for any reason you need help with day-to-day activities such as bathing, preparing meals, shopping, managing finances, etc., do you get the help you need? (I don't need any help (0), I get all the help I need (1), I could use a little more help (2), I need a lot more help (3))
- How often do you feel lonely or isolated from those around you? (Never (0), Rarely (1), Sometimes (2), Often (3), Always (4))
- Do you speak a language other than English at home? (No (0), Yes (1))
- Do you want help with school or training? (No (0), Yes (1))
- In the last 30 days, other than the activities you did for work, on average, how many days per week did you engage in moderate exercise? (0, 1, 2, 3, 4, 5, 6, 7)
- On average, how many minutes did you usually spend exercising at this level on one of those days? (0, 10, 20, 30, 40, 50, 60, 90, 120, 150 or greater)
- How many times in the past 12 months have you had 5 or more drinks in a day (males) or 4 or more drinks in a day (females)? (Never (0), Once or Twice (1), Monthly (2), Weekly (3), Daily or Almost Daily (4))
- How many times in the past 12 months have you used tobacco products? (Never (0), Once or Twice (1), Monthly (2), Weekly (3), Daily or Almost Daily (4))
- How many times in the past year have you used prescription drugs for non-medical reasons? (Never (0), Once or Twice (1), Monthly (2), Weekly (3), Daily or Almost Daily (4))
- How many times in the past year have you used illegal drugs? (Never (0), Once or Twice (1), Monthly (2), Weekly (3), Daily or Almost Daily (4))
- Stress means a situation in which a person feels tense, restless, nervous, or anxious, or is unable to sleep at night because his or her mind is troubled all the time. Do you feel this kind of stress these days? (Not at all (0), A little bit (1), Somewhat (2), Quite a bit (3), Very much (4))
- [Age gated] Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions? (5 years old or older) (No (0), Yes (1))
- [Age gated] Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor's office or shopping? (15 years old or older) (No (0), Yes (1))
Clients will select an answer to each question using a unique scale per question, as listed under Assessment questions above.
Patient Mania Questionnaire-9 (PMQ9)
Category: Anxiety
Number of questions: 9
About this assessment
The Patient Mania Questionnaire-9 is a brief 9-item scale for assessing and monitoring manic symptoms over the past week.
Instructions: Over the past week how often have you...
- Had little or no sleep, and still felt energized
- Felt easily irritated
- Felt overactive
- Acted impulsively or done things without thinking about consequences
- Felt sped up or restless
- Been easily distracted
- Felt pressure to keep talking or been told by someone you are more talkative
- Felt argumentative
- Had racing thoughts
Clients will select an answer to each question using the following scale: Not at all (0), Several Days (1), More Than Half of Days (2), Nearly Every Day (3). Adding all items will provide a total score.
Columbia-Suicide Severity Rating Scale (C-SSRS)
Category: Suicide risk
About this assessment
The Columbia-Suicide Severity Rating Scale assesses the severity of suicidal thoughts and behaviors. Completed by the provider during a clinical evaluation — it is not sent to clients to fill out. This assessment can be found in the Assessments tab, and it is also built into the progress note when SI risk is flagged.
Dimensional Obsessive-Compulsive Scale (DOCS)
About this assessment
The DOCS is a 20-item assessment that measures OCD and OCD-spectrum symptoms across four dimensions: contamination, responsibility for harm, symmetry/ordering, and unacceptable thoughts. It tracks both symptom frequency and functional impact.
The total score reflects overall OCD symptom severity, with higher scores indicating more severe symptoms. It is designed for repeated use to track symptom changes throughout treatment.
Generalized Anxiety Disorder 7-item (GAD-7)
Category: Anxiety
Number of questions: 7
About this assessment
The Generalized Anxiety Disorder 7-item (GAD-7) is a self-report questionnaire designed to assess and measure the severity of anxiety symptoms in individuals. It includes seven questions about various aspects of anxiety, such as worrying too much, feeling restless, and experiencing difficulty in controlling worry.
