GAD-7: Anxiety Screening
The GAD-7 (Generalised Anxiety Disorder-7) is a seven-item self-report measure used to screen for anxiety severity, scored 0-21, commonly paired with the PHQ-9.
What Is the GAD-7?
The Generalised Anxiety Disorder-7 scale is the standard self-report anxiety screening tool in outpatient therapy. Seven items are scored from 0 (not at all) to 3 (nearly every day), yielding a total score of 0-21.
Scoring and Clinical Cutoffs
| Score Range | Severity | Clinical Action |
|---|---|---|
| 0-4 | Minimal | Monitor; no intervention typically needed |
| 5-9 | Mild | Watchful waiting; psychoeducation and coping strategies |
| 10-14 | Moderate | Active treatment indicated |
| 15-21 | Severe | Intensive treatment; consider combined approaches |
A reliable change index of 4+ points indicates clinically meaningful change.
Clinical Applications
Broad Anxiety Screening
Although validated for generalised anxiety disorder, the GAD-7 performs well across anxiety presentations including panic disorder, social anxiety, and general worry. For OCD or specific phobias, supplement with disorder-specific measures for more precise tracking.
Paired Administration With the PHQ-9
The GAD-7 and PHQ-9 are designed as companion instruments. Administering both takes under 5 minutes and captures the two most common presenting concerns in outpatient therapy. Many insurance payers expect both scores in clinical documentation.
Treatment Plan Integration
Use GAD-7 scores as measurable objectives in treatment plans: “Client will reduce GAD-7 score from 16 (severe) to below 10 (moderate) within 10 weeks.”
Practical Tips
- Administration time: 1-2 minutes
- Cost: Free — no licensing fees
- Frequency: Every 2-4 sessions alongside the PHQ-9
- Documentation: Include scores in session notes to build a quantified treatment trajectory
For implementation guidance, see our outcome measures guide.
Related Resources
PHQ-9: Depression Screening
The PHQ-9 (Patient Health Questionnaire-9) is a nine-item self-report measure used to screen for depression severity, scored 0-27, widely used in routine outcome monitoring.
Treatment Plans
A treatment plan is a structured document that outlines a client's diagnoses, therapeutic goals, interventions, and measurable objectives to guide the course of therapy.
Stay informed
Enjoyed this guide?
Get practical tips and in-depth guides for your therapy practice delivered straight to your inbox.
Ready to streamline your practice?
AI-powered notes, client management, and more — free for up to 5 clients.