Background: Triage involves matching resources to the patient - based on limited information - as quickly as possible. Principles from triage can be applied to the assessment and management of patients with psychological distress. Objective: This article describes four steps in triage - once significant distress is identified: assessing the severity, looking for indicators that point to a diagnosis, formulating a working diagnosis, and treating the distress. Discussion: When the presenting symptoms are nonspecific, or the nature of the distress remains unclear, an approach to gathering more information over three visits is described. After this further assessment is completed, options to tailor treatment to the patient are suggested.