The GAD-7 helps identify individuals who may be experiencing symptoms of generalized anxiety disorder. It provides a quick and reliable way for healthcare professionals to assess the presence and severity of anxiety symptoms, facilitating appropriate interventions and treatment planning. The total score ranges from 0 to 21, with higher scores indicating more severe anxiety symptoms.
Clients will select an answer to each question using the following scale: 0 (not at all), 1 (several days), 2 (more than half the days), 3 (nearly every day).
Instructions: Over the last 2 weeks, how often have you been bothered by any of the following problems?
- Feeling nervous, anxious, or on edge
- Not being able to stop or control worrying
- Worrying too much about different things
- Trouble relaxing
- Being so restless that it is hard to sit still
- Becoming easily annoyed or irritable
- Feeling afraid, as if something awful might happen
Clients will select an answer to each question using the following scale: 0 (not at all), 1 (several days), 2 (more than half the days), 3 (nearly every day). Adding all items will provide a total score.
- 0 - 4: Minimal anxiety
- 5 - 9: Mild anxiety
- 10 - 14: Moderate anxiety
- 15 - 21: Severe anxiety
Patient Health Questionnaire 9-item (PHQ-9) / Patient Health Questionnaire 8-item (PHQ-8)
Category: Depression
Number of questions: 8 or 9
About this assessment
The Patient Health Questionnaire-9 (PHQ-9) / Patient Health Questionnaire 8-item (PHQ-8) is a self-report tool designed to assess and measure the severity of depression symptoms in individuals. It includes eight to nine questions that cover various aspects of depression, including mood, energy levels, and changes in sleep and appetite.
Healthcare professionals commonly use the PHQ-8 / PHQ-9 to identify individuals who may be experiencing symptoms of depression. The questionnaire provides a quick and reliable way to assess the presence and severity of depressive symptoms, aiding in the formulation of appropriate interventions and treatment plans. The total score ranges from 0 to 27 (for PHQ-9) or 0 to 24 (for PHQ-8), with higher scores indicating more severe depressive symptoms.
The key difference between the PHQ-9 and PHQ-8 is the inclusion of a ninth question about suicidal ideation, while the PHQ-8 omits this question and focuses only on depressive symptoms.
Clients will select an answer to each question using the following scale: 0 (not at all), 1 (several days), 2 (more than half the days), 3 (nearly every day).
Instructions: Over the last 2 weeks, how often have you been bothered by any of the following problems?
- Little interest or pleasure in doing things
- Feeling down, depressed, or hopeless
- Trouble falling or staying asleep, or sleeping too much
- Feeling tired or having little energy
- Poor appetite or overeating
- Feeling bad about yourself or that you are a failure or have let yourself or your family down
- Trouble concentrating on things, such as reading the newspaper or watching television
- 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
- Thoughts that you would be better off dead, or of hurting yourself (not included on PHQ-8)
Clients will select an answer to each question using the following scale: 0 (not at all), 1 (several days), 2 (more than half the days), 3 (nearly every day). Adding all items will provide a total score.
- 1 - 4: Minimal depression
- 5 - 9: Mild depression
- 10 - 14: Moderate depression
- 15 - 19: Moderately severe depression
- 20 - 27: Severe depression
For question 9, if the client answers anything above 0 (not at all), you will be notified via email that there was an elevated score on that question. The client will also immediately receive crisis resources.
Patient Mania Questionnaire-9 (PMQ-9)
About this assessment
The PMQ-9 is a 9-item assessment that measures manic symptom frequency and severity across nine dimensions. Developed by the UW AIMS Center and designed as a PHQ-9 complement, it enables providers to track both depressed and manic phases in clients with bipolar or mood cycling diagnoses.
The total score reflects manic symptom burden, with higher scores indicating more frequent and severe symptoms. It is designed for repeated use to monitor changes in manic symptoms throughout treatment.
