Sending assessments to clients on Headway

Updated

Our Assessments feature is currently in Early Access mode. We'll be expanding access in the coming weeks – stay tuned! In the meantime:

Assessments (i.e. PHQ-9, GAD-7, etc.) help you track client-reported concerns to better prepare for upcoming sessions. From the profile page of a client, click on the Assessments tab to get started.

For each client in your caseload, you can choose to send up to 6 assessments, and adjust how frequently you send each one. You can also pause or discontinue these assessments at any time.

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. 

 

Overview

View the video below to learn more about using assessments in your clinical practice, including what it assessments are, why we’re looking to offer them, and how you can use them on Headway.

 

Sending assessments

To view and send the available assessments: 

  1. Visit your Client list
  2. Click on the name of the client you'd like to send assessment(s) to 
  3. Below the client's information box, select the Assessments tab 
    Screenshot 2024-04-01 at 10.06.26 AM.png
  4. Click See list of assessments
    • To preview the assessment
      1. Click the checkbox next to the assessment(s) you'd like to view
      2. Next to Preview selected assessments, click View
    • To send assessment(s) to your client
      1. Click the checkbox next to the assessment(s) you'd like to send
      2. Edit the Frequency and Next send date
      3. Once complete, click Save and send

 

Customizing assessments 

To edit the frequency of assessments: 

  1. Visit your Client list
  2. Click on the name of the client whose assessment(s) you'd like to edit
  3. Below the client's information box, select the Assessments tab 
  4. Click Manage assessments
  5. Scroll to find the assessment you'd like to edit 
  6. Edit Frequency and Next send date as needed
  7. Click Save 

To pause assessments for a client: 

  1. Visit your Client list
  2. Click on the name of the client whose assessment(s) you'd like to edit
  3. Below the client's information box, select the Assessments tab 
  4. Click Manage assessments
  5. Uncheck the assessment(s) you'd like to pause
  6. Click Save 

Viewing assessment results 

Assessment results will appear in the Assessments tab automatically once the client completes the assessment(s).

 

About the assessments


Generalized Anxiety Disorder 7-item (GAD-7)


Category: 
Anxiety 

Number of questions: 

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.

Assessment questions

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?

  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
Scoring

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)


Category: 
Depression 

Number of questions:

About this assessment

The Patient Health Questionnaire-9 (PHQ-9) is a self-report tool designed to assess and measure the severity of depression symptoms in individuals. It includes nine questions that cover various aspects of depression, including mood, energy levels, and changes in sleep and appetite.

Healthcare professionals commonly use the 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, with higher scores indicating more severe depressive symptoms.

Assessment questions

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?

  1. Little interest or pleasure in doing things
  2. Feeling down, depressed, or hopeless
  3. Trouble falling or staying asleep, or sleeping too much
  4. Feeling tired or having little energy
  5. Poor appetite or overeating
  6. Feeling bad about yourself or that you are a failure or have let yourself or your family down
  7. Trouble concentrating on things, such as reading the newspaper or watching television
  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
  9. Thoughts that you would be better off dead, or of hurting yourself 
Scoring

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
Safety concerns

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.

 

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.

Assessment questions

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.

  1. I have felt cheerful and in good spirits
  2. I have felt calm and relaxed
  3. I have felt active and vigorous
  4. I woke up feeling fresh and rested
  5. My daily life has been filled with things that interest me
Scoring

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.

Assessment questions

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.

  1. Repeated, disturbing, and unwanted memories of the stressful experience?
  2. Repeated, disturbing dreams of the stressful experience?
  3. Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reliving it)?
  4. Feeling very upset when something reminded you of the stressful experience?
  5. Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, trouble breathing, sweating)?
  6. Avoiding memories, thoughts, or feelings related to the stressful experience?
  7. Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations)?
  8. Trouble remembering important parts of the stressful experience?
  9. 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)?
  10. Blaming yourself or someone else for the stressful experience or what happened after it?
  11. Having strong negative feelings such as fear, horror, anger, guilt, or shame?
  12. Loss of interest in activities that you used to enjoy?
  13. Feeling distant or cut off from other people?
  14. Trouble experiencing positive feelings (for example, being unable to feel happiness or have loving feelings for people close to you)?
  15. Irritable behaviour, angry outbursts, or acting aggressively?
  16. Taking too many risks or doing things that could cause you harm?
  17. Being “superalert” or watchful or on guard?
  18. Feeling jumpy or easily startled?
  19. Having difficulty concentrating?
  20. Trouble falling or staying asleep?
Scoring

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
Safety concerns

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

Assessment questions

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?

