Assessments Overview

Use validated psychological assessments to screen for conditions, measure treatment progress, and demonstrate outcomes. Praxi includes Australian-validated instruments that meet Medicare and AHPRA requirements for outcome measurement.

Core Assessments

Praxi includes the most commonly used validated instruments in Australian mental health practice. These assessments are free to use (public domain) and have strong Australian normative data.

PHQ-9 (Patient Health Questionnaire-9)

Purpose: Depression screening and severity measurement

Property	Value
Items	9
Time	3 minutes
Age range	12+ years
Scoring	Sum of items (0-27)
Licence	Public domain (free)

Scoring interpretation:

Score	Severity	Clinical action
0-4	Minimal	Monitor, no treatment indicated
5-9	Mild	Watchful waiting, repeat at follow-up
10-14	Moderate	Treatment plan warranted
15-19	Moderately severe	Active treatment recommended
20-27	Severe	Immediate treatment, consider psychiatry referral

Critical item: Item 9 asks about suicidal ideation. Any score greater than 0 requires immediate follow-up and safety assessment.

Reliable Change Index: A change of 6 or more points indicates statistically reliable change (95% confidence).

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GAD-7 (Generalised Anxiety Disorder-7)

Purpose: Anxiety screening and severity measurement

Property	Value
Items	7
Time	2 minutes
Age range	12+ years
Scoring	Sum of items (0-21)
Licence	Public domain (free)

Scoring interpretation:

Score	Severity	Clinical action
0-4	Minimal	Monitor, psychoeducation
5-9	Mild	Watchful waiting, relaxation techniques
10-14	Moderate	CBT or treatment indicated
15-21	Severe	Active treatment strongly recommended

Clinical cut-off: A score of 10 or higher indicates probable generalised anxiety disorder (sensitivity 89%, specificity 82%).

Reliable Change Index: A change of 5 or more points indicates statistically reliable change.

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DASS-21 (Depression Anxiety Stress Scales)

Purpose: Combined screening for depression, anxiety, and stress

Property	Value
Items	21 (7 per subscale)
Time	5 minutes
Age range	17+ years
Scoring	Three subscales, each multiplied by 2
Licence	Free for clinical use (© Psychology Foundation of Australia)

Australian Standard

The DASS-21 was developed in Australia by Lovibond and Lovibond (1995) at the University of New South Wales. It is freely available and widely used in Australian clinical practice and research.

Scoring: Sum each 7-item subscale, then multiply by 2 to align with DASS-42 norms.

Depression subscale (items 3, 5, 10, 13, 16, 17, 21):

Score (x2)	Severity
0-9	Normal
10-13	Mild
14-20	Moderate
21-27	Severe
28+	Extremely severe

Anxiety subscale (items 2, 4, 7, 9, 15, 19, 20):

Score (x2)	Severity
0-7	Normal
8-9	Mild
10-14	Moderate
15-19	Severe
20+	Extremely severe

Stress subscale (items 1, 6, 8, 11, 12, 14, 18):

Score (x2)	Severity
0-14	Normal
15-18	Mild
19-25	Moderate
26-33	Severe
34+	Extremely severe

Critical item: Item 21 ("I felt that life was meaningless") requires follow-up if endorsed at any level.

Reliable Change Index: A change of 7 or more points on any subscale indicates statistically reliable change.

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K10 (Kessler Psychological Distress Scale)

Purpose: General psychological distress screening

Property	Value
Items	10
Time	2-3 minutes
Age range	18+ years
Scoring	Sum of items (10-50)
Licence	Public domain (free)

Australian Standard

The K10 is the recommended outcome measure for Australian Medicare-funded mental health services. It is used in the Australian National Survey of Mental Health and Wellbeing and is required for Better Access outcome reporting.

Scoring interpretation (Andrews & Slade, 2001 thresholds used in Praxi):

Score	Level	Clinical interpretation
10-19	Low	Likely to be well
20-24	Moderate	Likely to have a mild mental disorder
25-29	High	Likely to have a moderate mental disorder
30-50	Very high	Likely to have a severe mental disorder

Cut-off Variation

Some sources use slightly different cut-offs (such as the Andrews & Slade 2001 set: 10-15, 16-21, 22-29, 30-50). Praxi uses the 10-19 / 20-24 / 25-29 / 30-50 banding shown above. See Interpreting Results for details.

Critical items: Items 4 (hopelessness) and 10 (worthlessness) require follow-up if endorsed "most of the time" or "all of the time".

