Skip to main content
Headway

Compliance and documentation

How to use the PCL-5 to assess PTSD

Learn more about the PCL-5 assessment and how you can incorporate it into your practice.

October 11, 2024 • Updated on August 29, 2025

8 min read

If you work with clients who have experienced significant trauma, you may be considering a diagnosis of post-traumatic stress disorder (PTSD). The DSM-5 is your best resource for considering this diagnosis, but screening tools like the PCL-5 can help you understand more about a client’s experience — and guide you in your diagnosis process. 

Below, learn more about the PCL-5 assessment and how you can incorporate it into your practice.

What is PCL-5?

The PCL-5 is a measurement that assesses the 20 DSM-5 symptoms of PTSD. It’s used to screen clients for PTSD, make provisional PTSD diagnosis, and monitor symptoms during treatment for the condition.

It’s a self-administered assessment, which means the client fills it out on their own, marking the symptoms they’re experienced in the last month and how frequently they’ve experienced them. Then, a medical provider scores the assessment based on the client’s answers. 

The PCL-5 is a helpful supplement to use as part of a structured clinical assessment or interview, but it’s not a formal diagnostic tool on its own. As with any assessment, the PCL-5 can come with a self-reporting bias. You may consider using the results as a guide for what to assess when you meet with your client. 

Previously, the PCL-5 for DSM-IV had three versions: PCL-M (military), PCL-C (civilian), and PCL-S (specific). Now, there’s only one version of the PTSD checklist in the updated DSM-5.

PCL-5 assessment

The PCL-5 assessment includes the following questions and prompts clients to mark “not at all,” “a little bit,” “moderately,” “quite a bit,” or “extremely.”

In the past month, how much were you bothered by: 

  1. Repeated, disturbing, and unwanted memories of the stressful experience?
  2. Repeated, disturbing dreams of the stressful experience?
  3. Suddenly feeling or acting as if the stressful experience were actually happening again (as if you were actually back there reliving it)?
  4. Feeling very upset when something reminded you of the stressful experience?
  5. Having strong physical reactions when something reminded you of the stressful experience (for example, heart pounding, trouble breathing, sweating)?
  6. Avoiding memories, thoughts, or feelings related to the stressful experience?
  7. Avoiding external reminders of the stressful experience (for example, people, places, conversations, activities, objects, or situations)?
  8. Trouble remembering important parts of the stressful experience?
  9. Having strong negative beliefs about yourself, other people, or the world (for example, having thoughts such as: I am bad, there is something seriously wrong with me, no one can be trusted, the world is completely dangerous)?
  10. Blaming yourself or someone else for the stressful experience or what happened after it?
  11. Having strong negative feelings such as fear, horror, anger, guilt, or shame?
  12. Loss of interest in activities that you used to enjoy?
  13. Feeling distant or cut off from other people?
  14. Trouble experiencing positive feelings (for example, being unable to feel happiness or have loving feelings for people close to you)?
  15. Irritable behavior, angry outbursts, or acting aggressively?
  16. Taking too many risks or doing things that could cause you harm?
  17. Being “superalert” or watchful or on guard?
  18. Feeling jumpy or easily startled?
  19. Having difficulty concentrating?
  20. Trouble falling or staying asleep?

Practice in-network with confidence

Simplify insurance and save time on your entire workflow — from compliance and billing to credentialing and admin.

Talk to a practice consultant

PCL-5 scoring

Each measure on the assessment is measured on a four-point scale and assigned a certain number of points.

Extremely: 4 points

Quite a bit: 3 points

Moderately: 2 points

A little bit: 1 point

Not at all: 0 points

​​When each answer is assigned a point value, the total score for the PCL-5 assessment can range from 0–80. Some research suggests a PCL-5 score of 31-33 indicates probable PTSD, but keep in mind the results only suggest a provisional diagnosis.

Monitoring changes in PCL-5

While it’s often used as a tool for screening and diagnosing PTSD in new clients, the PCL-5 is also useful in re-assessing clients so you can adjust their treatment plan as needed. For example, if you diagnosed a client with post-traumatic stress disorder six months ago, you can re-issue the PCL-5 to determine the current severity of that person’s symptoms and adjust your treatment plan as needed. Assessing which questions scored higher can also inform the focus of your treatment plan and interventions provided, such as addressing nightmares specifically versus, say, beliefs of self-blame.

Get support with Headway’s flexible tools

How can you keep track of all these assessments? Headway streamlines progress notes with AI-powered tools and templates designed for compliance. Our platform helps you stay organized and focused, so you can deliver informed care with less administrative stress and more time for meaningful client work.

Talk to a practice consultant

This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.

© 2026 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.

Compliance and documentation

How to write progress notes

Progress notes are the core piece of documentation a provider should write after each client session, but it’s more than just a record of what happened.