Top 20 Auto-Scored Mental Health Assessments Every Clinician Should Use (PHQ-9, GAD-7, Vanderbilt, Y-BOCS & More)

Outcome measurement is no longer optional in mental health care. Insurance companies require it, evidence-based practice demands it, and most importantly—it improves patient outcomes by 30-40% when used consistently.

But manually scoring assessments wastes precious clinical time. This guide covers the top 20 auto-scored mental health assessments every clinician should use, with scoring interpretation, clinical applications, and how to integrate them seamlessly into your workflow.

Why Auto-Scored Assessments Matter

The Evidence:

• Routine outcome monitoring improves treatment outcomes by 30-40%
• Reduces treatment duration by identifying what's working faster
• Catches deterioration early (prevents crisis)
• Supports evidence-based treatment decisions
• Required by most insurance companies
• Demonstrates treatment effectiveness

The Problem with Manual Scoring:

• Takes 5-10 minutes per assessment
• Prone to calculation errors
• Delays clinical decision-making
• Often skipped due to time constraints

The Solution: Auto-scored assessments in your EHR calculate scores instantly, track trends over time, and flag concerning changes—all without extra work.

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Top 20 Auto-Scored Mental Health Assessments

1. PHQ-9 (Patient Health Questionnaire-9)

What It Measures: Depression severity Items: 9 questions Time: 2-3 minutes Scoring: 0-27 (higher = more severe)

Score Interpretation:

• 0-4: Minimal depression
• 5-9: Mild depression
• 10-14: Moderate depression
• 15-19: Moderately severe depression
• 20-27: Severe depression

Clinical Use:

• Initial depression screening
• Track depression treatment progress
• Monitor medication effectiveness
• Required by most insurance for depression treatment

Key Features:

• Question 9 assesses suicidal ideation
• Can be used weekly to track progress
• Validated across diverse populations
• Free to use in clinical practice

When to Use:

• Every new patient with depression concerns
• Every 4-6 weeks during treatment
• When adjusting medications
• Before discharge/termination

2. GAD-7 (Generalized Anxiety Disorder-7)

What It Measures: Anxiety severity Items: 7 questions Time: 2 minutes Scoring: 0-21 (higher = more severe)

Score Interpretation:

• 0-4: Minimal anxiety
• 5-9: Mild anxiety
• 10-14: Moderate anxiety
• 15-21: Severe anxiety

Clinical Use:

• Initial anxiety screening
• Track anxiety treatment progress
• Monitor medication/therapy effectiveness
• Works for GAD, panic, social anxiety, PTSD

Key Features:

• Brief and easy to complete
• Sensitive to change over time
• Can be used weekly
• Free to use in clinical practice

When to Use:

• Every new patient with anxiety concerns
• Every 4-6 weeks during treatment
• When adjusting medications or therapy approach
• Alongside PHQ-9 for comorbid depression/anxiety

3. PCL-5 (PTSD Checklist for DSM-5)

What It Measures: PTSD symptom severity Items: 20 questions Time: 5-7 minutes Scoring: 0-80 (higher = more severe)

Score Interpretation:

• 0-30: Minimal PTSD symptoms
• 31-32: Provisional PTSD diagnosis cutoff
• 33-80: Clinically significant PTSD symptoms

Clinical Use:

• Screen for PTSD
• Monitor PTSD treatment progress
• Track trauma therapy effectiveness
• Assess symptom clusters (intrusion, avoidance, cognition/mood, arousal)

Key Features:

• Aligned with DSM-5 PTSD criteria
• Can identify specific symptom clusters
• Sensitive to treatment changes
• Free to use in clinical practice

When to Use:

• Any patient with trauma history
• Before starting trauma-focused therapy
• Every 4-6 weeks during trauma treatment
• After completing trauma therapy protocol

4. YMRS (Young Mania Rating Scale)

What It Measures: Mania severity Items: 11 items (clinician-rated) Time: 15-30 minutes Scoring: 0-60 (higher = more severe)

Score Interpretation:

• 0-12: Normal/euthymic
• 13-19: Mild mania/hypomania
• 20-25: Moderate mania
• 26+: Severe mania

Clinical Use:

• Monitor bipolar disorder treatment
• Track mood stabilizer effectiveness
• Assess mania severity
• Required for bipolar disorder treatment documentation

