A Qualitative Study of Clinicians Experience with Rating of the Global Assessment of Functioning (GAF) Scale

The severity of illness in psychiatry is rated using the Global Assessment of Functioning (GAF) scale. The GAF scale is often used in both research settings and in the clinic. The scale ranges from 1 to 100 and is subdivided into ten 10-point intervals, each with verbal rating instructions called anchor points and examples. GAF is an instrument that needs improvement. Studying clinicians' experiences with this rating system may be important for developing improvements. The aim of this study was to collect information from clinicians about their experiences with the GAF instrument, and to collect their ideas on how the GAF scale can be improved, particularly in the area of verbal instructions (i.e., anchor points and examples). Qualitative interviews were performed with 25 clinicians. Through this interview process, several weaknesses of the GAF scale were revealed. We found that clinicians have unique experiences that can be important for the development of a better GAF scale. Rating with the GAF scale also requires sufficient collection of patient information.