CORE-OM

What is the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM)?

The Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM), developed as part of the CORE System Trust, is a widely used core outcome measure in mental health settings to assess the effectiveness of therapeutic interventions. Developed in the UK by a group of psychotherapists and researchers, it was designed to provide a standardised brief outcome measure for evaluating changes in the outcome measures of a patient's psychological well-being throughout treatment.

The CORE-OM consists of 34 self-report items that measure a broad range of psychological difficulties, including subjective well-being, problems or symptoms, life functioning, and risk (both to self and to others). These items are rated on a 5-point Likert scale, ranging from "not at all" to "most or all of the time," allowing patients to express the frequency and intensity of their experiences. The items are divided into four domains: well-being (4 items), problems/symptoms (12 items), functioning (12 items), and risk (6 items).

One of the key strengths of the CORE-OM is its comprehensive nature, capturing both positive and negative aspects of mental health. This allows therapists to better view a patient's progress rather than focusing solely on symptom reduction. Additionally, the measure is designed to be sensitive to changes in clinical outcomes, making it suitable for tracking progress over time.

The CORE-OM has been validated in clinical populations from various settings, showing good psychometric properties that are essential to consider in counselling and psychotherapy research and practice. In clinical settings, the CORE-OM results are integrated into core information management systems to ensure consistent monitoring of patient outcomes.

It is often used at the beginning and end of therapy to assess the effectiveness of the treatment and guide clinical decision-making. Sometimes, it may also be used periodically throughout therapy to monitor progress and adjust interventions as needed.

How to use our CORE-OM template

Step 1: Download the template

First, download the CORE-OM template, which includes all the necessary fields for patient information, instructions, and assessment.

Step 2: Fill out patient information

Have the patient fill in their personal details at the top of the form, including their name, age, date of assessment, and the examiner's name.

Step 3: Administer the CORE-OM

Guide the patient through the 34 statements in the CORE-OM section. Ask them to reflect on their feelings over the past week and select the response that best matches their experience. Each statement is rated on a scale from 0 (not at all) to 4 (most or all the time).

Step 4: Scoring and interpretation

After the patient completes the form, calculate the total score by adding up the responses for all 34 items, with the maximum score being 136. To find the average response, divide the total score by 34, giving you a score between 0 and 4. Higher scores generally indicate more significant distress or dysfunction. Use the subscale categories provided (subjective well-being, problems/symptoms, life functioning, and risk/harm) to interpret the results more specifically. You can also compare the patient's scores to normative percentiles to see how they compare to others seeking psychological help.

Step 5: Monitor and graph progress

If the CORE-OM is used multiple times, track the patient's progress by graphing their total clinical percentile and subscale percentiles over time. These visual aids can help you and the patient see areas of improvement or where more focus might be needed in therapy.

Scoring and interpretation

Each item on the CORE-OM is rated on a 5-point Likert scale, from "Not at all" (0) to "Most or all of the time" (4). The total score is derived by summing these responses, with higher scores indicating greater psychological distress. In addition to an overall score, the CORE-OM provides detailed subscale scores across four key domains, allowing for a nuanced understanding of an individual's or a clinical population's mental health, often verified through confirmatory factor analysis to ensure accuracy.

When interpreting these scores, especially within the context of implementing core outcome batteries like the CORE-OM, it’s essential to consider the specific characteristics of the clinical population to ensure the insights are both accurate and meaningful.

Next steps after using the CORE-OM

After administering the CORE-OM and obtaining the results, the next steps typically involve several key actions to ensure the information is effectively used in the therapeutic process.

Discuss findings

After interpreting the results, discussing them with the patient is essential. This conversation should focus on explaining the scores, their meaning, and how they relate to clinical psychology and the patient's experiences.

Integrate findings into the treatment plan

Use the CORE-OM results to inform and adjust the treatment plan. If the scores indicate significant distress in certain areas, these should become focal points in therapy. Conversely, if the scores show improvement or areas of strength, these can be reinforced and built upon through psychological therapies. The results can guide the choice of therapeutic interventions, ensuring they are tailored to the patient’s needs.

Monitor progress over time

As therapy progresses, the CORE-OM can be readministered periodically to track changes in the patient's mental health. Comparing scores over time allows both the therapist and the patient to see the impact of the interventions and make necessary adjustments. Regular monitoring helps identify positive or negative trends and ensures that the therapy remains effective.

Use results for reflective practice

Finally, the results from the CORE-OM can be used for reflective practice. Therapists can review the outcomes to evaluate the effectiveness of their interventions and consider what might need to be done differently in future sessions. This reflection can contribute to professional development and improve overall therapeutic effectiveness.