TRACE

Identify what could go wrong before treatment begins.

28 clinician-rated items · ~5 minutes · at intake

You rate what you see. TRACE organizes it across four clinical domains and flags what might not work for this client.

Initial Validation

956

test scenarios

100%

safety sensitivity

20/20

clinic simulation

How it works

You answer 28 questions about your client — sleep, stress, emotional reactivity, thinking patterns, decision-making, and more. TRACE checks these observations against clinical rules and tells you which treatment approaches might not be safe for this person right now.

Every result traces directly back to what you entered. No guessing. No AI. The same answers always produce the same analysis. Built on the work of Herman, van der Kolk, Siegel, Young, Beck, Linehan, and Kernberg.

Clinical scope

Designed for: General adult outpatient — mood, anxiety, complex trauma, burnout, behavioral activation deficits, schema-level patterns.

Outside current scope: OCD, eating disorders, active psychosis, substance use disorders.

Join the clinical pilot

Use TRACE on real intakes. Provide structured feedback. Contribute to the first published validation.

For licensed behavioral health professionals. Does not replace your clinical judgment.

Clinical Decision Support Tool — For licensed behavioral health professionals only. This tool provides structured observations based on your clinical input. It does not replace your independent clinical judgment.

Safety

Safety Screening

Does this client need immediate referral before proceeding? Answer based on what you observe now.

Active mania or hypomania Elevated/expansive mood, reduced sleep need, racing thoughts, impulsivity, or grandiosity currently present?

Mania / hypomania flagged — standard assessment not appropriate.

Active psychosis Hallucinations, delusions, disorganized thinking, or reality-testing impairment currently present?

Active psychosis flagged — reality testing impaired.

Suicidal ideation or active safety risk Active suicidal thoughts, recent self-harm act, or current safety concerns?

Active safety risk flagged — immediate safety assessment required.

Destabilizing substance use Daily use, withdrawal risk, or intoxication that is disrupting functioning?

Destabilizing substance use flagged — stabilization required first.

Acute neurological condition Head injury, seizure, suspected dementia, or active medical crisis affecting cognition?

Neurological condition flagged — medical evaluation required.

⚠ One or more safety flags are active. Immediate referral is needed before starting standard therapy. TRACE will generate a referral report for your documentation.

Physical Functioning

How is the body doing? Rate each area based on what you know about this client right now.

Sleep quality & quantity

How well is the client sleeping — onset, duration, and restorative quality?

Nutrition & appetite

Is the client eating adequately — regularity, appetite, and nutritional quality?

Physical safety & environment

Is the client's physical environment safe — housing, relationships, personal security?

Current stress & accumulated life burden

What is the client's overall stress burden — accumulation of demands, chronic stressors, and life load across all domains?

Physical health & chronic pain

Is the client affected by physical illness, pain, or medical conditions impacting daily functioning?

Is this physical burden ongoing or temporary?

Is the physical/medical load something chronic, or a temporary situation that may resolve?

Emotional

Emotional Regulation

How does this client handle emotions? It's common for clients to show both numbness and flooding — rate each one independently. The combination matters.

Emotional reactivity to triggers

How intensely and quickly does the client respond emotionally to triggering situations?

Emotional numbness or disconnection

Does the client report feeling emotionally flat, numb, or disconnected from their feelings?

Emotional flooding — overwhelmed by intensity

Does the client experience emotional intensity that overwhelms their capacity to function?

Are emotional responses proportionate?

Do the client's emotional reactions match the scale and nature of the triggering event?

What's driving the emotional difficulties?

Choose the option that best describes the main source. If multiple apply, pick the most significant one.

Thinking & Beliefs

Cognitive Patterns

How rigid or flexible is this client's thinking? How do they hold their beliefs and view other people?

Cognitive flexibility — ability to update beliefs

Can the client consider alternative perspectives and update their thinking when presented with new information?

Use of intellectualization to avoid change

Does the client use analysis, reasoning, or insight as a way to avoid actual behavioral or emotional change?

Identity threat when beliefs are challenged

When the client's beliefs are challenged, does it feel like an attack on their identity or sense of self?

Entrenchment of core belief patterns

How deeply entrenched are the client's core beliefs — do they function as immovable facts about reality?

Relational splitting — all-or-nothing view of others

Does the client describe people in polarized terms — entirely good or entirely bad — with little capacity for holding a mixed or nuanced view of the same person?

Relational instability — idealization/devaluation cycles

Do the client's views of important people shift dramatically — from idealized ("they're amazing") to devalued ("they're terrible") — in short timeframes?

Planning & Follow-Through

Executive Function & Agency

Can this client make decisions and act on them? Do they have the energy and freedom to follow through? If you're unsure about any item, choose the least severe option — it's safer to underestimate than overestimate.

Does this client have ADHD or Autism?

A formal diagnosis isn't required — use your best clinical judgment. This changes how TRACE interprets executive function patterns, since ADHD and Autism present differently from psychological or stress-related dysfunction.

Ability to make and follow through on decisions

Can the client initiate decisions and carry them through to completion without excessive difficulty?

Gap between insight and behavioral change

The client understands what they need to do — but how well does understanding translate into actual change?

Mental fatigue or executive exhaustion

How fatigued is the client's mental and executive capacity — depletion of planning, focus, and cognitive effort?

History of autonomy suppression

Has the client historically been denied, punished, or discouraged from exercising independent choice and agency?

Intentionality of daily functioning

To what degree does the client move through their day with conscious intention vs. automatic, habitual patterns?

Does making independent decisions feel safe?

When the client contemplates making their own choices, what is their felt sense of psychological safety?

Origin & Pathway

How Did This Develop?

These questions help determine whether this client's difficulties come from being worn down (they used to cope better), never developed (they never had this capacity), or blocked (the capacity exists but something makes it unsafe to use). This changes the treatment approach.

Go with your best clinical sense. You can always reassess as you learn more.

When this person was functioning well, it was because...

What best characterizes the relationship between this client's history and their current capacity?

How this began...

What best describes the onset pattern of the client's current difficulties?

What does recovery look like for this person?

Based on available history, what pattern best predicts how recovery would occur?

TRACE

TRACE — Structured Clinical Decision Support

Behavioral Health — Clinical Pilot v4.5 — Not for official clinical records

For qualified clinical use only

© 2026 Treatment Routing And Contraindication Engine. All Rights Reserved. Proprietary and Confidential.
This report is generated by an algorithmic clinical decision support tool for documentation support purposes. It does not constitute a psychiatric or psychological diagnosis, treatment prescription, or substitute for independent clinical judgment. All routing suggestions, contraindication flags, and treatment sequencing recommendations must be reviewed, verified, and approved by the assessing clinician before being incorporated into any treatment plan or clinical record. The clinician retains full responsibility for all clinical decisions. For use by qualified, licensed behavioral health professionals only.

Clinical Frameworks Informing This Tool:
Fear circuit & limbic system models (LeDoux) · Chronic stress & allostatic load theory (McEwen) · Window of tolerance framework (Siegel) · Maladaptive schema theory (Young) · ACT cognitive fusion model (Hayes) · Object relations & personality organization (Kernberg) · Transference-Focused Psychotherapy — TFP (Kernberg, Clarkin, Yeomans) · Mentalization-Based Treatment — MBT (Bateman & Fonagy) · DBT (Linehan) · Trauma-informed care (Herman, Courtois) · Somatic approaches