Key Features:

• Gold standard for mania assessment
• Clinician-administered (not self-report)
• Sensitive to medication changes
• Widely used in research and clinical practice

When to Use:

• Every visit for patients with bipolar I disorder
• When adjusting mood stabilizers
• During manic or hypomanic episodes
• Monthly for stable bipolar patients

5. PANSS (Positive and Negative Syndrome Scale)

What It Measures: Schizophrenia symptom severity Items: 30 items (clinician-rated) Time: 30-40 minutes Scoring: 30-210 (higher = more severe)

Score Interpretation:

• Positive symptoms: 7-49
• Negative symptoms: 7-49
• General psychopathology: 16-112

Clinical Use:

• Monitor schizophrenia treatment
• Track antipsychotic effectiveness
• Assess positive and negative symptoms separately
• Required for schizophrenia treatment documentation

Key Features:

• Comprehensive psychosis assessment
• Separates positive, negative, and general symptoms
• Gold standard for schizophrenia research
• Requires training to administer

When to Use:

• Every 4-8 weeks for patients with schizophrenia
• When adjusting antipsychotic medications
• During acute psychotic episodes
• For treatment-resistant schizophrenia

6. Vanderbilt ADHD Diagnostic Rating Scale

What It Measures: ADHD symptoms (parent/teacher-rated) Items: 55 items (parent form), 43 items (teacher form) Time: 10 minutes Scoring: Separate scores for inattention, hyperactivity/impulsivity, combined

Score Interpretation:

• Inattention: 6+ symptoms = clinically significant
• Hyperactivity/Impulsivity: 6+ symptoms = clinically significant
• Combined: Both domains elevated

Clinical Use:

• ADHD diagnosis in children/adolescents
• Monitor ADHD treatment effectiveness
• Track medication response
• Gather collateral information from teachers

Key Features:

• Includes performance and comorbidity items
• Parent and teacher versions
• Aligned with DSM-5 criteria
• Free to use in clinical practice

When to Use:

• Initial ADHD evaluation
• Every 3-6 months during treatment
• When adjusting ADHD medications
• Annual school performance monitoring

7. Y-BOCS (Yale-Brown Obsessive Compulsive Scale)

What It Measures: OCD symptom severity Items: 10 items (clinician-rated) Time: 20-30 minutes Scoring: 0-40 (higher = more severe)

Score Interpretation:

• 0-7: Subclinical
• 8-15: Mild OCD
• 16-23: Moderate OCD
• 24-31: Severe OCD
• 32-40: Extreme OCD

Clinical Use:

• Monitor OCD treatment progress
• Track medication/ERP therapy effectiveness
• Assess obsession and compulsion severity separately
• Required for OCD treatment documentation

Key Features:

• Gold standard for OCD assessment
• Separates obsessions and compulsions
• Sensitive to treatment changes
• Widely used in OCD research

When to Use:

• Initial OCD evaluation
• Every 4-6 weeks during treatment
• When adjusting medications or ERP protocols
• Before and after intensive OCD treatment

8. MDQ (Mood Disorder Questionnaire)

What It Measures: Bipolar disorder screening Items: 13 items + 2 follow-up questions Time: 5 minutes Scoring: Positive screen = 7+ "yes" answers + clustering + impairment

Score Interpretation:

• Positive screen: Suggests bipolar disorder (requires clinical evaluation)
• Negative screen: Bipolar disorder less likely

Clinical Use:

• Screen for bipolar disorder in depression patients
• Identify patients who need mood stabilizers vs. antidepressants
• Prevent antidepressant-induced mania
• Quick screening tool

Key Features:

• Brief and easy to complete
• High sensitivity for bipolar I disorder
• Free to use in clinical practice
• Should not be used alone for diagnosis

When to Use:

• Every new patient presenting with depression
• Before starting antidepressants
• When depression doesn't respond to treatment
• Family history of bipolar disorder

9. AUDIT (Alcohol Use Disorders Identification Test)

What It Measures: Alcohol use disorder severity Items: 10 questions Time: 2-3 minutes Scoring: 0-40 (higher = more severe)

Score Interpretation:

• 0-7: Low risk
• 8-15: Hazardous drinking
• 16-19: Harmful drinking
• 20+: Possible alcohol dependence

Clinical Use:

• Screen for alcohol use disorders
• Assess drinking severity
• Monitor alcohol treatment progress
• Required for substance use documentation

Key Features:

• Brief and non-threatening
• Validated internationally
• Sensitive to early problem drinking
• Free to use in clinical practice

When to Use:

• Every new patient intake
• Annually for all patients
• When prescribing medications that interact with alcohol
• Before starting benzodiazepines

10. DAST-10 (Drug Abuse Screening Test)

What It Measures: Drug use disorder severity Items: 10 questions Time: 2-3 minutes Scoring: 0-10 (higher = more severe)

Score Interpretation:

• 0: No problems
• 1-2: Low level
• 3-5: Moderate level
• 6-8: Substantial level
• 9-10: Severe level

Clinical Use:

• Screen for drug use disorders
• Assess substance use severity
• Monitor substance use treatment
• Complement AUDIT for comprehensive screening

Key Features:

• Brief and easy to score
• Covers all drug classes
• Non-judgmental wording
• Free to use in clinical practice

When to Use:

• Every new patient intake
• Annually for all patients
• When prescribing controlled substances
• Before starting stimulants or benzodiazepines

11. C-SSRS (Columbia-Suicide Severity Rating Scale)

What It Measures: Suicidal ideation and behavior Items: 6 "yes/no" questions + follow-ups Time: 5-10 minutes Scoring: Categorical (ideation, intent, plan, behavior)

Score Interpretation:

• Ideation only: Lower risk
• Ideation + intent: Moderate risk
• Ideation + intent + plan: High risk
• Recent behavior: Highest risk

Clinical Use:

• Assess suicide risk
• Track suicidal ideation over time
• Required by many insurance companies
• Document safety planning

Key Features:

• Gold standard for suicide assessment
• Distinguishes ideation from behavior
• Tracks lifetime and recent risk
• Free to use in clinical practice

When to Use:

• Every new patient intake
• Any positive PHQ-9 question 9
• When patient reports increased distress
• Before discharge from higher level of care

12. ASRS (Adult ADHD Self-Report Scale)

What It Measures: Adult ADHD symptoms Items: 18 questions (6-item screener available) Time: 5 minutes Scoring: Part A (6 items) = screener; Full scale = symptom severity

Score Interpretation:

• Part A: 4+ symptoms = positive screen
• Full scale: Tracks symptom severity over time

Clinical Use:

• Screen for adult ADHD
• Monitor ADHD treatment in adults
• Track medication effectiveness
• Differentiate inattentive vs. hyperactive symptoms

Key Features:

• Designed specifically for adults
• Brief screener available
• Aligned with DSM-5 criteria
• Free to use in clinical practice

When to Use:

• Adults presenting with concentration problems
• Before starting ADHD medications
• Every 3-6 months during treatment
• When adjusting stimulant doses

13. EPDS (Edinburgh Postnatal Depression Scale)

What It Measures: Perinatal depression and anxiety Items: 10 questions Time: 3-5 minutes Scoring: 0-30 (higher = more severe)

Score Interpretation:

• 0-9: Minimal symptoms
• 10-12: Mild symptoms
• 13+: Moderate to severe symptoms (clinical evaluation needed)

Clinical Use:

• Screen for postpartum depression
• Monitor perinatal mental health
• Track treatment effectiveness
• Can be used during pregnancy

Key Features:

• Designed for perinatal period
• Includes anxiety items
• Question 10 assesses self-harm thoughts
• Free to use in clinical practice

When to Use:

• During pregnancy (each trimester)
• 2 weeks, 6 weeks, 3 months, 6 months postpartum
• Any time perinatal mood concerns arise
• Before starting medications during pregnancy/breastfeeding

14. SCARED (Screen for Child Anxiety Related Disorders)

What It Measures: Childhood anxiety disorders Items: 41 questions (child and parent versions) Time: 10 minutes Scoring: 0-82 (higher = more severe)

Score Interpretation:

• 25+: Anxiety disorder likely
• Subscales: Panic, GAD, separation anxiety, social phobia, school avoidance

Clinical Use:

• Screen for anxiety in children/adolescents
• Monitor anxiety treatment progress
• Identify specific anxiety subtypes
• Track therapy/medication effectiveness

Key Features:

• Child and parent versions
• Identifies specific anxiety disorders
• Free to use in clinical practice
• Validated for ages 8-18