Reliable Change Index: a change of roughly 8 or more points exceeds measurement error at 95% confidence and is flagged as statistically reliable.

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Specialised Assessments

Praxi includes a comprehensive library of validated instruments across many clinical domains. Below are the main categories.

Rows marked (gated) are not in your library

The tables below catalogue the instruments Praxi has built, which is not the same as the instruments Praxi can offer you. An entry marked (gated) is licence-gated: its rights holder requires a paid licence or written permission for commercial or electronic use, so it does not appear in your assessment library and cannot be allocated to a client. Everything unmarked is available now.

See Instrument licensing for the reasoning and for what happens if your practice holds its own licence.

Trauma & PTSD

Assessment	Full Name	Items	Use
PCL-5	PTSD Checklist for DSM-5	20	PTSD screening and monitoring
ITQ	International Trauma Questionnaire	18	PTSD and Complex PTSD (ICD-11)
LEC-5	Life Events Checklist for DSM-5	17	Trauma exposure assessment
ACE-Q	Adverse Childhood Experiences	10	Childhood trauma history
DES-II-B (gated)	Dissociative Experiences Scale	28	Dissociation screening
DAR-5 (gated)	Dimensions of Anger Reactions	5	Anger and emotional regulation
TGI-SR+	Traumatic Grief Inventory-SR Plus	22	Prolonged grief (bereavement)

Substance Use

Assessment	Full Name	Items	Use
AUDIT	Alcohol Use Disorders Identification Test	10	Alcohol use screening
AUDIT-C	AUDIT Consumption Questions	3	Brief alcohol screening
CAGE-AID	CAGE Adapted to Include Drugs	4	Quick substance screening
DAST-10 (gated)	Drug Abuse Screening Test	10	Drug use screening
DUDIT	Drug Use Disorders Identification Test	11	Drug use severity
PGSI	Problem Gambling Severity Index	9	Gambling behaviour screening

Depression (additional)

Assessment	Full Name	Items	Use
PHQ-2	Patient Health Questionnaire-2	2	Ultra-brief depression screen
PHQ-15	Patient Health Questionnaire-15	15	Somatic symptom severity
EPDS (gated)	Edinburgh Postnatal Depression Scale	10	Perinatal depression
GDS-15	Geriatric Depression Scale	15	Depression in older adults
MDQ	Mood Disorder Questionnaire	15	Bipolar disorder screening
PHQ-A	PHQ-9 Modified for Adolescents	13	Adolescent depression (11-17)

Anxiety (additional)

Assessment	Full Name	Items	Use
GAD-2	Generalised Anxiety Disorder-2	2	Ultra-brief anxiety screen
PAS (gated)	Panic and Agoraphobia Scale	13	Panic disorder severity
SPIN (gated)	Social Phobia Inventory	17	Social anxiety
SHAI (gated)	Short Health Anxiety Inventory	18	Health anxiety
SCARED (gated)	Screen for Child Anxiety Related Disorders	41	Child and adolescent anxiety

Sleep

Assessment	Full Name	Items	Use
ISI (gated)	Insomnia Severity Index	7	Sleep problems

Wellbeing & Functioning

Assessment	Full Name	Items	Use
WEMWBS (gated)	Warwick-Edinburgh Mental Wellbeing Scale	14	Positive wellbeing
WHO-5	WHO Well-Being Index	5	Subjective wellbeing
CORE-10	Clinical Outcomes in Routine Evaluation	10	General functioning
CORE-OM	CORE Outcome Measure	34	Comprehensive functioning
K5	Kessler-5	5	Brief distress screening
K6	Kessler-6	6	Distress screening
ORS (gated)	Outcome Rating Scale	4	Session-by-session outcome
SRS (gated)	Session Rating Scale	4	Therapeutic alliance
PWI-A	Personal Wellbeing Index - Adult	7	Quality of life domains
SWLS	Satisfaction With Life Scale	5	Life satisfaction
Flourishing Scale	Flourishing Scale	8	Psychological flourishing
AAQ-2 (gated)	Acceptance and Action Questionnaire	7	Psychological flexibility
SCS-SF	Self-Compassion Scale - Short Form	12	Self-compassion
PSS-10	Perceived Stress Scale	10	Stress level
DERS-16	Difficulties in Emotion Regulation	16	Emotion regulation
FFMQ-15	Five Facet Mindfulness Questionnaire	15	Mindfulness
WHODAS-12 (gated)	WHO Disability Assessment Schedule	12	Functional disability