World Health Organization - Five Well-Being Index (WHO-5)
Category: Quality of life
Number of questions: 5
About this assessment
The World Health Organization-Five Well-Being Index (WHO-5) is a self-reported questionnaire designed to assess an individual's overall well-being. It includes five statements that cover positive mood, vitality, and general interest in daily activities.
The WHO-5 assesses the subjective well-being of individuals. It can be employed to screen for potential mood disturbances and monitor changes in well-being over time. The assessment focuses on positive aspects of mental health, providing insights into an individual's emotional and psychological state. It is particularly useful for tracking changes in well-being and evaluating the impact of interventions or treatments aimed at improving mental health. The total score ranges from 0 to 25, with higher scores indicating better well-being.
Clients will select an answer to each question using the following scale: 0 (at no time), 1 (some of the time), 2 (less than half of the time), 3 (more than half of the time), 4 (most of the time), 5 (all of the time).
Instructions: Over the last 2 weeks, indicate how you've been feeling for each of the statements below.
- I have felt cheerful and in good spirits
- I have felt calm and relaxed
- I have felt active and vigorous
- I woke up feeling fresh and rested
- My daily life has been filled with things that interest me
Clients will select an answer to each question using the following scale: 0 (at no time), 1 (some of the time), 2 (less than half of the time), 3 (more than half of the time), 4 (most of the time), 5 (all of the time). Adding all items will provide a total raw score. Raw scores of 0-25 are multiplied by 4 to get a percentage score.
- 0 - 28: Very low mental wellbeing, screening for depression is suggested
- 29 - 52: Poor mental wellbeing, screening for depression is suggested
- 53 - 74: Moderate mental wellbeing
- 75 - 100: High mental wellbeing
PTSD Checklist for DSM-5 (PCL-5)
Category: Trauma
Number of questions: 20
About this assessment:
The PTSD Checklist for DSM-5 (PCL-5) is a self-report questionnaire used to assess the presence and severity of post-traumatic stress disorder (PTSD) symptoms in individuals based on the criteria outlined in the DSM-5. The PCL-5 is a valuable instrument for understanding and addressing the impact of traumatic experiences on an individual's mental health, helping clinicians tailor interventions and treatment plans to specific PTSD symptoms.
The PCL-5 includes 20 items that cover a range of PTSD symptoms, including intrusive thoughts, avoidance behaviors, negative alterations in mood and cognition, and heightened arousal and reactivity.
Clients will select an answer to each question using the following scale: 0 (not at all), 1 (a little bit), 2 (moderately), 3 (quite a bit), 4 (extremely).
Instructions: Below is a list of problems and complaints that people sometimes have in response to stressful life experiences. How much you have been bothered by that problem IN THE LAST MONTH.
- Repeated, disturbing, and unwanted memories of the stressful experience?
- Repeated, disturbing dreams of the stressful experience?
- Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reliving it)?
- Feeling very upset when something reminded you of the stressful experience?
- Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, trouble breathing, sweating)?
- Avoiding memories, thoughts, or feelings related to the stressful experience?
- Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations)?
- Trouble remembering important parts of the stressful experience?
- Having strong negative beliefs about yourself, other people, or the world (for example, having thoughts such as: I am bad, there is something seriously wrong with me, no one can be trusted, the world is completely dangerous)?
- Blaming yourself or someone else for the stressful experience or what happened after it?
- Having strong negative feelings such as fear, horror, anger, guilt, or shame?
- Loss of interest in activities that you used to enjoy?
- Feeling distant or cut off from other people?
- Trouble experiencing positive feelings (for example, being unable to feel happiness or have loving feelings for people close to you)?
- Irritable behaviour, angry outbursts, or acting aggressively?
- Taking too many risks or doing things that could cause you harm?
- Being “superalert” or watchful or on guard?
- Feeling jumpy or easily startled?
- Having difficulty concentrating?