When to Use:

• Initial evaluation of anxious children
• Every 6-8 weeks during treatment
• When adjusting anxiety medications
• Before and after CBT for anxiety

15. BDI-II (Beck Depression Inventory-II)

What It Measures: Depression severity Items: 21 questions Time: 5-10 minutes Scoring: 0-63 (higher = more severe)

Score Interpretation:

• 0-13: Minimal depression
• 14-19: Mild depression
• 20-28: Moderate depression
• 29-63: Severe depression

Clinical Use:

• Comprehensive depression assessment
• Track depression treatment progress
• Research and clinical practice
• Alternative to PHQ-9 for more detail

Key Features:

• More comprehensive than PHQ-9
• Includes cognitive and somatic symptoms
• Widely used in research
• Requires purchase/licensing

When to Use:

• Initial comprehensive depression evaluation
• Research protocols
• When more detailed assessment needed
• Every 4-6 weeks during treatment

16. BAI (Beck Anxiety Inventory)

What It Measures: Anxiety severity Items: 21 questions Time: 5-10 minutes Scoring: 0-63 (higher = more severe)

Score Interpretation:

• 0-7: Minimal anxiety
• 8-15: Mild anxiety
• 16-25: Moderate anxiety
• 26-63: Severe anxiety

Clinical Use:

• Comprehensive anxiety assessment
• Track anxiety treatment progress
• Distinguish anxiety from depression
• Alternative to GAD-7 for more detail

Key Features:

• Focuses on somatic anxiety symptoms
• Complements BDI-II
• Widely used in research
• Requires purchase/licensing

When to Use:

• Initial comprehensive anxiety evaluation
• Research protocols
• When more detailed assessment needed
• Every 4-6 weeks during treatment

17. PSC (Pediatric Symptom Checklist)

What It Measures: Psychosocial problems in children Items: 35 questions (parent-rated) Time: 5 minutes Scoring: 0-70 (higher = more problems)

Score Interpretation:

• 28+ (ages 6-16): Positive screen
• 24+ (ages 4-5): Positive screen

Clinical Use:

• Broad screening for child mental health
• Identify children needing evaluation
• Monitor overall functioning
• Track treatment progress

Key Features:

• Brief and easy for parents
• Covers multiple domains
• Free to use in clinical practice
• Validated for ages 4-16

When to Use:

• Well-child visits
• Initial mental health evaluation
• Every 6 months during treatment
• School performance concerns

18. WHODAS 2.0 (WHO Disability Assessment Schedule)

What It Measures: Functional impairment Items: 12 or 36 questions Time: 5-20 minutes (depending on version) Scoring: 0-100 (higher = more impairment)

Score Interpretation:

• 0-4: No disability
• 5-24: Mild disability
• 25-49: Moderate disability
• 50-95: Severe disability
• 96-100: Extreme disability

Clinical Use:

• Assess functional impairment
• Track treatment impact on functioning
• Required for disability documentation
• Measure treatment outcomes

Key Features:

• Measures functioning across 6 domains
• Aligned with ICF framework
• Free to use in clinical practice
• Multiple versions available

When to Use:

• Initial evaluation for disability claims
• Every 3-6 months during treatment
• Before and after major interventions
• Discharge planning

19. CSSRS-Screener (Columbia Suicide Severity Rating Scale - Screener)

What It Measures: Suicide risk (brief version) Items: 6 questions Time: 2-3 minutes Scoring: Categorical (low, moderate, high risk)

Score Interpretation:

• No ideation: Low risk
• Ideation without intent/plan: Moderate risk
• Ideation with intent/plan or recent behavior: High risk

Clinical Use:

• Quick suicide risk screening
• Triage in emergency settings
• Regular monitoring of at-risk patients
• Required by many insurance companies

Key Features:

• Brief version of full C-SSRS
• Easy to administer
• Clear risk stratification
• Free to use in clinical practice

When to Use:

• Every session with high-risk patients
• Any positive depression screening
• Emergency/crisis evaluations
• Before prescribing potentially lethal medications

20. WEMWBS (Warwick-Edinburgh Mental Wellbeing Scale)

What It Measures: Positive mental wellbeing Items: 14 questions Time: 3-5 minutes Scoring: 14-70 (higher = better wellbeing)

Score Interpretation:

