Seidr Clinical Decision Support System

Dawn Sowell | Aug 14, 2022 | 6 min read

BHCS is very lucky to have Dawn share her work on our blog. Dawn is seeking her master's in counseling at Montana State University and helping BHCS out with beta-testing our Seidr software at MSU's Human Development Clinic


As a counseling intern at the Human Development Clinic, I am a participant in new assessment procedures recently adopted by the clinic. Seidr Software (BHTI, 2022) presents assessment tools to measure mental health disorders and traits and offers a detailed report of assessment results which can inform interventions and treatment plans. An overall triage score helps clinicians determine severity of symptoms and may necessitate additional assessment and intervention.

A current client, who has been struggling with life transitions, recently expressed consideration of beginning consumption of antidepressants; they had also described executive functioning deficits and symptoms of ADHD including being unable to concentrate on tasks, a tendency to make lists and then feel too overwhelmed to complete the tasks, and the need to stay busy all day (Silverstein et al., 2018). Assisting clients to make informed and educated decisions on appropriate medication for mental health disorders is an ethical obligation as counselors (ACA Code of Ethics, 2014), and I aimed to utilize Seidr to better inform medication administration and treatment planning. If client assessment results showed the presence of ADHD, depressive symptoms can be managed by appropriate ADHD medication (Sakai et el., 2021) and treatment planning can be appropriately developed.

The client's current diagnosis is F43.21 adjustment disorder with depressed mood based on fulfillment of criterion A through E in the DSM-5 (APA, 2013), and differential diagnosis includes major depressive disorder and normative stress reactions.

Process and Administration of Assessment

During a recent session, I explained the introduction of the assessment tools to clinic procedures and asked the client if they felt comfortable taking the assessments. Upon agreement, the client was emailed the assessments and a description of the assessment process; answers were submitted, and results were generated using Seidr.

Analysis of Assessment Data

Interpretation of client scores differ across assessment tools and inclusion of client history including wellness, developmental, environmental, family, trauma, and medication is imperative to properly diagnose clients (BHTI, 2022). The client reported no diagnosed ADHD in their family and disclosed the presence of maternal depression. The client's scores did not reveal reflect the presence of ADHD; ASRS-5 score was six, and a score of 11+ is necessary for the client to be cascaded into additional assessments (BHTI, 2022). Assessment for depression using the PHQ-9 also showed minimal evidence of disorder; the client's score of three does not place them within even the mild category (which is five to nine).

Gathering qualitative data from the client by asking questions about emotional experiences will be the next step for further exploration. After seeking supervision, I will present at session and inquire about client experience with depressive symptoms and lack of motivation in addition to client experiences with attention deficit symptoms. Additionally, I will ask the client when symptoms are usually present, how long they last for, and symptom intensity. Recording client's assessment scores and qualitative session content will be recorded in clinic DAP notes and can be compared over time to measure effectiveness of interventions and modify treatment planning.

Proposed Intervention and Treatment Plan

The client's triage score of three in addition to individual assessment scores as reported by Seidr did not indicate the need to immediately further assess the client for mental health disorders. A consistent intervention throughout the course of counseling will include re-evaluation; client re-evaluation will be conducted once per month using the checkup feature in Seidr to measure effectiveness of clinical interventions. In six months, another re-evaluation will be administered using the six-month follow up feature in Seidr to see if client's risk score changed, which can measure effectiveness of interventions and influence the modification of client's treatment plan if needed.

Discussion and collaboration between counselor/supervisor and counselor/client will further inform interventions and treatment planning. Counselor will encourage client to be mindful of emotional states, motivation levels, and attention deficits to monitor symptom presence.

A client goal includes finding a balance between life roles as parent, partner, professional, and self. Solution-focused brief therapy, an evidence-based therapy approach, may be an appropriate therapy modality to utilize with the client by engaging in solution-focused problem talk that aims to elicit, clarify, and acknowledge client problems (Choi, 2019). Re-evaluation monthly can help determine if this therapy approach is effective for the client.

Another client goal is to develop greater motivation to get things done without overworking or procrastinating. While client assessment results did not indicate the presence of ADHD, client masking may have been a factor when completing the assessments (BHTI, 2022) and re-evaluation monthly, particularly the ASRS-5, may assist with getting more accurate scoring results. Clinical interventions to assist with goal achievability between assessment re-evaluation will include value sorting and processing, modifying, and reframing existing beliefs, and supporting the client as they learn to gain trust in self.

Re-visiting treatment plan goals and objectives every 10 weeks will help measure effectiveness of interventions, and updated assessment scores will further inform clinical diagnosis and decision-making. The client's adjustment disorder diagnosis will remain in their client file and treatment plan until further assessment supports an alternate or additional diagnosis.


American Counseling Association. (2014). ACA Code of Ethics.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Link

Choi, J.J. (2019). A microanalytic case study of the utilization of “solution-focused problem talk” in solution-focused brief therapy. The American Journal of Family Therapy, 47(4), 244–260. Link

Sakai, C., Tsuji, T., Nakai, T., Namba, Y., Mishima, H., Fujiwara, M., & Matsunaga, H. (2021). Change in antidepressant use after initiation of ADHD medication in Japanese adults with comorbid depression: a real-world database analysis. Neuropsychiatric Disease and Treatment, 17, 3097–3108. Link

Silverstein, M.J., Faraone, S. V., Alperin, S., Leon, T. L., Biederman, J., Spencer, T. J., & Adler, L. A. (2019). Validation of the expanded versions of the adult ADHD self-report scale v1.1 symptom checklist and the adult ADHD investigator symptom rating scale. Journal of Attention Disorders, 23(10), 1101–1110. Link

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