Praxical.Psych
General outcome

Outcome Questionnaire-45

Track global distress across symptom, interpersonal and social role domains, session by session, with empirically derived alarm signals for cases that are going badly.

OQ-45Described, items not reproduced

Psychometrics

The OQ-45 is the instrument that made feedback-informed treatment practical. Its three subscales are symptom distress, interpersonal relations and social role performance. Its distinctive contribution is not the score but the expected-treatment-response trajectory: actual progress is compared against the trajectory of similar patients, and cases falling below it are signalled to the clinician.

Cautions and misuse

The alert is only useful if something changes in response to it. Studies where clinicians received feedback but had no protocol for acting on it show much smaller effects.

Sources

  • Lambert, M. J., Whipple, J. L., & Kleinstäuber, M. (2018). Collecting and delivering progress feedback: A meta-analysis of routine outcome monitoring. Psychotherapy, 55(4), 520–537

    meta-analysis
Educational use only

Praxical.Psych is a teaching tool. It is not medical, clinical, psychological or legal advice, not a diagnosis, not treatment, not supervision, and not a credential. Nothing here creates a clinician–patient or solicitor–client relationship. Every patient, case, transcript and simulated session is fictional. Clinical and legal requirements vary by jurisdiction and change over time — verify anything that bears on a real decision against your own regulator, statute and current professional guidance, and consult a qualified professional.

Do not enter real patient information. If you or someone else is in crisis: US & Canada 988 · UK & Ireland 116 123 · Australia 13 11 14 · elsewhere findahelpline.com · immediate danger, your local emergency number.

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Praxical.Psych · © 2026 Moonlit Social Labs. All rights reserved.

Before you begin

What Praxical.Psych is, and is not

Praxical.Psych is an educational tool. It teaches the theory, evidence base and clinical method of psychotherapy at the level of an advanced survey course, and it lets you rehearse a complete session in a simulator.

It is not medical, clinical, psychological or legal advice. It cannot diagnose or treat anyone, and it does not state the law where you practise — requirements differ by jurisdiction and change. Nothing here creates a clinician–patient or solicitor–client relationship.

  • Every patient, transcript and case in this app is fictional — a composite written for teaching. None depicts a real person.
  • Praxical.Psych is not therapy, not a substitute for supervision, and not a credential. Competence to practise comes from training, supervised hours and licensure.
  • Scores from the instruments here are for learning how they behave. They are not a diagnosis and not a risk assessment, and must not inform a decision about a real person.
  • Do not enter real patient information. Everything you type stays in this browser, but that is not the same as a compliant clinical record system.
If you are in crisis

In the US and Canada, call or text 988. In the UK and Ireland, call 116 123 (Samaritans). Elsewhere, find a local line at findahelpline.com. In immediate danger, use your local emergency number.

Read the full disclaimer