> ## 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. # K10 — Kessler Psychological Distress Scale > Ten-item general distress screener — the Canadian standard for non-specific psychological distress. The K10 is the general distress screener Statistics Canada uses, provincial health systems administer, and most EFAP programs default to. Ten items, one month look-back, and a single total score that lands a client in one of four bands — well, mild, moderate, or severe. If you trained in the US your reflex is probably PHQ-9 + GAD-7. The K10 sits next to those, not against them: PHQ-9 quantifies depression, GAD-7 quantifies generalized anxiety, the K10 quantifies non-specific distress — the "something is wrong" signal before symptoms have sorted themselves into a diagnosis. ## What it measures Non-specific psychological distress over the past 30 days — the mix of anxious arousal, depressive cognition, fatigue, and agitation that predicts (but doesn't diagnose) a current mental disorder. The items ask how often the client felt tired without reason, nervous, hopeless, restless, depressed, that everything was an effort, so sad nothing could cheer them up, or worthless. ## When to use it * **Intake.** Especially with Canadian clients — they recognize the K10 from previous interactions with their family doctor or workplace EFAP. * **Periodic during treatment.** A K10 every 4-6 weeks is a low-burden trajectory check that doesn't lock you into a single diagnostic frame. * **EFAP and workplace mental health referrals.** The K10 is the expected attachment in most Canadian EFAP referral packages. * **Post-significant-event check-ins** (workplace incidents, family bereavement, post-disaster) where you want a distress baseline before deciding on a treatment frame. ## How clients fill it out Ten items on a 5-point frequency scale (None of the time → All of the time). Takes most clients under three minutes. Reading level is grade 8\. You can administer in-session — tap the K10 from the templates picker and the client answers on your screen — or send the link in a message for the client to complete async. ## How Rivet scores it Sum of all ten items. Range 10-50. | Total | Band | | ----- | ------------------------ | | 10-15 | Likely well | | 16-21 | Likely mild disorder | | 22-29 | Likely moderate disorder | | 30-50 | Likely severe disorder | Bands surface live as the client completes the form and lock into the session note. ## Clinical change The K10 is sensitive to change. Practitioners commonly look for a 4-6 point drop across a treatment course as evidence of clinical improvement, with a band shift (e.g. moderate → mild) as the more robust signal. ## Risk flagging The K10 doesn't include a suicide item. It's a distress measure, not a risk measure. If your client is in the severe band or trending up, pair the K10 with a risk-specific instrument (C-SSRS) and pick up risk directly in conversation. ## K10 vs PHQ-9 and GAD-7 The K10 doesn't try to name the problem. It measures non-specific psychological distress over thirty days, which makes it the right first instrument when you don't yet know whether you're looking at depression, anxiety, or the aftermath of something situational. The [PHQ-9](/clinical-templates/screening/phq-9) and [GAD-7](/clinical-templates/screening/gad-7) pair does the opposite — each is tied to a specific set of diagnostic criteria, and each tells you about the last two weeks. A common sequence is K10 at intake to size the distress, then the PHQ-9/GAD-7 pair once the presentation is clearer, because those are the measures a referral or an insurer will ask for. The K10 is also the one most often already familiar in Canadian practice — it's standard in EFAP and workplace mental-health work here in a way it isn't in tools built for the US market. ## Is it free to use? **Yes.** Kessler's scale is distributed freely and treated as a free clinical-use instrument throughout the published literature. ## Citation Kessler, R. C., Andrews, G., Colpe, L. J., Hiripi, E., Mroczek, D. K., Normand, S. L., et al. (2002). "Short screening scales to monitor population prevalences and trends in non-specific psychological distress." *Psychological Medicine,* 32(6): 959-976. Free clinical use. Verbatim canonical wording. ## When not to use it * **You need a depression-specific score.** Use the PHQ-9 — the K10 blends depression with arousal and won't separate them. * **You need a PTSD-specific score.** Use the PCL-5 or, for the ICD-11 frame, the ITQ. * **You're working with a child or adolescent under 18.** The K10 is validated in adult samples. For pediatric distress, lean on the SDQ or RCADS. ## Related articles When you want depression, anxiety, and stress on three separate axes instead of a single distress score. A stress-specific measure for burnout and adjustment presentations. The suicide risk screener to pair with K10 when distress is high.