When to screen
The common cadence:- Intake. A PHQ-9 + GAD-7 baseline on the first session, often sent async ahead of time so they’re already filled when you sit down together.
- Every 2–4 weeks during treatment. Track response without screening burnout. PHQ-9 takes the client about two minutes.
- Pre/post a discrete intervention. Around an EMDR target, a CBT protocol, a medication change, or any time you want to attribute a symptom change to a specific piece of work.
- Discharge. Outcome documentation for the chart, for the referrer, and for the client to see what changed.
What the severity bands tell you
Every measure in this family has a published total-score-to-severity-band mapping (e.g. PHQ-9: 0–4 Minimal, 5–9 Mild, 10–14 Moderate, 15–19 Moderately severe, 20–27 Severe). Rivet shows you the band live as soon as the total crosses a threshold. The bands are interpretive aids, not diagnoses. A PHQ-9 of 14 doesn’t mean the client has Major Depressive Disorder — it means their self-reported symptoms over the last two weeks fall in the moderate-severity range on a nine-item screening instrument. The clinical interview is what makes a diagnosis; the band is what helps you triage attention. The most useful question to ask about a score is what changed. A drop from 18 to 10 over six weeks is a clinically meaningful response. A flat 14 across three months suggests the current approach isn’t moving the client.Picking between depression measures
Rivet includes four self-report depression scales. They cover overlapping ground; the practical differences:- PHQ-9 — Nine items, two-week frame, the universal default. Pair with GAD-7. Item 9 surfaces suicidal ideation in a single item.
- QIDS-SR-16 — Sixteen items, two-week frame, mirrors DSM-IV-TR symptom domains. Used widely in research and outcome-tracking. Item 12 is the suicidality item.
- CES-D-R — Twenty items, past-week frame, covers all nine DSM symptom groups. Often selected when there’s continuity with prior CES-D documentation. Items 14 and 15 split death wish and self-harm into two items.
- SPIN — Seventeen items specifically for social anxiety / Social Phobia. Past-week frame. Different family from the other three; use when the presenting concern is social-evaluative anxiety.
The risk-flag rule
Every depression measure in this family carries a suicidality item (sometimes two). Across PHQ-9, QIDS, and CES-D-R, the rule is the same: Each per-measure article calls out the specific item(s) that trigger the flag and how Rivet displays it.A note on clinical change
A common practitioner question is “how big a drop counts as real change?” The convention from the literature varies by measure — a 5-point PHQ-9 drop is often cited (Kroenke 2010 follow-up), and similar conventions exist for GAD-7 and the others. Rivet doesn’t compute “change” between two responses; the in-session scoring pill shows the current total only. If you want week-over-week trends, that’s the role of measurement-based care, not the in-session template.Every measure in this section
Twenty-five instruments, grouped by what they are for. Each page carries the scoring rules, the cutoffs and what a change in score actually means.Depression and mood
PHQ-9
The default depression measure. Nine items, and Item 9 carries a risk flag.
QIDS-SR-16
Depression severity with a highest-item rule across the sleep, weight and psychomotor domains.
CES-D-R
Depressive symptoms over the past week, with a longer look-back than the PHQ-9.
WHO-5
Five items on well-being rather than symptoms. Reverse-scored — higher is better.
MDQ
Screens for a history of hypomanic or manic episodes before you treat for depression.
Anxiety, worry and stress
GAD-7
The standard anxiety companion to the PHQ-9.
DASS-21
Depression, anxiety and stress on three separate subscales.
PSWQ
Worry as a trait rather than a symptom — useful in GAD work.
SPIN
Social anxiety across fear, avoidance and physiological arousal.
OCI-R
Obsessive-compulsive symptoms across six dimensions.
PSS-10
Perceived stress over the last month — appraisal rather than event count.
Trauma
PCL-5
The DSM-5 PTSD checklist. The adult standard.
CPSS-5
The pediatric counterpart to the PCL-5, ages 8 to 18.
ITQ
The ICD-11 measure, and the one that separates PTSD from Complex PTSD.
ACE
Childhood adversity as a count, not a severity score. Read the caveats before using it.
Sleep
ISI
Insomnia severity, with a published 6-point threshold for meaningful change.
PSQI
Sleep quality across seven components over the past month.
Eating
SCOFF
A five-question screen. Two or more positives warrants a fuller assessment.
EDE-Q
Eating-disorder psychopathology across four subscales.
Personality, regulation and function
MSI-BPD
A brief screen for borderline personality features.
BSL-23
Borderline symptom severity, tracked over time — the DBT outcome standard.
ERQ
Reappraisal and suppression as emotion-regulation strategies.
WHODAS-12
Functional disability across six life domains, independent of diagnosis.
K10
General psychological distress. A wide net when the presentation is unclear.
MSPSS
Perceived social support from family, friends and a significant other.
Related articles
What's in the library
The three kinds of templates and how scoring works.
Filling a template in-session
The live collaborative flow from picker to PDF.