Clinical Outcomes in Routine Evaluation (CORE-OM)

Description
The CORE Outcome Measure (CORE-OM) was conceived as a self-report measure of psychological distress designed to be administered before and after therapy. The client is asked to respond to 34 questions about how they have been feeling over the last week, using a 5-point scale ranging from ‘not at all’ to ‘most or all of the time’. The 34 items of the measure cover four dimensions:

– Subjective well-being
– Problems/symptoms
– Life functioning
– Risk/harm

The questionnaire is repeated after the last session of treatment; comparison of the pre-and post-therapy scores offers a measure of ‘outcome’ (i.e. whether or not the client’s level of distress has changed, and by how much).

Validity
Since its development the CORE-OM has been validated with samples from the general population, NHS primary and secondary care, and in older adults.

Clinical normative data came from 21 sites from England, predominately within the NHS. The clinical population comprising users waiting for or receiving a wide variety of psychological interventions in a wide variety of settings (total n = 890). This normative data is reported in the CORE SYSTEM USER MANUAL and is used to compute percentile ranks.

Interpretation
Higher total raw scores total (range 0-136) represent poorer overall functioning and scores are also presented as a the mean score (from 0 – 4) which represents the clients average answer. In addition, scores are presented as a percentile compared to a clinical normative sample, where a percentile of 50 represents the average psychological distress of someone seeking psychological intervention.

There are 4 subscales:
– Subjective well-being (items 4, 14, 17, 31)
– Problems/symptoms (items 2, 5, 8, 11, 13, 15, 18, 20, 23, 27, 28, 30)
– Life functioning (1, 3, 7, 12, 10, 19, 21, 25, 26, 29, 32, 33)
– Risk/harm (9, 6, 16, 22, 24, 34)

Developer
Evans C, Connell J, Barkham M, Margison F, McGrath G, Mellor-Clark J, Audin K. Towards a standardised brief outcome measure: psychometric properties and utility of the CORE-OM. Br J Psychiatry. 2002 Jan;180:51-60.

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