Behavioral Activation Patient Education Handout

This handout provides information about depression, explains the benefit of scheduling daily activities, and includes a worksheet for scheduling daily activities. It is for Behavioral Health Care Managers to use when delivering Behavioral Activation to a patient.

Relapse Prevention Plan Template (Spanish)

This relapse prevention plan template should be filled out by a patient with their Behavioral Health Care Manager in the months prior to completing an episode of Collaborative Care. The purpose of a relapse prevention plan (RPP) is to remind a patient to continue doing the things that make them feel better, assess their own symptoms and warning signs, and know when to ask for more help if it is needed. In other words, a RPP is a self-management tool for patients. We also have a Relapse Prevention Plan Template available in English.

Behavioral Health Care Manager Role and Job Description

The Behavioral Health Care Manager is responsible for coordinating and supporting mental health care within the clinic and for coordinating referrals to clinically indicated services outside the clinic. The Behavioral Health Care Manager may provide evidence-based treatments or work with other mental health providers when such treatment is indicated.

The job description below provides a comprehensive list of the duties and responsibilities required of a Behavioral Health Care Manager.

Quality Aims Example

Provides an example from our MHIP implementation of what kind of metrics can be tracked. Note that this is an example only and is relevant for one snapshot in time. These Quality Aims are regularly reviewed and revised based on previous successes and failures.

PHQ-9 Depression Scale Questionnaire

The PHQ-9 is a measurement tool providers can use to ensure measurement-based treatment to target within Collaborative Care. This concise nine-item health questionnaire can function as a screening tool, aids in diagnosis, and measures treatment response.

Advantages of the PHQ-9

Patient filling out PHQ-9

  • It is shorter than other depression rating scales
  • Multiple administration options (in person by a clinician, by telephone, or self-administered by the patient)
  • Facilitates diagnosis of major depression
  • Assesses symptom severity
  • Well-validated and documented in a variety of populations
  • Directly based on the nine diagnostic criteria for major depressive disorder in the DSM-5
  • Valid for use in adolescents as young as 12 years of age

How to Use the PHQ-9

At the initial visit, the PHQ-9 aids in the diagnosis and identification of potential depressive symptoms. At follow-up visits, it measures treatment response. The Questionnaire can be clinician or self-administered.

Scoring the PHQ-9

The PHQ-9 is a tool to assist clinicians in identifying and diagnosing major depression. It has a maximum score of 27. Elevated scores strongly correlate with a major depression diagnosis. However, it’s essential to remember that not everyone with a high PHQ-9 score will have major depression. Trained clinicians must make the final diagnosis.

Patient Health Questionnaire 2 (PHQ-2)

The Patient Health Questionnaire 2 (PHQ-2) effectively screens large groups for depression. It consists of the first two questions on the PHQ-9. If the patient responds affirmatively to either question on the PHQ-2, the PHQ-9 should be administered. No permission is required to reproduce, translate, display, or distribute the PHQ-2.

PHQ-9 Questionnaire and Translations

The PHQ-9, translations of the measure, and an instruction manual are available at No permission is required to reproduce, translate, display, or distribute the PHQ-9.

Protocols for Suicide Prevention

The PHQ-9 asks about suicidal ideation, and clinics should have a plan in place for when a patient scores positive on this question. The Protocols for Suicide Prevention in Primary Care assists clinics in refining existing protocol(s) for responding to patients who present with suicidality or violent behavior.

PHQ-9 Aids

Introducing the PHQ-9

To increase staff comfort in discussing the PHQ-9 with patients, the AIMS Center provides the Helping Clinic Staff Talk about the PHQ-9 tool. This resource equips clinic staff to administer the PHQ-9 by addressing commonly asked patient questions.

PHQ-9 Visual Answer Aid 

This answer aid visually represents the PHQ-9 answer scale: English | Spanish.

Problem Solving Treatment (PST)

Problem-Solving Treatment (PST) is a brief form of evidence-based treatment that was originally developed in Great Britain for use by medical professionals in primary care. It is also known as Problem-Solving Treatment – Primary Care (PST-PC). PST has been studied extensively in a wide range of settings and with a variety of providers and patient populations.

PST teaches and empowers patients to solve the here-and-now problems contributing to their depression and helps increase self-efficacy. It typically involves six to ten sessions, depending on the patient’s needs. The first appointment is approximately one hour long because, in addition to the first PST session, it includes an introduction to PST techniques. Subsequent appointments are 30 minutes long.

PST is not indicated as a primary treatment for: substance abuse/dependence, acute primary post-traumatic stress disorder, panic disorder, new onset bipolar disorder, new onset psychosis.

Learn more about how to get trained in PST on this page.

Brief Pain Inventory (BPI)

The Brief Pain Inventory is a medical questionnaire used to measure pain, developed by the Pain Research Group of the WHO Collaborating Centre for Symptom Evaluation in Cancer Care.

Help Clinic Staff Talk with Patients About the PHQ-9

This tool is designed to help clinic support staff with answers to frequent questions they may hear from patients about the PHQ-9.

It’s best for support staff to have the opportunity to role play and practice before using the PHQ-9 with patients. It can also be helpful for support staff to keep this someplace where they can refer to it, as needed, when they get questions from patients.