• 14-40: Low wellbeing
• 41-59: Moderate wellbeing
• 60-70: High wellbeing

Clinical Use:

• Measure positive mental health (not just symptoms)
• Track wellbeing improvements
• Complement symptom measures
• Assess treatment impact on flourishing

Key Features:

• Focuses on positive mental health
• Sensitive to change
• Free to use in clinical practice
• Validated across populations

When to Use:

• Alongside symptom measures
• Positive psychology interventions
• Wellness programs
• Every 6-8 weeks during treatment

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How to Choose the Right Assessment

By Clinical Presentation

Depression:

• Primary: PHQ-9
• Comprehensive: BDI-II
• Perinatal: EPDS

Anxiety:

• Primary: GAD-7
• Comprehensive: BAI
• Children: SCARED

ADHD:

• Adults: ASRS
• Children: Vanderbilt

Trauma:

• Primary: PCL-5

Bipolar:

• Screening: MDQ
• Mania monitoring: YMRS

Psychosis:

• Primary: PANSS

OCD:

• Primary: Y-BOCS

Substance Use:

• Alcohol: AUDIT
• Drugs: DAST-10

Suicide Risk:

• Comprehensive: C-SSRS
• Brief: C-SSRS Screener

Children:

• Broad screening: PSC
• Anxiety: SCARED
• ADHD: Vanderbilt

By Treatment Phase

Initial Evaluation:

• PHQ-9 (depression)
• GAD-7 (anxiety)
• AUDIT (alcohol)
• DAST-10 (drugs)
• C-SSRS (suicide risk)
• Disorder-specific measures

Ongoing Treatment:

• PHQ-9 every 4-6 weeks
• GAD-7 every 4-6 weeks
• Disorder-specific measures every 4-8 weeks
• C-SSRS as needed

Medication Management:

• Symptom measures before each adjustment
• YMRS for mood stabilizers
• PANSS for antipsychotics
• PHQ-9/GAD-7 for antidepressants

Discharge Planning:

• All baseline measures repeated
• WHODAS 2.0 for functional improvement
• WEMWBS for wellbeing

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Implementing Auto-Scored Assessments in Your Practice

Step 1: Choose Your Core Battery

Minimum Essential Battery:

• PHQ-9 (depression)
• GAD-7 (anxiety)
• C-SSRS Screener (suicide risk)

Recommended Battery:

• PHQ-9
• GAD-7
• PCL-5 (if trauma population)
• AUDIT
• DAST-10
• C-SSRS
• Disorder-specific measures

Step 2: Integrate into Workflow

Intake Process:

1. Send assessments via patient portal before first session
2. Auto-score upon completion
3. Review results before session
4. Discuss results with patient

Ongoing Treatment:

1. Send assessments every 4-6 weeks
2. Auto-score and track trends
3. Review changes with patient
4. Adjust treatment based on results

ClinikEHR Automation:

• Assessments sent automatically based on schedule
• Instant auto-scoring
• Trend graphs show progress over time
• Alerts for concerning changes
• Insurance-ready documentation

Step 3: Train Your Team

Clinical Staff:

• How to interpret scores
• When to administer each assessment
• How to discuss results with patients
• When to escalate concerning scores

Administrative Staff:

• How to send assessments via portal
• How to track completion
• How to follow up on incomplete assessments

Step 4: Monitor Compliance

Track:

• Assessment completion rates
• Time to completion
• Score trends across your practice
• Insurance documentation compliance

Goal: 80%+ completion rate for scheduled assessments

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Common Mistakes to Avoid

Mistake 1: Too Many Assessments

Problem: Overwhelming patients with 10+ assessments Solution: Start with core battery (PHQ-9, GAD-7, C-SSRS)

Mistake 2: Not Discussing Results

Problem: Administer but never review with patient Solution: Always discuss scores and trends

Mistake 3: Inconsistent Administration

Problem: Only give assessments when you remember Solution: Automate with EHR scheduling

Mistake 4: Ignoring Concerning Scores

Problem: Miss deterioration or suicide risk Solution: Set up alerts for high-risk scores

Mistake 5: Manual Scoring

Problem: Waste time and make errors Solution: Use auto-scored assessments in EHR

Mistake 6: Not Tracking Trends

Problem: Can't see if treatment is working Solution: Use EHR trend graphs

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Insurance and Documentation Requirements