OCD

Assessment	Full Name	Items	Use
OCI-R	Obsessive-Compulsive Inventory - Revised	18	OCD symptom screening
Y-BOCS-SR	Yale-Brown OCD Scale - Self-Report	10	OCD severity

Neurodiversity

Assessment	Full Name	Items	Use
ASRS	Adult ADHD Self-Report Scale	18	ADHD screening
AQ-10 (gated)	Autism Spectrum Quotient - 10	10	Autism screening
RAADS-R (gated)	Ritvo Autism Asperger Diagnostic Scale	80	Detailed autism screen

Eating Disorders

Assessment	Full Name	Items	Use
ED-15 (gated)	Eating Disorder Examination	15	Eating disorder severity
BES	Binge Eating Scale	16	Binge eating screening

Pain

Assessment	Full Name	Items	Use
NRS-Pain	Numeric Rating Scale for Pain	1	Quick pain intensity
PSEQ (gated)	Pain Self-Efficacy Questionnaire	10	Pain coping confidence
Tampa Scale (gated)	Tampa Scale of Kinesiophobia	17	Fear of movement

Risk Assessment

Assessment	Full Name	Items	Use
C-SSRS	Columbia Suicide Severity Rating Scale	Variable	Suicide risk assessment

C-SSRS Secure Delivery

The C-SSRS can be delivered with enhanced security features including lockdown mode, screenshot prevention, and crisis protocol notifications. Questions 5 and 6 trigger an immediate crisis protocol if answered "Yes", notifying the practitioner instantly.

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Child & Adolescent Assessments

Assessment	Full Name	Items	Age	Use
SDQ (gated)	Strengths and Difficulties Questionnaire	25	4-17	Behavioural screening
RCADS (gated)	Revised Child Anxiety and Depression Scale	47	8-18	Anxiety/depression
RCADS-25 (gated)	RCADS Short Version	25	8-18	Brief anxiety/depression
YP-CORE (gated)	Young Person's CORE	10	11-16	General functioning
PSC-17	Pediatric Symptom Checklist-17	17	4-16	Psychosocial screening

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Assessment Batteries

Praxi includes predefined assessment batteries -- groups of assessments commonly administered together. Batteries cover common clinical scenarios such as initial assessment, trauma, substance use, child and adolescent, anxiety, depression, and wellbeing. When you schedule a battery, all included assessments are sent to the client in a single operation.

To schedule a battery:

1. Open the client's Assessments tab
2. Click Schedule Battery
3. Select the battery template (e.g., "Initial Assessment Battery")
4. Choose the delivery method
5. Praxi creates individual sessions for each assessment in the battery

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Accessing Assessments

From Client Record

1. Open the client record
2. Navigate to the Assessments tab
3. Click New Assessment
4. Select the instrument from the list
5. Choose your delivery method

From Appointment

1. During or after an appointment
2. Click Assessments in the sidebar
3. Client is pre-selected
4. Choose the assessment
5. Administer or send

Quick Access

Press Cmd/Ctrl + K and type "new assessment" to quickly start an assessment for any client.

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Delivery Methods

Method	How it works	Best for
Email	Time-limited secure link sent via email	Remote clients, between-session
SMS	Secure link sent via SMS to client's mobile	Clients who prefer text messages
QR code	Generate a QR code the client scans on their phone	Waiting room or in-session on own device
Direct link	Shareable link you can copy and send any way	Flexible delivery via any channel
In-session	Complete on your device during the session	Immediate results, assisted completion
Kiosk	Client completes on a shared device in the practice	Waiting room self-service

No Account Required

Clients do not need a Praxi account to complete assessments. Each delivery method provides a secure, time-limited access token that works without logging in.

In-Session Completion

1. Click Start Assessment
2. Hand your device to the client (or read items aloud)
3. Client completes items using the on-screen options
4. Results display immediately when finished
5. Review and discuss findings with the client

Email or SMS Delivery

1. Select the assessment and client
2. Choose Email or SMS as the delivery method
3. The client receives a secure link with an 8-character access code
4. Client completes at their convenience (link expires after a set period)
5. You receive a notification when complete

QR Code Delivery

1. Select the assessment and client
2. Choose QR Code as the delivery method
3. A QR code displays on screen for the client to scan with their phone
4. The client completes the assessment on their own device
5. Results appear in Praxi when finished

