ADAPTEDPHQ-9&GAD-7QUESTIONNAIRES

Howtofillinthesequestionnaires:

Thesequestionnairesareusedby

psychologyservicestohelpusunderstand

howpeoplefeel.

• Onequestionnairemeasureshowsad

peoplefeel.

• Onequestionnairemeasureshow

worriedpeoplefeel.

Questionnairesalsohelpusseeifpeople

feelbetteraftertheyseeus.

Thesequestionnairesaskyouabouthow

youhavebeenfeelinginthepast2weeks.

Itmighthelpyoutothinkaboutsomething

thatyoudid2weeksagotoanswerthese

questions

Foreachquestion,tickoneoftheboxesto

showhowyouhavebeenfeelinginthepast

2weeks.

Ifyouneedhelporhavequestions,youcan

talktoyourtherapist.Questions

?

1 FEELINGSAD(PHQ-9)

Haveyoufeltlessinterestedin

doingthings?

Nodays Somedays Alotofdays Nearlyeveryday

2

Haveyoufeltsad?

Nodays Somedays Alotofdays Nearlyeveryday

3

Haveyouhadproblemswithyour

sleep?

Nodays Somedays Alotofdays Nearlyeveryday

4

Haveyoubeenfeelingtired?

Nodays Somedays Alotofdays Nearlyeveryday

5

Haveyoubeenmoreorlesshungry

thannormal?

Nodays Somedays Alotofdays Nearlyeveryday

6

Haveyoubeenfeelinglikeyouhave

letyourselfdownorletother

peopledown?

Nodays Somedays Alotofdays Nearlyeveryday

7

Hasitbeenhardtoconcentrateon

things?

Nodays Somedays Alotofdays Nearlyeveryday

8

Haveyoubeen

• movingorspeakingmoreslowly?

OR

• movingorspeakingalotfaster?

Nodays Somedays Alotofdays Nearlyeveryday

9

Haveyouhadthoughtsabout:

• Hurtingyourselfonpurpose?

• Killingyourself?

Nodays Somedays Alotofdays Nearlyeveryday

PHQ-9TOTAL

1 FEELINGWORRIED(GAD-7)

Haveyoubeenfeeling

worried?

Nodays Somedays Alotofdays Nearlyeveryday

2

Hasitbeenhardtostop

worrying?

Nodays Somedays Alotofdays Nearlyeveryday

STOP

3

Haveyoubeenworryingabout

lotsofdifferentthings?

Nodays Somedays Alotofdays Nearlyeveryday

4

Hasitbeenhardtorelax?

Nodays Somedays Alotofdays Nearlyeveryday

5

Hasitbeenhardtositstill?

Nodays Somedays Alotofdays Nearlyeveryday

6

Haveyoufeltangry?

Nodays Somedays Alotofdays Nearlyeveryday

Isthereanythingyouwanttotellusaboutyouranswers?

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Thankyou!

THESEQUESTIONNAIRESWEREADAPTEDBYJBREEN&KTHEODOREASPARTOFACLINICALPSYCHOLOGY

DOCTORATEATROYALHOLLOWAYUNIVERSITY(2017)

7

Haveyoufeltscared?

Nodays Somedays Alotofdays Nearlyeveryday

GAD-7TOTAL

ClinicianGuidelinesforusingtheadaptedPHQ-9andGAD-7clinicalmeasuresRESEARCHTITLE:AdaptingtheGAD-7andPHQ-7clinicalmeasuresforpeoplewithintellectualdisabilities.RESEARCHERS:JennyBreen(TraineeClinicalPsychologist)&DrKateTheodore(ClinicalTutor),RoyalHollowayUniversity.

Generalguidelines:TheadaptedversionsofthePHQ-9andGAD-7measuresareintendedforusewithclientswhorequirereasonableadjustmentstoaccesspsychologyservices,namelythosewithlearningdifficultiesordisabilities.TheyweredevelopedinathesisresearchprojectaspartofclinicalpsychologytrainingwithinputfromserviceuserswithlearningdisabilitiesaswellasprofessionalsworkinginspecialistLearningDisabilityandIAPTservices.Theliteraturesuggeststhatideallyinformationforpeoplewithlearningdifficultiesordisabilitiesshouldbetailoredtotheindividualandsoitisimportantforclinicianstothinkabouttheindividual’sneedsandadapttheadministrationandchoiceofoutcomemeasuresusedaccordingly.Somepeoplewillhaveapreferenceforvisualprompts,othersprefereasyreadEnglishonly,somewillrequiresupportwithadministrationandothersbeabletocompletethemeasuresthemselvesindependently.Theeasyreadguidelinesforserviceusersonthefirstpageoftheseadaptedmeasuresoffersomesupportforclinicianstocoversomeofthesepoints.Someadditionalusefulgeneralpointsforusingthemeasureswithclientsinclude:

• Usingtheterm“questionnaires”ratherthan“clinicalmeasures”• Introducingthemeasurestoclientsandexplainingwhyyouareaskingthemtodothese

o E.g.“Weaskeveryonewhoisseeninthisservicetodothesequestionnaires.Thisisimportantasithelpsustounderstandhowpeoplefeelandgivesusanideaifpeoplegetwellafterseeingus”

• Peoplewithlearningdisabilitiesarelikelytoneedahigherlevelofsupporttocompletethesequestionnairesthanotherclients.Thismayinvolvecompletingthequestionnaireswiththeclientinsessionsatfirst,tomakesurethattheyareabletoreporttheirsymptomsaccurately.Itmaybethatovertime,clientsneedlesssupporttocompletethesemeasures.