What Insurance Companies Require

Most Common Requirements:

• PHQ-9 for depression treatment
• GAD-7 for anxiety treatment
• Disorder-specific measures for specialty treatment
• Administered every 4-6 weeks
• Documented in treatment notes

Medicare Requirements:

• PHQ-9 for depression
• Documented at intake and periodically
• Used to demonstrate medical necessity

Medicaid Requirements:

• Vary by state
• Usually PHQ-9 and GAD-7 minimum
• May require additional measures

Documentation Best Practices

What to Document:

• Assessment name and date
• Score and interpretation
• Change from previous administration
• Clinical significance
• Treatment plan adjustments based on results

Sample Documentation:

PHQ-9 administered today: Score 14 (moderate depression), down from 18 four weeks ago. 
Patient reports improved mood and energy since starting sertraline 50mg. Plan: Continue 
current medication, reassess PHQ-9 in 4 weeks.

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Related Resources

ClinikEHR Features

• Auto-Scored Assessments
• Outcome Tracking
• Patient Portal
• EHR for Mental Health
• EHR for Therapist
• EHR for Psychiatrist

Related Guides

• Top 5 EHR for Mental Health 2026
• How to Start a PMHNP Private Practice
• 15-Minute New Patient Phone Screen Script

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Frequently Asked Questions

How often should I administer outcome measures? Every 4-6 weeks during active treatment is standard. More frequently (weekly) for high-risk patients or when making medication changes. Less frequently (every 3 months) for stable, maintenance patients.

Do I need to use all 20 assessments? No—start with a core battery (PHQ-9, GAD-7, C-SSRS) and add disorder-specific measures as needed. Most practices use 5-8 assessments regularly.

Can patients complete assessments at home? Yes—sending assessments via patient portal before sessions improves completion rates and saves session time. ClinikEHR's portal makes this seamless.

What if a patient scores high on suicide risk? Always follow up immediately with clinical assessment. High C-SSRS scores require same-day safety planning, possible hospitalization, or crisis services. Never ignore concerning scores.

Are these assessments free to use? Most are free for clinical use (PHQ-9, GAD-7, PCL-5, C-SSRS, AUDIT, DAST-10, etc.). Some require licensing (BDI-II, BAI). Check each assessment's terms before use.

How do I get patients to complete assessments? Explain the purpose ("helps us track if treatment is working"), make it easy (patient portal), keep it brief (core battery only), and always discuss results with them.

What if scores don't match clinical presentation? Scores are tools, not diagnoses. Always use clinical judgment. Discuss discrepancies with patients—they may minimize symptoms, have literacy issues, or misunderstand questions.

Do auto-scored assessments meet insurance requirements? Yes—as long as they're documented in the clinical record with interpretation and treatment planning. ClinikEHR's auto-scoring meets all insurance documentation requirements.

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Conclusion: Better Outcomes Through Better Measurement

Auto-scored mental health assessments are essential tools for modern evidence-based practice. They improve treatment outcomes, satisfy insurance requirements, and demonstrate your clinical effectiveness—all without adding administrative burden.

Key Takeaways:

• ✅ Start with core battery: PHQ-9, GAD-7, C-SSRS
• ✅ Add disorder-specific measures as needed
• ✅ Administer every 4-6 weeks during treatment
• ✅ Always discuss results with patients
• ✅ Use auto-scoring to save time and reduce errors
• ✅ Track trends to guide treatment decisions
• ✅ Set up alerts for concerning scores

Implementation Steps:

1. Choose your core assessment battery
2. Integrate into EHR with auto-scoring
3. Send via patient portal before sessions
4. Review trends and discuss with patients
5. Document scores and treatment adjustments
6. Monitor completion rates and outcomes

With ClinikEHR's auto-scored assessments, you'll spend less time on paperwork and more time providing excellent care—while demonstrating treatment effectiveness to insurance companies and improving patient outcomes.

Start Your Free 30-Day Trial — Get instant access to 20+ auto-scored assessments.

Questions about outcome measures? Contact our team — We help mental health professionals implement evidence-based assessment systems every day.

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Disclaimer: Assessment scores are clinical tools, not diagnostic instruments. Always use clinical judgment and consider the full clinical picture. This article provides general information for educational purposes. Consult assessment manuals and your professional licensing board for specific guidance.