BEGINNING OF TREATMENT BEGINNING OF TREATMENT COUNTY OF LOS ANGELESDEPARTMENT OF MENTAL HEALTH Program Support BureauMHSA Implementation and Outcomes Division OPTIONAL PEI OUTCOMES WORKSHEET Trauma: Individual Cognitive Behavioral Therapy 2026

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  1. Click ‘Get Form’ to open it in our editor.
  2. Begin by entering the administrative information. Fill in the Client ID, First Name, Last Name, Therapist ID/Staff Code, and Provider ID in the designated fields.
  3. Next, input the date of the first Evidence-Based Practice (EBP) treatment session under 'BEGINNING OF TREATMENT INFORMATION'.
  4. Proceed to complete the Youth Outcome Questionnaire sections. For clients aged 4-17, select either Parent or Self-Report and enter the administration date.
  5. Fill out each item under Intrapersonal Distress, Somatic, Interpersonal Relations, Social Problems, Behavioral Dysfunction, and Critical Items. Ensure you calculate and enter the total score accurately.
  6. For clients aged 19+, complete the Outcome Questionnaire and UCLA PTSD-RI DSM-5 sections similarly. Record any 'Unable to Collect' reasons if applicable.

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