- Trouble falling or staying asleep?
Clients will select an answer to each question using the following scale: 0 (not at all), 1 (a little bit), 2 (moderately), 3 (quite a bit), 4 (extremely). Adding all items will provide a total score. Divide the total score by the number of items (20) to receive a mean score. Scoring below is based on mean score.
- 0: No PTSD symptoms
- 1 - 20: Mild PTSD symptoms
- 21 - 40: Moderate PTSD symptoms
- 41 - 60: Significant PTSD symptoms
- 61 - 80: Extreme PTSD symptoms
For question 16, if the client answers anything above 0 (not at all), you will be notified via email that there was an elevated score on that question. The client will also immediately receive crisis resources.
Impact of Event Scale – Revised (IES-R)
Category: Trauma
Number of questions: 22
About this assessment
The Impact of Event Scale-Revised (IES-R) is a self-report questionnaire designed to assess the severity of distress caused by traumatic events. It is commonly used in clinical and research settings to evaluate the impact of specific life events, such as accidents, disasters, or assaults, on an individual's mental well-being. Mental health professionals use the IES-R to identify and assess the impact of traumatic experiences, aiding in treatment planning and intervention strategies.
The IES-R includes 22 items that cover a range of symptoms associated with traumatic stress. The total score on the IES-R provides an overall measure of the individual's stress-related symptoms, with higher scores indicating a greater level of distress.
See questions in this assessments
Clients will select an answer to each question using the following scale: 0 (not at all), 1 (a little bit), 2 (moderately), 3 (quite a bit), 4 (extremely).
Instructions: Below is a list of difficulties people sometimes have after stressful life events. Please read each item, and then indicate how distressing each difficulty has been for
you DURING THE PAST SEVEN DAYS with respect to ____ (EVENT) that occurred on ____ (DATE). How much have you been distressed or bothered by these difficulties?
- Any reminder brought back feelings about it.
- I had trouble staying asleep.
- Other things kept making me think about it.
- I felt irritable and angry.
- I avoided letting myself get upset when I thought about it or was reminded of it.
- I thought about it when I didn’t mean to.
- I felt as if it hadn’t happened or wasn’t real.
- I stayed away from reminders of it.
- Pictures about it popped into my mind.
- I was jumpy and easily startled.
- I tried not to think about it.
- I was aware that I still had a lot of feelings about it, but I didn’t deal with them.
- My feelings about it were kind of numb.
- I found myself acting or feeling like I was back at that time.
- I had trouble falling asleep.
- I had waves of strong feelings about it.
- I tried to remove it from my memory.
- I had trouble concentrating.
- Reminders of it caused me to have physical reactions, such as sweating, trouble breathing, nausea, or a pounding heart.
- I had dreams about it.
- I felt watchful and on-guard.
- I tried not to talk about it.
Clients will select an answer to each question using the following scale: 0 (not at all), 1 (a little bit), 2 (moderately), 3 (quite a bit), 4 (extremely). Adding all items will provide a total score.
- 0 - 24: Low to moderate distress
- 24 - 33: Moderate to high distress
- 33 - 36: Probable diagnosis of PTSD
- 37 or above: Severe distress
AUDIT-C (Alcohol Use Disorders Identification Test – Concise)
Category: Substance Use
Number of questions: 3
About this assessment
The AUDIT-C is a brief, 3-question version of the World Health Organization's Alcohol Use Disorders Identification Test. It screens for hazardous or harmful alcohol use and is widely used in clinical settings to identify clients who may benefit from further assessment or intervention. Each of the three questions uses its own set of answer options, and scores are totaled on a scale of 0–12. Higher scores indicate a higher level of alcohol use. Because scoring thresholds can vary by sex and clinical context, results are intended to be interpreted by the treating provider as part of a broader clinical picture.
See questions in this assessments
- How often did you have a drink containing alcohol in the past year?
