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Article
Publication date: 8 February 2013

Tina Perry, Michael Barkham and Chris Evans

The purpose of this paper is to establish staff and patient opinions on the acceptability, feasibility, and utility of using the Clinical Outcomes in Routine Evaluations …

Abstract

Purpose

The purpose of this paper is to establish staff and patient opinions on the acceptability, feasibility, and utility of using the Clinical Outcomes in Routine Evaluations – Outcome Measure (CORE‐OM) in secure hospitals.

Design/methodology/approach

Patients and nurses (male patients and their key workers) from high, medium and low secure hospitals participated in semi‐structured interviews after completing CORE‐OM or CORE‐OM (SV).

Findings

Template themes were acceptability, feasibility, relevance, suitability, changes to treatment, and understanding. Findings suggest that the CORE‐OM is acceptable and potentially useful in secure settings.

Practical implications

This paper suggests that the CORE‐OM is acceptable to patients and staff in secure settings and appears to be a feasible measure for such settings. Further research and accumulation of a referential database of item scores is needed for PROMS, including the CORE‐OM, to be fully useful in secure settings.

Originality/value

This paper will be of use to clinicians working with forensic mental health settings. It is one of only two papers which investigate the use of the CORE‐OM in forensic settings.

Details

The Journal of Forensic Practice, vol. 15 no. 1
Type: Research Article
ISSN: 2050-8794

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Article
Publication date: 23 September 2019

Henry Briscoe, Sarah Ashworth and Lyn Shelton

Individuals with an intellectual disability (ID) develop mental health difficulties at similar rates to individuals in the general population. Using Patient Reported…

Abstract

Purpose

Individuals with an intellectual disability (ID) develop mental health difficulties at similar rates to individuals in the general population. Using Patient Reported Outcome Measures can help track deterioration and improve the outcomes of individuals seeking help for their difficulties. The Clinical Outcome in Routine Evaluation-Learning Disabilities (CORE-LD) is a multi-trait measure of psychological distress which has shown moderate test-rest reliability. However, the CORE-LD is yet to be validated for the population it was designed for. Therefore the purpose of this paper is to establish the concurrent validity of the CORE-LD in a population of individuals with a diagnosis of mild–moderate ID.

Design/methodology/approach

Participants with a diagnosis of mild–moderate ID, as well as other co-morbidities, were recruited from two UK inpatient hospitals and asked to complete the CORE-LD and its general population counterpart the Clinical Outcome in Routine Evaluation-Outcome Measure (CORE-OM).

Findings

Statistically significant differences were found regarding the CORE-LD across gender, with females scoring higher on the CORE-LD than males. There was no significant difference between security levels. The overall mean scores on each measure were moderately correlated. The data from this analysis suggest a significant positive correlation (rs=0.68).

Originality/value

This initial study’s findings have demonstrated the CORE-LD may have concurrent validity, and further replication studies in larger and more diverse samples are needed.

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Article
Publication date: 23 September 2013

William Peter Andrews, Andrew Peter Wislocki, Fay Short, Daryl Chow and Takuya Minami

To replicate the Luton pilot study (Andrews et al., 2011), both by investigating treatment changes using the Human Givens (HG) approach via a practice research network…

Abstract

Purpose

To replicate the Luton pilot study (Andrews et al., 2011), both by investigating treatment changes using the Human Givens (HG) approach via a practice research network (PRN) and by assessing the viability of replacing the 34-item Clinical Outcome in Routine Evaluation Outcome Measure (CORE-OM) with the ten-item version (CORE-10).

Design/methodology/approach

Clients were included if they were offered the HG approach to manage psychological distress and attended at least one measured treatment session following their initial assessment. Pre-post treatment effect size (Cohen's d) was benchmarked against data from Clark et al. (2009). Potential differences in treatment effects based on type of termination (planned vs unplanned) and medication use were examined.

Findings

High correlation between the CORE-10 and CORE-OM and near-identical calculated effect sizes support the utilisation of CORE-10 as a routine outcome measure. Pre-post treatment effect size suggests that clients treated using the HG approach experienced relief from psychological distress.

Research limitations/implications

There was no experimental control nor evidence about the precise components of the HG treatment. Data on problem description and duration may not be reliable.

Practical implications

This larger study, involving thousands of cases in a wide variety of settings, reinforces the findings from the pilot study as to the plausibility of the HG approach in the relief of emotional distress.

Originality/value

The viability of using a ten-item scale to reliably measure treatment effectiveness will allow organisations to assess the quality of their treatment with minimal disruption to their service delivery allowing for true evidence-based practice. A PRN provides a suitable mechanism to assess psychotherapy treatment effectiveness in real-world settings.

Details

Mental Health Review Journal, vol. 18 no. 3
Type: Research Article
ISSN: 1361-9322

Keywords

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Article
Publication date: 2 September 2014

Patrick McHugh, Michael Gordon and Michael Byrne

– The purpose of this paper is to evaluate the clinical effectiveness of a brief CBT intervention within a primary care adult mental health service.

Abstract

Purpose

The purpose of this paper is to evaluate the clinical effectiveness of a brief CBT intervention within a primary care adult mental health service.

