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Template library · Assessments & screeners

PTSD Structured Interview Guide template

Guide for a structured clinical interview assessing PTSD symptom clusters.

Clinician-administered structured interview outline

  • 17 fields across 4 sections
  • Included with MyWellOps
  • Edit it, or save your own version

What’s in it

Assessment Details

  • Client NameText
  • Date of BirthDate
  • Client ID / MRNText
  • Date of AssessmentDate
  • Clinician / CoachText
  • Location / ModalityText

Symptom Clusters

  • Intrusion symptoms (memories, dreams, flashbacks)Text
  • Avoidance symptomsText
  • Negative alterations in cognition and moodText
  • Alterations in arousal and reactivityText
  • Duration and onset of symptoms relative to the traumaText

Risk Flags

  • Dissociative symptoms presentTick box
  • Comorbid substance useTick box
  • Suicidal ideation presentTick box
  • Significant functional impairmentTick box

Signatures

  • Clinician SignatureSignature
  • Date signed (clinician)Date

When to use it

Use an assessment at the start of work to set a baseline, then repeat it at review points so you and the client can see what has changed.

How it works in MyWellOps

  1. Pick it from Documents.
  2. Send it to the client to complete, or fill it in together during a session.
  3. Each completed copy is kept on the client’s record, so earlier results are there to compare.

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