Interpreting the Cosmetic Readiness Questionnaire

Dr Toni Pikoos discusses how to interpret the Cosmetic Readiness Questionnaire, a validated BDD screening tool.


Understanding and Interpreting the Cosmetic Readiness Questionnaire

The Cosmetic Readiness Questionnaire (CRQ) serves as a valuable tool for healthcare providers offering cosmetic treatments. This guide will help you to navigate the complexities of interpreting the CRQ report, thus enabling you to make informed decisions regarding patient treatments.

CRQ Overview

The CRQ report is divided into several sections, with the Assessment Summary being the most crucial. It indicates a patient’s risk level—low, moderate, or high—categorised into green, yellow, or red zones respectively. The risk level is determined by evaluating a patient’s likelihood of dissatisfaction with treatment and their propensity to experience adverse events post-treatment.

Green Zone

The green zone denotes a low risk level, indicating a patient’s readiness for treatment with minimal risk of dissatisfaction or adverse psychological impacts.  It is especially reassuring knowing that the CRQ’s openness scale detects how honest someone is being, meaning it is very difficult to “fake” being in the green zone.  The openness scale indicates how open and honest during their assessment. A green rating indicates a high likelihood of treatment satisfaction (providing the treatment doesn’t have any complication).

Yellow Zone 

The yellow zone represents a moderate risk level, indicating that a patient may have some dissatisfaction with the treatment and presents certain risk factors that could lead to a less optimal outcome. It is possible for a patient to score in the red zone on individual scales, such as body dysmorphia, but the overall scoring system is nuanced enough to distinguish between body dissatisfaction (common in cosmetic settings) and an actual risk of poor outcome. 

A yellow zone patient might require a more detailed consultation, possibly including education about realistic outcomes from the treatment to manage unrealistic expectations. If deemed necessary, a referral to a mental health professional may be considered for a yellow zone patient. The CRQ report provides consultation prompts for yellow or red zone scores on individual scales, offering recommendations for further discussions and precautions to prevent creating new insecurities.

Red Zone

A red zone score indicates high risk, with an increased likelihood of treatment dissatisfaction and possible adverse psychological impacts. The CRQ will provide specific recommendations for these patients, typically suggesting further assessments by an independent mental health practitioner before proceeding with any cosmetic treatments. 

Patients in the red zone often have red flags across several areas, such as high levels of body dysmorphia, psychological distress, self-criticism, and perfectionism. Therefore, their reports tend to be lengthier, providing in-depth guidance about potential risks. 


With experience, healthcare providers will familiarise themselves with the risk indicators and recommendations, thus improving their efficiency in assessing CRQ reports. Regardless of the zone a patient falls into, it is crucial to ensure that any concerns, questions, or need for additional support is appropriately addressed. The CRQ is not only a tool for assessing readiness for cosmetic treatment, but also an instrument to guide the dialogue about treatment expectations and outcomes with patients.


Video Credit: Dr Toni Pikoos, ReadyMind Co-Founder, Clinical Psychologist and Postdoctoral Researcher

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Cosmetic Readiness Questionnaire