Form cover
Page 1 of 2

Depression Assessment - (PHQ-9)

https://storage.tally.so/141b2b56-1a1e-416b-a824-6b048cab4b48/Title.jpg

Introduction

This Questionnaire (PHQ-9) is a widely used tool to assess the severity of depression symptoms. It consists of nine questions that ask about common experiences and emotions, such as feeling down, having little interest in daily activities, or trouble concentrating. By asking how often these issues have occurred over the past two weeks, this self-report questionnaire helps both the therapist and the client understand the severity of depression symptoms. The results can help guide the development of an appropriate treatment plan, enabling therapists to provide the most effective support for managing and alleviating depressive symptoms.

This assessment is not a diagnosis but rather a guide that provides valuable insights to help refine our therapeutic approach and create a customized plan tailored to your most important needs and goals.
Please take your time with each question and answer as honestly and openly as you can. There are no right or wrong answers—just your experience, which is valuable and important.
I look forward to our time together.

Warmly, Monika

Integrative Somatic Psychotherapist, Trauma Specialist, EMDR, IFS, SE, PSYCH-K
https://storage.tally.so/d755af8a-5f94-43d9-831e-820e576b4e31/YourDetails.jpg

What is your full name?

What is your email?

What is your mobile number?

What is your location?

https://storage.tally.so/d8f1534a-7824-44db-8906-6d5ab31005ed/Instructions.jpg

Instructions

Over the last 2 weeks, how often have you been bothered by any of the following problems? Please read each statement carefully and choose the number that best reflects your experience.
Rating Scale:
0 = Not at all
1 = Several days
2 = More than half the days
3 = Nearly every day


1. Little interest or pleasure in doing things

1. Little interest or pleasure in doing things
Not at allNearly every day

2. Feeling down, depressed, or hopeless

2. Feeling down, depressed, or hopeless
Not at allNearly every day

3. Trouble falling or staying asleep, or sleeping too much

3. Trouble falling or staying asleep, or sleeping too much
Not at allNearly every day

4. Feeling tired or having little energy

4. Feeling tired or having little energy
Not at allNearly every day

5. Poor appetite or overeating

5. Poor appetite or overeating
Not at allNearly every day

6. Feeling bad about yourself — or that you are a failure or have let yourself or your family down

6. Feeling bad about yourself — or that you are a failure or have let yourself or your family down
Not at allNearly every day

7. Trouble concentrating on things, such as reading the newspaper or watching television

7. Trouble concentrating on things, such as reading the newspaper or watching television
Not at allNearly every day

8. Moving or speaking so slowly that other people could have noticed, or being so fidgety/restless

8. Moving or speaking so slowly that other people could have noticed, or being so fidgety/restless
Not at allNearly every day

9. Thoughts that you would be better off dead or of hurting yourself in some way

9. Thoughts that you would be better off dead or of hurting yourself in some way
Not at allNearly every day

Thank you for completing this questionnaire. Your responses will be discussed during your next session to identify areas for support and healing.
https://storage.tally.so/23f9db53-a235-4641-ae7c-a497d69466dc/Quote.jpg