- How many drinks containing alcohol did you have on a typical day when you were drinking in the past year?How often did you have 5 or more drinks on one occasion in the past year?
Score interpretation is provided in Sigmund alongside completed results. Clinical follow-up is at the provider's discretion — Headway does not apply any automatic protocol based on AUDIT-C scores.
Adjustment Disorder - New Module 8-item (ADNM-8)
Category: Distress
Number of questions: 8
About this assessment
The Adjustment Disorder-New Module 8-item (ADNM-8) is a self-report questionnaire used to measure levels of distress and presence of adjustment disorder symptoms. Mental health professionals use the ADNM-8 to evaluate the impact of life changes on the mental health of their clients. The ADNM-8 is designed to assess various aspects of adjustment difficulties. The items cover emotional, behavioral, and cognitive reactions to life stressors.
The ADNM-8 consists of two parts: a stressor list and an item list. Individuals select experienced stressors from a broad range of acute and chronic life events of the past two years. They then select the most distressing event to answer a set of 8 items. The item list measures the symptoms in response to the most distressing event.
See questions in this assessments
Part I instructions: Below is a list of stressful life events. Please select the events that have happened during the past two years and are currently a strong burden to you, or have burdened you in the past six months. You can select as many events as applicable.
- Divorce / separation
- Family conflicts
- Conflicts in working life
- Conflicts with neighbors
- Illness of a loved one
- Death of a loved one
- Adjustment due to retirement
- Unemployment
- Too much / too little work
- Pressure to meet deadlines / time pressure
- Moving to a new home
- Financial problems
- Own serious illness
- Serious accident
- Assault
- Termination of an important leisure activity
Free text
- Any other stressful event (please indicate)
- The events you have just indicated can have numerous consequences for our well-being and behavior. Please indicate the most straining event(s) below.
Clients will check a box to indicate each event, and enter text in the free-text boxes.
Part II instructions: Below you will find various statements about which reactions these types of events can trigger. Please indicate how often the respective statement applies to you (“never” to “often”).
- I have to think about the stressful situation repeatedly.
- I have to think about the stressful situation a lot and this is a great burden to me.
- Since the stressful situation, I find it difficult to concentrate on certain things.
- I constantly get memories of the stressful situation and can’t do anything to stop them.
- My thoughts often revolve around anything related to the stressful situation.
- Since the stressful situation, I do not like going to work or carrying out the necessary tasks in everyday life.
- Since the stressful situation, I can no longer sleep properly.
- Overall, the stressful situation affected me strongly in my personal relationships, my leisure activities, or other important areas of life.
Clients will select an answer to each question using the following scale: 1 (never), 2 (rarely), 3 (sometimes), 4 (often). Adding all items will provide a total score.
- 0 - 8: Mild adjustment difficulty
- 9 - 17: Moderate adjustment difficulty
- 18 - 32: Significant adjustment difficulty
Adult ADHD Self-Report Scale v1.1 (ASRSv1.1)
Category: ADHD
Number of questions: 18
About this assessment
The Adult ADHD Self-Report Scale v1.1 (ASRSv1.1) is a self-report questionnaire designed to assess Attention Deficit Hyperactivity Disorder (ADHD) symptoms in adults.
See questions in this assessments
Instructions: Please answer the questions below, rating yourself on each of the criteria shown. As you answer each question, select the option that best describes how you have felt and conducted yourself over the PAST 6 MONTHS.
Part A
- How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?
- How often do you have difficulty getting things in order when you have to do a task that requires organization?
- How often do you have problems remembering appointments or obligations?
- When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
- How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?
- How often do you feel overly active and compelled to do things, like you were driven by a motor?
Part B
- How often do you make careless mistakes when you have to work on a boring or difficult project?
- How often do you have difficulty keeping your attention when you are doing boring or repetitive work?
- How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly?
- How often do you misplace or have difficulty finding things at home or at work?
- How often are you distracted by activity or noise around you?
