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The depression and anxiety screening family is the most-used corner of the template library. PHQ-9 and GAD-7 are the universally expected pair — insurers ask for them, EFAP referrals often require them, and outcome- informed therapy treats them as the standard depression and anxiety measures. Rivet includes three more depression scales (QIDS-SR-16, CES-D-R) and a social anxiety scale (SPIN) for cases where the standard pair isn’t the right fit.

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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.
You’re free to administer them less often — these are tools, not rules — but most outcome-informed practices land on something close to this rhythm.

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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.

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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.
If you don’t have a preference, start with PHQ-9. It’s the expected default and pairs naturally with GAD-7.

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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:
Any positive answer on a suicidality item warrants follow-up regardless of the total score. A PHQ-9 of 6 with Item 9 answered “Several days” matters more than a PHQ-9 of 22 with Item 9 at zero. Rivet surfaces a flag in the scoring pill when the cutoff is crossed; the clinical judgment about what to do next is yours.
Each per-measure article calls out the specific item(s) that trigger the flag and how Rivet displays it.

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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.

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The five measures in this section

PHQ-9

The standard depression scale. 9 items, 0–27.

GAD-7

The standard anxiety scale. 7 items, 0–21.

QIDS-SR-16

DSM-domain-aligned depression. 16 items, 0–27 canonical (raw-sum proxy in Rivet).

CES-D-R

Twenty-item revised CES-D. Past-week frame.

SPIN

Social Phobia Inventory. 17 items, 0–68.

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.