  1. Any reminder brought back feelings about it.
  2. I had trouble staying asleep.
  3. Other things kept making me think about it.
  4. I felt irritable and angry.
  5. I avoided letting myself get upset when I thought about it or was reminded of it.
  6. I thought about it when I didn’t mean to.
  7. I felt as if it hadn’t happened or wasn’t real.
  8. I stayed away from reminders of it.
  9. Pictures about it popped into my mind.
  10. I was jumpy and easily startled.
  11. I tried not to think about it.
  12. I was aware that I still had a lot of feelings about it, but I didn’t deal with them.
  13. My feelings about it were kind of numb.
  14. I found myself acting or feeling like I was back at that time.
  15. I had trouble falling asleep.
  16. I had waves of strong feelings about it.
  17. I tried to remove it from my memory.
  18. I had trouble concentrating.
  19. Reminders of it caused me to have physical reactions, such as sweating, trouble breathing, nausea, or a pounding heart.
  20. I had dreams about it.
  21. I felt watchful and on-guard.
  22. I tried not to talk about it.
Scoring

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

 

Adjustment Disorder - New Module 8-item (ADNM-8)


Category: 
Distress 

Number of questions: 

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

Assessment questions

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”).

  1. I have to think about the stressful situation repeatedly.
  2. I have to think about the stressful situation a lot and this is a great burden to me.
  3. Since the stressful situation, I find it difficult to concentrate on certain things.
  4. I constantly get memories of the stressful situation and can’t do anything to stop them.
  5. My thoughts often revolve around anything related to the stressful situation.
  6. Since the stressful situation, I do not like going to work or carrying out the necessary tasks in everyday life.
  7. Since the stressful situation, I can no longer sleep properly.
  8. Overall, the stressful situation affected me strongly in my personal relationships, my leisure activities, or other important areas of life.
Scoring

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

Assessment questions

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?
Scoring

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.

Assessment questions

Instructions: Please rate the severity of your insomnia problem(s) over the PAST 2 WEEKS.

  1. Difficulty falling asleep
  2. Difficulty staying asleep
  3. Problems waking up too early
  4. How SATISFIED/DISSATISFIED are you with your CURRENT sleep pattern?
  5. How NOTICEABLE to others do you think your sleep problem is in terms of impairing the quality of your life?
  6. How WORRIED/DISTRESSED are you about your CURRENT sleep problem?
  7. 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?
Scoring

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 


Will Headway share assessment results with anyone?

Headway will selectively share aggregate and non-identifiable assessment results with 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 have specific names or personally identifiable information attached to them.

Headway won’t share any directly identifiable data about either you or your client with any insurers or third parties. This includes your client’s specific responses to assessment questions, which insurers and third parties will not have access to.

 

Why does Headway share high-level assessment results with insurance companies?

In short, 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. 

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. We will only share aggregate, non-identifiable data with select health plans. Nothing will be traceable to you or your client. 

 

Will Headway use my assessment data to deny client care, lower payment rates, or assess my eligibility to use Headway?

No – Headway will never do any of 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 aggregate and non-identifiable assessments results with insurers for the purpose of negotiating contracts or demonstrating effectiveness of care across the Headway network of providers.

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.

 

What questionnaires is Headway automatically sending my clients?

For clients who find you through Headway, we’ll automatically send the PHQ-9 and GAD-7 three times each — at the 30-, 60- and 90-day mark of care. We won’t send additional assessments after this, unless you choose to turn them on. 

Based on feedback we’ve received from providers, we no longer send assessments outside of the PHQ-9 and GAD-7 automatically, since they’re not always applicable to every client or type of treatment involved.

 

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. With this in mind, we'll automatically send 3 rounds of both the GAD-7 and PHQ-9 to clients who find you through Headway. 

We don’t automatically send assessments to clients you brought to Headway, but you can turn on assessments for these clients 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.

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