ResponseOptions&Scoring:Whenintroducingthescale,itishelpfultoorientclientstothescale,particularlytheresponseoptions.Itmaybehelpfultothinkwiththemaboutsomethingtheydidtwoweeksearlierandusingthisasananchorintime:

o E.g.“TodayisTuesday.CanyouremembersomethingthatyoudidtwoTuesdaysago?OK,whenansweringthesequestions,IwantyoutothinkabouthowyouhavefeltbetweennowandwhenyoudidX”

Somepeoplemayneedadditionalsupporttounderstandtheresponseoptions.Ifso,itmaybehelpfulexplainthevisualsbydrawingnumbersontothevisualcueslikeascaletorepresentthenumberofdaysthateachoptionisaskingaboutsopeoplecanunderstandthismoreclearly.Forexample–thevisualhereshows‘alotofdays’(whichcorrespondstotheoriginalPHQ-9andGAD-7responseitem‘morethanhalfthedays’,hencethenumberswrittenonthevisualscaleitem.TheadaptedversionsofthePHQ-9andGAD-7measuresarescoredinexactlythesamewayastheoriginalmeasures:AdaptedResponseoption OriginalResponseoption ScoreNodays Notatall 0Somedays Severaldays 1Alotofdays Morethanhalfthedays 2Nearlyeveryday Nearlyeveryday 3Individualitemscoresineachmeasureshouldbetotalledtoobtainoverallscoresforeachofthemeasures.ThetotalscoresforthePHQ-9andGAD-7measurecanbewritteninthetotalscoreboxattheendofeachmeasure.Alternativeitemexplanations:ThetablesonthefollowingpagesprovidesuggestedalternativesfortermsusedandexamplesofpromptswhichyoucouldusewithclientswhichmayhelpthemunderstandtheindividualitemsonthePHQ-9andGAD-7measures.Manyofthesehavebeensuggestedbyadultswithlearningdisabilitieswhowereinvolvedinthedevelopmentoftheadaptedversionsoftheclinicalmeasures.

PHQ-9ITEMNUMBER

PHQ-9ITEMWORDING ADAPTEDWORDING SUGGESTEDALTERNATIVEHELPFULTERMS

EXAMPLESOFPROMPTS

1 Lessinterestorpleasureindoingthings

Haveyoufeltlessinterestedindoingthingsyounormallyliketodo?

None • Likejustwantingtostayathome

• Notwantingtohangoutwithyourfriends

• Notwantingtowatchyourfavouritesoaps/tvshows

• Notwantingtodoyourfavouritehobbies

2 Feelingdown,

depressedorhopelessHaveyoufeltsad?

• Depressed

• Wantingtobeonyourownmore

• Cryingalot

3 Troublefallingorstayingasleeporsleepingtoomuch

Haveyouhadproblemswithyoursleep?

None • Likefindingithardtofallasleepatnight

• Sleepingtoomuchlikenotwantingtowakeupinthemorning

• Wakingupinthenightalot

4 Feelingtiredorhavinglittleenergy

Haveyoubeenfeelingtired?

• Noenergytodothings

• Feelingtiredallthetime• Likewhenyoudon’twanttodo

much• Wantingtosleepallthetime

5 Poorappetiteor

overeating

Haveyoubeenmoreorlesshungrythannormal?

• Appetite

• Eatingless/morefoodthannormal

6 Feelingbadaboutyourselforthatyouareafailureorhaveletyourselforyourfamilydown

Haveyoufeltlikeyouhaveletyourselfdownorletotherpeopledown

• Haveyoubeenfeelinglikeyou’renogood?

• Failure

• Feelinglikeyou’veletpeopledown

• Feelinglikeyou’veletyourselfdown

7 Troubleconcentrating

onthings,suchasreadingthenewspaperorwatchingtelevision

Hasitbeenhardtoconcentrateonthings?

• Findingithardtofocus

• Beingdistracted• Gettingbored

easily

• Likewhenwatchingyourfavouritetvprogramme

8 Movingorspeakingsoslowlythatotherpeoplecouldhavenoticedortheoppositebeingsofidgetyorrestlessthatyouhavebeenmovingaroundalotmorethanusual

Haveyoubeenmovingorspeakingmoreslowlyoralotfaster?

• Fidgetingalot• Feelingrestless

9 Thoughtsthatyouwouldbebetteroffdeadorofhurtingyourselfinsomeway

Haveyouwantedto• Hurtyourselfon

purpose?• Killyourself?

• Selfharming • Usingaknifetocutyourself• Takinglotsoftablets• Feelinglikeyoudon’twantto

liveanymore• Wantingtoendyourlife

GAD-7ITEMNUMBER

GAD-7WORDING ADAPTEDWORDING SUGGESTEDALTERNATIVEHELPFULTERMS

EXAMPLESOFPROMPTS

1 Feelingnervous,anxiousoronedge

Haveyoubeenfeelingworried?

• Nervous

2 Notbeingabletostoporcontrolworrying

Hasitbeenhardtostopworrying?

None • Worryingalot

3 Worryingtoomuchaboutlotsofdifferentthings

Haveyoubeenworryingaboutlotsofdifferentthings?

None • Money,bills,gettingajob,friends,family,passingexams

4 Troublerelaxing Hasitbeenhardtorelax?

• Chillout• Calmdown

• Thinkingwiththepersonhowtheynormallyrelax

5 Beingsorestlessthatitis

hardtositstill

Hasitbeenhardtositstill?

• Feelingrestless• Fidgetingalot

6 Becomingeasilyannoyed

orirritableHaveyoufeltangry?

• Annoyed

7 Feelingafraidasifsomethingawfulmayhappen

Haveyoufeltscared?

• Worried• Afraid

• Worryingthatsomethingbadmighthappentoyouorsomeoneelse

• Notfeelingsafe• Worryingthatyoumightget

hurt• Beingmuggedorhavingyour

bagorphonetaken