I'd like a specific set of selected cells to return a specific cell - all text or x

can you mock up a workbook with the various options AND your expected answers - follow the instructions at the top of the post in the yellow banner.

I'll admit I don't understand your workbook. Please note, I asked for a representative sample AND expected outcomes.
looking at sheet1 you have a list of stressors and levels of Hi and Low (col C) and col D more levels of if Hi or Low referral to community support or counseling or trauma counselling etc.
as an aside and it is your data but as an RN I cannot imagine why if you have low life stressors you'd need community support or counseling?
But, can you provide actual examples (made up of course) and your expected results - you can hand type them in. For example, does someone answer a question like on a scale of 5 (Hi) to 1 (Low) about their life stressors and depending on the number it should trigger an outcome of community referral?

Since you are open to different options, I'm uploading my interpretation. I would use helper columns. I'm assuming that one patient will be done at a time and assigning a score to the options of Life Stressors, Trauma, SUDS and Mental health. Then a lookup column with the optional outcomes possible and a formula looking up the sum for each patient and their outcomes. There is one outcome for each patient, I put in pt A as the example (all in the results tab). If you change the levels in C2 through C5 you'll see different results populate in for each option.

EDIT: my assumption is that you only need one outcome per patient. You can do multiple patients in the same worksheet, you just need to adjust the sumif ranges but you can keep the same lookup table.

You're very welcome, AND thank you for the rep!

You might also want to note that I used odd sets of numbers in column A and the lookups in column J. This is because if I used simple numbers like 1,2,3 and 4 combinations of them would end up causing errors for the lookups, for example 1 plus 2 would be equal to 3 so the lookup would go to the first 3 value in column J SUD counseling and ignore the community referral for life stressors and trauma. That is why you'll see that the numbers are oddly sporadic, so none of them when added together will equal any of the others either individually or when added.

I tested every combo I thought of but missed that one. So in D2 change the vlookup to this...
=VLOOKUP(SUMIF($C$2:$C$5,"Hi",$A$2:$A$5),$J$2:$K$17,2,FALSE)
in J16 add this =a3+a5 and in J17 add this =a2+a3+a5
in K16 add this Mental Health and Trauma Counseling
and in K17 add this Community Referral and Trauma and Mental Health Counseling
the new range for the vlookup will cover those additional rows in J and K. You should be fine with that.
if it occurs again, just add another to the list, like I wrote, I thought (hoped) I accounted for each combination.

I appreciate the thought but knowing I got you a working formula that helped save you time is plenty of thanks. Wish I had got it complete the first time. I should've realized that with four options there would be 16 possible outcomes (four squared).