PHQ-9 GAD-7 Online Screening Built Into the Client Portal

The problem: measurement that never happens

Most clinicians agree that tracking symptoms over time improves care, and many payers and referral sources expect it. In practice, measurement-based care stalls on logistics: paper questionnaires handed out in the waiting room, scored by hand, filed somewhere, and compared with last month's score only when someone remembers to look.

There is also a safety problem. A client who answers the PHQ-9 suicide item on paper the night before a session leaves that answer unseen until the session starts, if it is noticed at all.

Prexella's fix is validated screenings built into the client portal, scored when they are submitted, saved to the client's record, and wired to a safety follow-up.

How Prexella's PHQ-9 GAD-7 online screening works

1. Clients complete check-ins in the portal. In the client portal, under Check-ins, clients choose a screening and answer it on a phone or computer. You can also send the PHQ-9, the ASRS or a symptom and functioning check from the Forms tab as a form with a direct link.
2. Each one is scored on submit. Prexella totals the answers, places the score in its severity band and stores it with the date. The client sees their own result.
3. Follow-ups run automatically. Any answer above zero on PHQ-9 item 9 routes the client straight to the C-SSRS screener, and a positive AUDIT-C leads to the full AUDIT.
4. Risk is flagged. A high-risk result is flagged on the record, the client is shown crisis resources (988, 911 and the nearest emergency room), and the result appears as a high-risk item in the dashboard notifications.
5. You review it on the record. The client's record in the dashboard lists every completed screening with its score and severity, so you can see change across treatment.

Instruments and score bands

Instrument	What it screens	How the score is shown
PHQ-9	Depression	0–4 minimal, 5–9 mild, 10–14 moderate, 15–19 moderately severe, 20–27 severe
GAD-7	Anxiety	0–4 minimal, 5–9 mild, 10–14 moderate, 15–21 severe
PCL-5	Post-traumatic stress	0–32 below provisional threshold, 33–80 at or above threshold
AUDIT-C	Alcohol use	0–3 lower risk, 4–7 increased risk, 8–12 higher risk; 4 or more leads to the full AUDIT
DAST-10	Drug use	Scored by severity band
C-SSRS screener	Suicide risk	Risk level from the items endorsed; intent, plan or behavior is flagged high risk
ASRS v1.1 Part A	Adult ADHD	Offered when attention symptoms are a concern

Part of the client record, not a separate tool

Screenings sit alongside the rest of the client's record: sessions, notes and signed forms collected with ESIGN and UETA e-signatures. For the clinical side of using these tools, including how often to repeat them, see using the PHQ-9 and GAD-7 in private practice.

Who it is for

Built-in screening is most useful to clinicians who track outcomes across treatment:

• Psychologists practicing measurement-based care alongside assessment.
• Counselors who want a quick read on symptoms before each session.
• Therapists who want PHQ-9 and GAD-7 trends without paper forms.
• Clinical social workers who need a safety follow-up built into intake.

To see the check-ins, scoring and the safety follow-up with your own forms, request a demo.