Over the last 2 weeks, how often have you been bothered
by any of the following problems?
Total Score
0
If you checked any problems, how difficult have they
made it for you to do your work, take care of things at
home, or get alone with other people?
Not difficult at all
Somewhat difficult
Very difficult
Extremely difficult
Scale: Sadness and hopelessness
EXPAND SECTION
Patient Health Questionnaire 9 (PHQ-9)
Over the last 2 weeks, how often have you been bothered
by any of the following problems?
Total Score 0
If you checked any problems, how difficult have they
made it for you to do your work, take care of things at
home, or get alone with other people?
Not difficult at all
Somewhat difficult
Very difficult
Extremely difficult
Scale: Trauma and numbness
EXPAND SECTION
PTSD Checklist for DSM-5 (PCL-5)
In the past month, how much were you bothered by:
Total Score 0
Screening questions
EXPAND SECTION
The screening questions are simple questions you can ask
They are adapted from widely used screening tools
They don’t give a diagnosis, but can give you some direction
in understanding her mental health
You should keep the information from the screening questions
confidential so that it can’t be misused
General questions
EXPAND SECTION
Identifying her emotions and including them in counselling will
help you to achieve the best outcome
“Now that we have talked about the problems you have been facing
and we are working on ways to make the situation better, I’m
going to ask you some questions about your health”
These questions are common to fear and worry, sadness and
hopelessness