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Assessment Results

What Results Include

Element	Description
Total score	Overall numerical score
Severity band	Clinical interpretation (e.g., "Moderate")
Subscales	Domain-specific scores (where applicable)
Item responses	Individual answers for clinical review
Risk flags	Critical items highlighted for follow-up
Change indicators	Comparison to previous administrations

Critical Item Alerts

Some assessment items flag for immediate clinical attention:

• PHQ-9 Item 9: Suicidal ideation (any score > 0)
• DASS-21 Item 21: Life meaninglessness (any score > 0)
• K10 Items 4, 10: Hopelessness/worthlessness (score 4-5)
• C-SSRS: Any ideation or behaviour items endorsed

Critical Item Protocol

When a client endorses critical items, Praxi immediately alerts you with a prominent notification. You must document your clinical response to critical items, including any safety planning or referrals made. This documentation is subject to your professional body's audit requirements and 7-year retention under the Privacy Act 1988.

Validity Flags

Praxi automatically checks for response patterns that may compromise assessment validity:

Flag	What it detects	Threshold
Rapid responding	Client answered faster than they could reasonably read the items	Median response time below 2 seconds
Straight-lining	Client selected the same answer for most or all Likert-scale items	More than 80% identical responses

When validity flags are raised, the assessment is marked with a warning. You can review the flags and, if clinically appropriate, dismiss them by adding a note explaining your reasoning (for example, the client may have completed the assessment quickly because they are familiar with the items).

Population Comparison

Praxi compares each client's score to Australian population normative data, showing where they stand relative to the general population. This comparison includes:

• Percentile rank (e.g., "higher than 78% of Australians")
• Z-score (standard deviations from the population mean)
• Category (well below average, below average, average, above average, well above average)
• Source and sample size of the normative data used

Australian norms are used where available (DASS-21, K10, PHQ-9, GAD-7). For other instruments, international norms are shown with a note about their origin.

PDF Progress Reports

Generate professional PDF reports showing a client's assessment progress over time. Reports include:

• Client demographics and treatment period
• Score trends for each assessment type
• Baseline versus current scores with interpretation
• Reliable Change Index (RCI) analysis
• Population percentile comparisons
• Practitioner details and AHPRA number

To generate a report:

1. Open the client's Assessments tab
2. Click Generate Report (or Download PDF)
3. The report downloads as a PDF suitable for sharing with GPs, insurers, or the client

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Tracking Progress Over Time

Assessment Timeline

View all assessments chronologically:

1. Open client's Assessments tab
2. Select assessment type (e.g., PHQ-9)
3. View the score graph showing all administrations
4. Hover over points for detailed results
5. Click any point to view full results

Outcome Tracking Dashboard

The Outcome Alerts dashboard shows at-a-glance summaries across your caseload:

• Needs reassessment -- clients whose last assessment was more than 4 weeks ago
• High risk -- clients with reliable deterioration in the past 30 days
• Improvements -- clients showing reliable improvement in the past 30 days

Progress Indicators

Indicator	Meaning
↓ Green arrow	Clinically meaningful improvement
→ Grey arrow	No significant change
↑ Red arrow	Clinically meaningful deterioration

Understanding Reliable Change

Not all score changes are meaningful. Praxi calculates the Reliable Change Index (RCI) to determine if change exceeds measurement error:

Assessment	RCI Threshold	Meaning
PHQ-9	6 points	Change must exceed 6 points to be reliable
GAD-7	5 points	Change must exceed 5 points to be reliable
DASS-21	7 points (per subscale)	Change must exceed 7 points to be reliable
K10	5.5 points	Change must exceed 5.5 points to be reliable

Duration-Adjusted Reliable Change (DARCI)

Praxi also supports Duration-Adjusted Reliable Change Index (DARCI), which adjusts the RCI threshold based on the time between assessments:

• Treatment monitoring mode -- uses stricter thresholds for shorter intervals (less change is expected early in treatment)
• Relapse prevention mode -- uses more sensitive thresholds for longer intervals (any change during maintenance is significant)

See Interpreting Results for detailed information on RCI and DARCI.

