Fortunately, ClinicTracker has long made it easy for clinics to incorporate these assessments. Clinicians can either use one of the pre-stored scales or create their own. Regardless of which scale you use, you’ll be able to administer, score, and record it without having to retype so much as the client’s name. That’s the beauty of an all-inclusive software solution. The only limitation is that the scale has to be in the public domain or have a copyright the authors are willing to assign.
Below we describe three of the pre-stored scales ClinicTracker administers. They are among the most widely used and evidence-based assessment tools in the industry. Our software not only scores them, but it also graphs the results of multiple administrations:
The PHQ-9 (Patient Health Questionnaire) is a brief measure that clinicians can use to screen, identify, and monitor depressive symptoms. Clients complete a 9-item measure that asks about DSM-style symptoms of depression, including lack of energy, trouble eating, poor concentration, and the like. They rate how often over the past two weeks they’ve experienced these symptoms (from not at all to nearly every day). In addition to inquiring directly about suicidality, the scale asks clients about the extent to which their depression causes actual impairment in functioning. That focus on impairment, rather than simply on how often symptoms arise, makes this scale especially valuable. The scores ClinicTracker tabulates let the clinician use standardization tables to estimate severity, generate a provisional diagnosis, and consider treatment options. Like almost all outcome measures, the PHQ-9 is useful both diagnostically, but also in assessing the course of treatment over time.
Hamilton Anxiety Rating Scale
While the PHQ-9 is designed to assess depression, the venerable Hamilton Anxiety Rating Scale (HAM-A) pegs the severity of a patient’s anxiety. However, unlike the client-completed PHQ-9, clinicians fill out the 14-item HAM-A, typically within about 10 minutes. Appropriate for use across the lifespan, this scale measures both internal states (such as agitation, fears, and tension) as well as somatic complaints (such as gastrointestinal, respiratory, and cardiovascular symptoms). Widely used to measure treatment response, the HAM-A boasts an impressive research base that establishes a high level of validity and reliability.
Hamilton Depression Rating Scale
Like its HAM-A counterpart, the Hamilton Depression Rating Scale (HAM-D) is a clinician-rated survey used for diagnosis and outcome assessment. It scores 17 domains of depressive symptomology, including feelings of depression, guilt, anxiety, agitation, and suicide. Similar to the PHQ-9, it further asks about the impact of mood problems on areas such as work, speed of though/speech, and falling asleep. After ClinicTracker totals responses, you can determine the level of depression, from normal (a score of 0-7) to very severe (>= 23). The scale also offers 4 un-scored items that provide additional information about phenomena that might characterize the depression. For example, clinicians can indicate whether there is diurnal variation, depersonalization, and paranoid symptoms.
All three of these measures, as well as the others Clinictracker offers, enjoy broad inclusion in many clinic protocols for assessing diagnostic status and outcome. However, none of them should be used in isolation. Brief rating scales, while helpful in assessment, must always be supplemented by other data and clinical judgment.
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