- How often do you leave your seat in meetings or other situations in which you are expected to remain seated?
- How often do you feel restless or fidgety?
- How often do you have difficulty unwinding and relaxing when you have time to yourself?
- How often do you find yourself talking too much when you are in social situations?
- When you’re in a conversation, how often do you find yourself finishing the sentences of the people you are talking to, before they can finish them themselves?
- How often do you have difficulty waiting your turn in situations when turn taking is required?
- How often do you interrupt others when they are busy?
Clients will select an answer to each question using the following scale: never (0), rarely (0), sometimes (1), often (1), very often (1). Adding all items will provide a total score.
-
Part A: Add the scores for questions 1 -
6; scores range from 0 - 6.
- 0 - 2: Patient did not endorse symptoms consistent with ADHD in adults.
- 4 - 6: Patient has symptoms highly consistent with ADHD in adults and further investigation is warranted.
-
Part B: Add the scores for questions 7 -
18; scores range from 0 - 12.
No total score or diagnostic likelihood is utilized for the twelve questions. Rather, the frequency scores on Part B provide additional cues and can serve as further probes into the patient’s symptom severity and the impact that inattention or hyperactivity has on their life. Pay particular attention to marks 'Often' and 'Very Often'. -
Total score: Add the scores for all questions;
scores range from 0 - 18.
Use the Percentile Chart below and match with the specific age range. These percentiles compare total scores to age related peers, so it is imperative to ensure the correct client data of birth is entered for the client.
Total Score (Raw Score) 18-29 year olds 30-39 year olds 40-49 year olds 50-64 year olds 65+ year olds 0 23.29% 20.17% 23.30% 27.86% 27.90% 1 31.37% 30.40% 34.22% 39.57% 45.64% 2 40.46% 42.45% 46.66% 52.32% 64.31% 3 50.10% 55.26% 59.43% 64.83% 80.03% 4 59.73% 67.54% 71.27% 75.90% 90.64% 5 68.80% 78.15% 81.16% 84.75% 96.37% 6 76.86% 86.43% 88.62% 91.12% 98.84% 7 83.60% 92.26% 93.69% 95.26% 99.70% 8 88.91% 95.95% 96.80% 97.69% 99.94% 9 92.87% 98.07% 98.52% 98.97% 99.99% 10 95.63% 99.16% 99.37% 99.58% 100.00% 11 97.46% 99.67% 99.76% 99.85% 100.00% 12 98.60% 99.88% 99.92% 99.95% 100.00% 13 99.27% 99.96% 99.97% 99.98% 100.00% 14 99.64% 99.99% 99.99% 100.00% 100.00% 15 99.83% 100.00% 100.00% 100.00% 100.00% 16 99.92% 100.00% 100.00% 100.00% 100.00% 17 99.97% 100.00% 100.00% 100.00% 100.00% 18 99.99% 100.00% 100.00% 100.00% 100.00%
Insomnia Severity Index (ISI)
Category: Sleep
Number of questions: 7
About this assessment
The Insomnia Severity Index (ISI) is a brief screening tool for insomnia.
Instructions: Please rate the severity of your insomnia problem(s) over the PAST 2 WEEKS.
- Difficulty falling asleep
- Difficulty staying asleep
- Problems waking up too early
- How SATISFIED/DISSATISFIED are you with your CURRENT sleep pattern?
- How NOTICEABLE to others do you think your sleep problem is in terms of impairing the quality of your life?
- How WORRIED/DISTRESSED are you about your CURRENT sleep problem?
- To what extent do you consider your sleep problem to INTERFERE with your daily functioning (e.g. daytime fatigue, mood, ability to function at work/daily chores, concentration, memory, mood, etc.) CURRENTLY?
Clients will select an answer to each question using the following scale: 0 (none), 1 (mild), 2 (mild), 3 (severe), 4 (very severe). Adding all items will provide a total score.