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Integration with Clinical Notes

Adding Results to Notes

Include assessment results in your clinical notes:

1. In the note editor, click Insert > Assessment
2. Select the assessment administration
3. Choose display format:
   • Summary - Score and severity only
   • Detailed - Full results including item responses
   • Comparison - Include previous result and change

Automatic Inclusion

Configure notes to automatically include:

• Assessments completed on the same day as the appointment
• Significant score changes (reliable change threshold)
• Any critical item endorsements

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Medicare and Outcome Measurement

Better Access Requirements

For Medicare Better Access sessions, outcome measurement is recommended:

• Initial assessment: Administer a validated outcome measure (K10, PHQ-9, or DASS-21)
• Review sessions: Re-administer the same measure to track progress
• GP report: Include outcome measure results

Recommended Assessment Protocol

Session	Action
Session 1	Baseline K10/PHQ-9/DASS-21
Session 4-6	Mid-treatment reassessment
Session 10	Final reassessment (Better Access cap)
Review session	Reassessment before next referral period

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Organisation Templates

Practice owners can create standardised assessment protocols. Assessment schedule templates are configured within the assessment scheduling workflow. Templates can include:

• Specific assessments to administer
• Delivery schedules
• Auto-assignment rules based on referral type or presenting concern

See Scheduling Assessments for detailed configuration.

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Best Practices

Selecting Assessments

1. Match to presentation - Use depression measures for depression, anxiety measures for anxiety
2. Consider burden - Don't over-assess; choose the most efficient valid measure
3. Medicare requirements - Include measures required for funding bodies
4. Track consistently - Use the same instrument throughout treatment

Administration

1. Standardise instructions - Read the standard instructions consistently
2. Minimise influence - Don't lead or interpret questions for clients
3. Review immediately - Discuss results with the client in the same session
4. Document appropriately - Record scores and clinical interpretation in notes

Interpretation

1. Clinical context - Scores are one data point among many
2. Cultural factors - Consider the validity of norms for your client's background
3. Item review - Look at individual items, not just totals
4. Collaborative discussion - Involve the client in understanding their results

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Troubleshooting

Assessment Not Appearing

1. Check the assessment is enabled for your organisation (Settings > Clinical)
2. Verify your role has permission to administer assessments
3. Confirm client age meets assessment requirements (e.g., K10 requires 18+)
4. Contact your practice administrator

Expired or Incomplete Assessments

If a client's assessment link has expired or they did not finish:

• Extend -- generates a new access link for the same session, preserving any partial responses already submitted. If more than 48 hours have passed since the client's last activity, a recall validity warning is shown.
• Reissue -- cancels the existing session and creates a fresh one. No responses are carried over. Use this when a completely new attempt is preferred.

Both options are available from the assessment session list. Look for the Extend or Reissue buttons on expired or cancelled sessions.

Client Cannot Access Email Link

1. Check the link hasn't expired
2. Verify the email address is correct
3. Check spam/junk folders
4. Use Extend to generate a new link
5. Offer alternative method (QR code or in-session)

Scoring Discrepancy

1. Ensure all items were completed
2. Check for data entry errors (manual entry)
3. Verify correct assessment version
4. Review DASS-21 multiplication (subscales x2)
5. Recalculate manually if needed

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Permissions

Assessment permissions are linked to clinical notes permissions:

Action	Required Role
View assessment library	Any clinical role (practitioner, intern)
Schedule and send assessments	Practitioner, supervisor, practice owner
View own client results	Any clinical role
View all client results	Supervisor, practice owner
Cancel, extend, or reissue	Practitioner, supervisor, practice owner
Dismiss validity flags	Practitioner, supervisor, practice owner
Generate PDF reports	Any clinical role

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Instrument licensing

Praxi's library contains only instruments we can lawfully offer inside a commercial healthcare platform. Every instrument is classified against its rights holder's terms before it becomes available:

• Available (42 instruments) — public-domain measures and instruments whose copyright terms permit commercial electronic use (for example K10, PHQ-9, GAD-7, DASS-21, AUDIT, ACE-Q). These appear in your assessment library and can be allocated immediately.
• Licence-gated (24 instruments) — measures whose rights holders require a paid licence or written permission for commercial or electronic use (for example ORS/SRS, WEMWBS, EPDS, SDQ), or whose seeded form did not match the validated original. These do not appear in your library. As licences are obtained, instruments are enabled platform-wide — no action needed in your practice.

"Free for clinicians" often means free for an individual photocopying a paper form — not free for a software platform to reproduce electronically. Praxi takes the conservative reading so your practice never administers an instrument outside its licence terms.

If your practice holds its own licence for a gated instrument, or you need a measure we have not yet licensed, contact support — practice-held licences can be registered so the instrument is enabled for your organisation.

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Related

• Scheduling Assessments - Set up automated assessment delivery
• Interpreting Results - Clinical interpretation and reporting
• Clinical Notes Overview - Documenting assessment findings

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