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Axis V
Global Assessment of Functioning Scale.
Global Assessment of Functioning is for reporting the clinician's judgment of the
individual's overall level of functioning and carrying out activities of daily living. This
information is useful in planning treatment and measuring its impact, and in predicting outcome.
The Global Assessment of Functioning Scale is a 100-point scale that measures a
patients overall level of psychological, social, and occupational functioning on a hypothetical
continuum.
The GAF Report decision tree is designed to guide clinicians through a methodical and
comprehensive consideration of all aspects of a patients symptoms and functioning to determine a
patients GAF rating in less than 3 minutes.
The GAF Report addresses the growing need for accuracy and reliability in determining
and reporting on GAF ratings by ensuring all aspects of a patients functioning are considered. Use
the “current” or “past week” rating to indicate current management needs,
the “at discharge” rating to document progress and quality of care, and the “highest
level in past year” rating as a target for termination of treatment.
The GAF scale is particularly useful for managed care-driven diagnostic evaluations to
determine eligibility for treatment and disability benefits and to delineate the level of care
required for patients. On completion of the GAF Report questions, a 10-point range is automatically
determined. Then, using the sliding rating scale, you can quickly indicate the specific GAF rating
within this 10-point range, using clinical judgment and hypothetical comparison with other patients
in the range. Explanation screens provide clarification of specific questions throughout the
assessment. The report, which summarizes a patients results, can be produced immediately after an
assessment .Global Assessment of Functioning
Global Assessment of Functioning Scale.
Scale Consider psychological, social, and occupational functioning on a
hypothetical continuum of mental health-illness.
Do not include impairment in functioning due to physical or environmental limitations.
You do not need to know the numbers but rather what the GAF measures and is used for Code ( Note. Use intermediate codes when appropriate, e.g., 45, 68, 72.)
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91-100
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Superior functioning in a wide range of
activities, life's problems never seem to get out of hand, is sought out by others because
of his or her many positive qualities. No symptoms
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| 81-90 |
Absent or minimal symptoms ( e.g., mild anxiety before an exam ), good
functioning in all areas, interested and involved in a wide range of activities, socially
effective, generally satisfied with life, no more than everyday problems or concerns ( e.g.,
an occasional argument with family members )
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| 71-80 |
If symptoms are present, they are transient and expectable
reactions to psychosocial. stressors ( e.g., difficulty concentrating after family argument
); no more than slight impairment in social occupational, or school functioning ( e.g.,
temporarily falling behind in schoolwork ).
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| 61-70 |
Some mild symptoms ( e.g., depressed mood and mild insomnia ) OR some
difficulty in social occupational, or school functioning ( e.g., occasional truancy or theft
within the household ), but generally functioning pretty well, has some meaningful
interpersonal relationships.
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| 51-60 |
Moderate symptoms ( e.g., flat affect and circumstantial
speech, occasional panic attacks ) OR moderate difficulty in social, occupational, or school
functioning ( e.g., few friends, conflicts with peers or co-workers ).
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| 41-50 |
Severe symptoms ( e.g., suicidal ideation, severe obsessional rituals, frequent shoplifting
) OR any serious impairment in social, occupational or school functioning ( e,g., no
friends, unable to keep a job ).
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| 31-40 |
Some impairment in reality testing or communication ( e.g., speech is at
times illogical, obscure, or irrelevant ) OR major impairment in several areas, such as work
or school, family relations, judgment, thinking, or mood ( e.g., depressed man avoids
friends, neglects family, and is unable to work; child frequently beats up younger children,
is defiant at home, and is failing at school ).
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| 21-30 |
Behavior is considerably influenced by delusions or hallucinations OR serious
impairment in communication or judgment ( e.g., sometimes incoherent, acts grossly
inappropriately, suicidal preoccupation ) OR inability to function in almost all areas (
e.g., stays in bed all day, no job, home, or friends ).
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| 11-20 |
Some danger of hurting self or others ( e .g., suicidal
attempts without clear expectation of death; frequently violent; manic excitement ) OR
occasionally fails to maintain minimal personal hygiene ( e.g., smears feces ) OR gross
impairment in communication ( e.g., largely incoherent or mute ).
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| 1-10 |
Persistent danger of severely hurting self or others ( e.g., recurrent violence
) OR persistent inability to maintain minimal personal hygiene OR serious suicidal act with
clear expectation of death.0 Inadequate information.
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