- 0 - 7: No clinically significant insomnia
- 8 - 14: Subthreshold insomnia
- 15 - 21: Clinical insomnia (moderate severity)
- 22 - 28: Clinical insomnia (severe)
Frequently asked questions
Why does Headway share assessment results with insurance companies?
Insurance companies ask for this information because it helps them demonstrate the quality of their behavioral health offerings, which in turn helps them acquire more customers, such as large employers seeking out health plan contracts.
For some more context: Following COVID, demand for behavioral health boomed. Employers quickly moved to incorporate more behavioral health insurance as part of their offering to their employees. In return, insurers—whose main customers are these employers—partnered with Headway to quickly grow their health plan offerings.
That demand has only increased today – now, it’s not just about access, but about quality access. Employers want to know that their employees are getting better.
One of the ways to communicate this to employers is through clinical outcome data. To be clear, this outcome data is just a single data point of a bigger picture, and insurers know this too. However, it’s an important way we continue to demonstrate the value of investing in behavioral health to employers — by being able to communicate what percentage of patients are improving over time.
As we partner with insurers to communicate the value of care to employers, our intent is to always put our providers first.
Will Headway use my assessment data to deny client care or assess my eligibility to use Headway?
No – Headway will never do these things based on your assessment results. We designed assessments to stay within each provider’s control, in a way that works for and benefits you.
In terms of how Headway will use assessment results, here are some actions Headway will take:
- Automatically send you an email notification and your client a list of crisis resources, if the client indicates a risk of self-harm in an assessment response.
- Selectively share assessment results with insurers for the purpose of negotiating contracts or demonstrating effectiveness of care across the Headway network of providers.
Will Headway share assessment results with anyone?
Headway will selectively share aggregate and non-identifiable assessment results with some insurers for the purpose of demonstrating the quality of Headway providers’ behavioral health offerings at a high level. “Aggregated and non-identifiable” means that these statistics will be generated only from a very large number of samples, and none of those samples will include your clients’ names or personally identifiable information.
Headway shares assessment results only in de-identified, aggregated views by default. Individual-level results are shared only for permitted purposes — for example, claims processing, audits, and quality programs. When a health plan requests network- or member-level data, that sharing is treated under the same HIPAA standards that apply to Headway: plans may receive this data to understand what's happening in their network or for routine compliance audits.
Please note: Headway and insurers won’t use assessment results to assess your eligibility to use Headway or to limit or deny care to your clients.
What if I change my mind or decide assessments aren’t the right fit for a particular client?
That’s fine! You can pause or fully turn off assessments at any time—and even do this on a per client basis. You're in control of which assessments you send, and to which clients. We understand that client needs change across the course of treatment.
However, the baseline assessment (the one before each client's first session) cannot be skipped or disabled, but the recurring cadence can be adjusted at any time.
What questionnaires is Headway automatically sending my clients?
All new adult clients (18+ years old) added to Headway will automatically receive a PHQ-9 or GAD-7 before their first session, regardless of how they were added to your caseload — including clients you added directly (you will be prompted to send at least a PHQ-9 or GAD-7 when you add a client). If you do not remind them to complete one, you will be asked to give a reason
Why does Headway send assessments to clients who find me using Headway’s search?
Providers have told us that assessments can help establish a baseline for concerns and treatment goals with new clients in particular.
As of May 27, 2026, PHQ-9 and GAD-7 will appear pre-checked when you add a new client through the add client flow. You can uncheck them during that flow, or adjust assessments for any client by going to the client's profile, clicking on the Assessments tab, then clicking Manage assessments.
Can I change if clients from Headway receive assessments?
Yes. You can turn assessments on and off, customize frequency, and even choose which specific assessments to send on a per-client basis. For each client, you can change these settings by going to your client’s profile, clicking on the Assessments tab, then clicking Manage assessments.
How to send additional assessments automatically?
You can have us send additional assessments automatically by visiting your client’s profile, clicking on the Assessments tab, and clicking Manage assessments.