> ## Documentation Index > Fetch the complete documentation index at: https://docs.getrivet.ca/llms.txt > Use this file to discover all available pages before exploring further. # GAD-7 — Generalized Anxiety Disorder scale > The companion to PHQ-9 for anxiety. 7 items, 0–21 total, severity bands from Minimal to Severe, scored on the same 2-week frequency frame. The GAD-7 is the companion to PHQ-9 for anxiety, and the second-most- administered measure in the library. The two are usually given together as the standard depression-anxiety baseline. ## What it measures Generalized anxiety severity over the last two weeks, mapped to DSM-5 Generalized Anxiety Disorder criteria. Seven items — nervousness, uncontrollable worry, excessive worry, trouble relaxing, restlessness, irritability, and anticipatory fear. Each rated on the same 4-point frequency scale as the PHQ-9, which makes co-administration smooth. ## When to use it * **Intake.** As a baseline measure on the first session, usually paired with PHQ-9. * **Every 2–4 weeks during treatment.** To track response. * **Pre/post a discrete intervention.** Around an anxiety-focused CBT protocol, exposure work, or a medication change. * **Discharge.** Outcome documentation. Comorbidity between depression and anxiety is the rule, not the exception, so pairing GAD-7 with [PHQ-9](/clinical-templates/screening/phq-9) catches presentations either measure alone would miss. ## How clients fill it Under two minutes on a phone. The 2-week stem prompt is the same shape as the PHQ-9 — "Over the last 2 weeks, how often have you been bothered by the following problems?" — followed by seven items with the same four-option frequency scale: * Not at all * Several days * More than half the days * Nearly every day Because the scale matches the PHQ-9, clients filling both back-to-back move through them quickly. ## How Rivet scores it Each option carries a score from 0 to 3, and the total is the sum of items 1–7. Range: 0–21. The score appears live in your scoring pill as the client answers. ## Severity bands | Total | Severity | | ----- | -------- | | 0–4 | Minimal | | 5–9 | Mild | | 10–14 | Moderate | | 15–21 | Severe | A score of 10 or higher is the recommended cutoff for further GAD evaluation (Spitzer 2006). ## Administering alongside PHQ-9 The two measures are designed to be given together. Practical pattern: * Send both in one async link before the intake session * Both scores appear in the conversation when the client submits * Read them as a pair — a high PHQ-9 with a low GAD-7 looks different from a moderate PHQ-9 with a high GAD-7, and shapes where treatment focus lands The matched 2-week frame and identical frequency scale make the pair easy for the client and clean for chart documentation. ## What GAD-7 doesn't screen The GAD-7 is specific to generalized anxiety. It doesn't capture: * **Panic disorder** — discrete panic attacks aren't part of the items * **Social anxiety** — use [SPIN](/clinical-templates/screening/spin) * **Obsessive-compulsive disorder** — use OCI-R * **Specific phobias** — no validated brief screen in the library; this is interview territory * **Trauma-related anxiety** — use PCL-5 or ITQ If the presentation isn't primarily generalized worry, GAD-7 will under- read. Pick the measure that matches the cluster. ## When NOT to use it * **Clients under 18.** Validated in adults; adolescent versions exist but aren't included under this ID. * **As a sole diagnostic instrument.** Screening, not diagnosis. * **When the anxiety is clearly situational.** A score of 18 the week before a custody hearing isn't the same construct as a chronic 18; the measure can't tell the difference, you can. ## GAD-7 vs the other anxiety measures The GAD-7 screens for generalized anxiety specifically. It does not capture panic, OCD, social anxiety or specific phobias — that's the single most useful thing to know when deciding whether it's the right instrument for the client in front of you. * **vs [DASS-21](/clinical-templates/screening/dass-21)** — the DASS splits into three subscales and captures general stress and arousal that belongs to neither depression nor GAD. Twenty-one items rather than seven, so most practices administer it less often. Pick it when the presentation blurs and you want the pattern; pick the GAD-7 when you want a number you can take every two weeks. * **vs [PSWQ](/clinical-templates/screening/pswq)** — the GAD-7 measures how frequent the symptoms were recently; the PSWQ measures worry as a stable trait. They answer different questions and are often run together in GAD work. * **vs [SPIN](/clinical-templates/screening/spin)** — if the fear is social-evaluative, the SPIN is the instrument. A normal GAD-7 does not rule out social anxiety. * **vs [HAM-A](/clinical-templates/clinician-administered/ham-a)** — the same construct rated by you in a structured interview rather than self-reported. * **vs the BAI** — the Beck Anxiety Inventory is licensed by Pearson and paid for per use. Rivet doesn't include it; the library was built from measures that carry no per-administration fee. ## Is it free to use? **Yes.** Covered by the same 2010 Pfizer free-public release as the rest of the PHQ family. ## Citation Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). "A brief measure for assessing generalized anxiety disorder: The GAD-7." *Archives of Internal Medicine*, 166(10): 1092–1097. Copyright Pfizer Inc. Released under the same 2010 Pfizer free-public- use posture as the PHQ-9. Rivet preserves the canonical item wording verbatim. ## Related articles The depression companion measure — administered together as the standard baseline. Social Phobia Inventory — for social-evaluative anxiety the GAD-7 won't capture. When to screen and the cadence for outcome tracking.