Clinical Screening Questionnaires Reference Table: An Introduction
Purpose of Clinical Questionnaires Table:
The purpose of this reference document is to provide information to service providers about each clinical questionnaire completed by YWHO clients, including number of items, purpose, frequency of administration, alerts, scoring, and relation of scores to intensity level of services offered.
Time to Complete Clinical Questionnaires:
Based on YWHO youth clients who have completed the tools on the Dacima platform thus far, it takes, on average, approximately 15 - 30 minutes to answer all of the clinical questionnaires.
Some General Examples of Low Medium High Level Intensity Services at YWHO Sites (*not a comprehensive list; Low, Medium, and High intensity services will differ across hubs, depending on services and interventions each site has available*):
- Low Intensity: Solution Focused Brief Therapy; Motivational Enhancement Therapy (MET) or Cognitive Behavioural Therapy (CBT; 1 4 sessions); individual or group peer support
- Medium Intensity: Evidence based structured psychotherapy for mental health concerns (Dialectical Behavioural Therapy (DBT) skills, CBT; 6-12 sessions); Evidence based group treatments for substance use/concurrent disorder concerns (MET, CBT, DBT; 6-12 sessions); Family support; Supported education/employment/housing, if relevant.
- High Intensity: YWHO based psychiatric response ( telepsychiatry or in person); medication consult; access to crisis supports; linkage to other existing higher intensity youth/young adult mental health and/or addictions services (e.g., long term psychotherapy, day treatment, inpatient, residential, ongoing psychiatric services, addiction medicine, specialist addiction treatment, withdrawal support).
Notes/Disclaimer:
- None of the screening instruments/clinical questionnaires listed in the document operate in isolation. Service providers should take into account findings from other screening questionnaires, and use their clinical judgment and discussions with clients and their families to make the most appropriate decisions regarding assessment and interventions for clients available at their specific YWHO site.
- For further information, please contact Janis Wolfe: janis.wolfe@youthhubs.ca.
Clinical Screening Questionnaires Before Session:
| Clinical Questionnaire Name | # of times | Purpose | First Visit | Subsequent Visit (less than 7 days) | Subsequent Visit (8 days to less than 29 days) | Subsequent Visit (30 days or more) | Scores on YWHO Data Collection Platform: Over time via progress tracker or single point in time? | Items Flagging Immediate Risk/Action | Scores Mapping onto low (L) - Medium (M) - High (H) Intensity Services (Hub-Specific) |
|---|---|---|---|---|---|---|---|---|---|
| Kessler Psychological Distress Scale (K10) | 10 | Global measure of distress based on questions about anxiety and depressive symptoms that a person has experienced in the most recent 30 days. | ✓ | - | - | ✓ | Can see scores over time with YWHO Data Collection Platform progress tracker. |
| |
| Kessler Psychological Distress Scale (Past Week) – (K10W) | 10 | Global measure of distress based on questions about anxiety and depressive symptoms that a person has experienced in the most recent 7 days. | - | - | ✓ | - | Can view past single points on same client to provide information over time; no progress tracker. |
| |
| Self-Rated Health (SRH) | 1 | Simple self-reported measure of general health. | ✓ | - | ✓ | ✓ | Can see scores over time with YWHO Data Collection Platform progress tracker. |
| |
| Self-Rated Mental Health (SRMH) | 1 | Simple self-reported measure of general mental health. | ✓ | - | ✓ | ✓ | Can see scores over time with YWHO Data Collection Platform progress tracker. |
| |
| Global Appraisal of Individual Needs: Short Screener (GAIN - SSS) | 12 (5 substance use items scored. Other items for clinical use only). | Screen to identify substance use disorders, and issues with disordered eating, traumatic distress, gambling, gaming, internet overuse. | ✓ | - | - | ✓ | Can view past single points on same client to provide information over time; no progress tracker. | “Thinking or feeling that people are watching you, following you, or out to get you” May represent potential flag for psychosis (no YWHO Data Collection Platform alert). |
|
| YWHO Substance Monitoring Form | 4 (first three items scored - last item for clinical use only). | Measure of number of days in the past week that clients used alcohol and drugs and frequency of negative consequences. | - | - | ✓ | - | Can view past single points on same client to provide information over time; no progress tracker. |
| |
| Patient Health Questionnaire (PHQ-9) | 9 | Screen for suicide risk within past two weeks (use of last question within YWHO initiative); Positive screen leads to C-SSRS completion. Can also view eight depression related item scores to support K-10 score. | ✓ | - | ✓ | ✓ | Can view past single points on same client to provide information over time; no progress tracker. | Item #9 response triggers suicidal ideation YWHO Data Collection Platform alert to service provider. C-SSRS then completed by provider with youth in session. |
|
| Outcome Rating Scale (ORS) | 4 | Measure of areas of life functioning using four visual analog scales. | ✓ | - | ✓ | ✓ | Can view past single points on same client to provide information over time; no progress tracker. |
| |
| Goal-Based Outcomes (GBO) | Self-developed number of goals plus single progress rating. | Evaluation of change and progress toward goals that are most important to clients. | ✓ | - | ✓ | ✓ | Questionnaire score is a rating at single point in time; can review past forms to see previous goals. | Goals can represent youth voice and help inform best intervention at any intensity level ((L)/(M)/(H)) |
