June 28th, 2020

The questionnaires a therapist may give you - and why you shouldn’t be afraid of them: PHQ-9, GAD-7 and CORE-10

By Dan Whale

  • Depression
  • Therapy

Overview

Over the last few years great strides have been made to reduce the stigma surrounding mental health. This is something we welcome enormously, but we also know that collective understanding of what talking therapy is and how it works could still be improved.

In this blog we are going to examine the type of questionnaires a therapist may well ask you to fill out. This is by no means a certainty, therapy comes in many different forms and there are various mental health conditions a person may experience. The questionnaires we are going to look at are just common examples of what are sometimes given to people at the beginning, during treatment and at the end/after their therapeutic journey.

If you’ve never had it before, therapy can seem daunting or even scary. “What if I say the wrong thing and they think I’m crazy? What if I fill something out incorrectly and they say I need to take lots of medication?” - these kinds of concerns are not uncommon. For some, the idea of taking any kind of ‘test’ can be very off putting. This prevents people who could really benefit from therapy from trying it out.

It is not our aim for every person to have therapy, but we would love to increase understanding of how therapy works and bust some frightening myths. We hope that by examining what you might be asked, this will be a positive first step in achieving that goal. You can also take these questionnaires by clicking the link at the end of the blog.

The questionnaires we’re looking at are called the PHQ-9, the GAD-7 and the CORE-10.

PHQ-9

The PHQ-9 is a series of questions which screens for the presence and severity of depression in a person. It was developed in the mid 1990s by doctors Spitzer, Williams and Kroenke at Columbia University and is used today in both NHS and private settings.

Its letters stand for Patient Health Questionnaire and the 9 refers to the fact it consists of just 9 questions. The PHQ-9 usually takes less than 3 minutes to complete and seeks to establish how frequently, if at all, the participant feels a certain way. Studies have shown it to be both a valid and reliable measure of depression severity.

GAD-7

The GAD-7 is a short questionnaire used to assess and measure the severity of symptoms commonly reported in Generalised Anxiety Disorder - frequently referred to as ‘Anxiety’. First published in 2006 by Spitzer et al, it is quick to administer and is used in both research and clinical settings.

Made up of just seven questions, the GAD-7 asks the level to which the individual has felt nervous/worried/restless etc over the past fortnight. Its validity and reliability have been studied and it has been proven to be a useful tool in measuring anxiety.

CORE-10

The CORE-10 acts as a combination assessment of several different mental health conditions including depression, anxiety, trauma, physical conditions and general functioning. Its letters stand for ‘Clinical Outcomes in Routine Evaluation’ and, as you may have guessed by now, it is made up of 10 questions.

When compared with the PHQ-9 and GAD-7, the CORE-10 is a broader set of questions, encompassing potential symptoms that may not commonly sit within anxiety and depression. The majority of mental health conditions will include some experiences similar to that seen in depression or anxiety, but the CORE-10 can give both the participant and the therapist an initial indication that there may be something else under the surface which needs to be examined.

Why are they used?

There are two main reasons that these questionnaires are often used at the beginning and throughout a therapeutic journey. Firstly, they can provide a helpful overview of what is going on for that person at that time, giving the therapist an initial understanding of the symptoms their client/patient is experiencing, their severity, and how they manifest. They also inform the initial assessment someone has with a therapist and can help with deciding the best course of treatment. Above all else, they are a good way to quickly identify if someone is in need of urgent support. Many people find it difficult at times to discuss their mental health needs and the PHQ-9, GAD-7 and Core-10 allow people to describe what they are experiencing without having to put it into words.

Secondly, the questionnaires serve a vital role in the most important aspect of therapy - improvement. Therapy should never be seen as a ‘cure’ in the same way that mental health shouldn’t be seen as an illness. Mental health will alter over time and can be impacted, strengthened and maintained. Therapy exists to help us along that journey, reducing the number of bad days we have and helping us handle certain situations better. All therapists would agree that if a client/patient is not seeing any improvement, they should change either their therapist or therapeutic approach. These questionnaires help them evaluate the therapy they are receiving.

Clinical Insight

“The PHQ-9, GAD-7 and CORE-10 are not only questionnaires but clinical tools. By completing them during therapy it gives people a simple way to measure the progress that they are making which can be easily interpreted. Improvements can be celebrated and difficulties identified. Importantly, any change, whether positive or negative can be shared and discussed with the therapist to feedback into the therapeutic process. This information can provide invaluable learning about someone’s mental health and how to maintain improvements.”

               - Dr Rumina Taylor, Chief Clinical Officer at HelloSelf
               

Take the questionnaires

Click here to register as a HelloSelf member and take the PHQ-9, GAD-7 and CORE-10. Becoming a member is completely free and you won’t automatically receive any marketing emails for joining.

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