Design/methodology/approach

In total, 92 participants with mild to moderate mental health difficulties were provided with five sessions of brief CBT. Clinical improvement was measured using the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) at pre-treatment, mid-treatment and post-treatment, and on the Beck Depression Inventory-II (BDI-II) at pre-treatment and post-treatment.

Findings

The planned five sessions of CBT were completed by 48.9 percent (n=45) of participants. Treatment completers with full clinical data (n=31) showed large statistically significant improvements on the CORE-OM and BDI-II from pre-therapy to post-therapy. Of treatment completers and non-completers with post-therapy and mid-therapy CORE-OM data, respectively (n=34), 61.8 percent showed reliable and clinically significant change. No statistically significant differences were found between treatment completers (n=45) and non-completers (n=47) in their pre-therapy clinical scores or socio-demographic characteristics.

Practical implications

Brief CBT can be a clinically effective primary care intervention but needs to be implemented in a way that ensures high treatment engagement across a range of service users.

Originality/value

This paper contributes to the evidence base of a primary care psychological intervention and demonstrates the importance of assessing treatment completion when evaluating clinical effectiveness.

Details

Mental Health Review Journal, vol. 19 no. 3
Type: Research Article
ISSN: 1361-9322

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Article
Publication date: 23 May 2011

Stephen Clift and Ian Morrison

This paper aims to describe the development and evaluation of an innovative community singing initiative with mental health services users and supporters in East Kent, UK.

Abstract

Purpose

This paper aims to describe the development and evaluation of an innovative community singing initiative with mental health services users and supporters in East Kent, UK.

Design/methodology/approach

A network of seven singing groups was established between September 2009 and June 2010. The choirs met weekly in three terms with breaks for Christmas and Easter, and joined together for two public performances in February and June 2010. In total, 137 participants were involved in the evaluation processes over this period. Of these, 42 provided complete data on the CORE questionnaire, a widely used clinical measure of mental distress, at baseline and eight months later.

Findings

Clinically significant improvements were observed in response to the CORE. These changes, together with qualitative feedback from participants, demonstrate that group singing can have substantial benefits in aiding the recovery of people with a history of serious and enduring mental health problems. A limited body of research has also shown that singing can be helpful for people with existing mental and physical health problems.

Originality/value

The research finds marked improvements in mental wellbeing on a clinically validated measure for people with a range of enduring mental health issues participating in a network of small choirs. Qualitative evidence indicates that group singing can offer a wide range of emotional and social benefits for mental health service users.

Details

Mental Health and Social Inclusion, vol. 15 no. 2
Type: Research Article
ISSN: 2042-8308

Keywords

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Article
Publication date: 22 June 2012

Anna Tsaroucha, Paul Kingston, Nadia Corp, Tony Stewart and Ian Walton

To broaden the range of well-being outcomes that can be measured for patients with depressed mood and/or other mental health issues the aim is to determine the reliability…

Abstract

Purpose

To broaden the range of well-being outcomes that can be measured for patients with depressed mood and/or other mental health issues the aim is to determine the reliability and validity of a self-reported instrument that was designed by the Human Givens Institute to evaluate emotional distress (emotional needs audit – ENA).

Design/methodology/approach

The ENA was administered to 176 patients, aged between 18-65 years (mean age: 39.2 years). The acceptability of the ENA was examined as well as its internal consistency (Cronbach ' s alphas). ENA was administered at four time points and test-retest reliability was conducted between times 1 and 2. The data from three scales also administered to these patients (SWLS, CORE-OM and HADS) were used to aid the conduct of the ENA construct validity (concurrent and discriminant). Analysis of the ENA sensitivity/specificity was also performed.

Findings

All the ENA items (except one) were shown to have good acceptability. The internal consistency was also very strong (Cronbach ' s alpha: 0.84); the construct validity also revealed positive results for the ENA: concurrent validity (r=0.51-0.62; p < 0.001); discriminant validity (r=0.22-0.28; p < 0.01). Test-retest reliability was r=0.46 (p < 0.001). Finally, ENA demonstrated high sensitivity (80 per cent), and moderate specificity (35 per cent).

Originality/value

ENA was shown to be a valid and reliable instrument for measuring wellbeing, quality of life and emotional distress. It also allows insight into the causes of symptoms, dissatisfaction and distress. It is suggested that this tool has complementarity to standardised tools when used in clinical practice.

Details

Mental Health Review Journal, vol. 17 no. 2
Type: Research Article
ISSN: 1361-9322

Keywords

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Article
Publication date: 28 April 2010

Gary Byrne, Sean Hammond and Philip Moore

With the increased need for quantitative measures of accountability and effectiveness in the therapeutic setting, standardised outcome measures have come to the fore. This…

Abstract

With the increased need for quantitative measures of accountability and effectiveness in the therapeutic setting, standardised outcome measures have come to the fore. This study aimed to assess the psychometric quality of the Clinical Outcomes in Routine Evaluation (CORE‐OM) used with an Irish population of adult victims of childhood abuse. The study indicated that the outcome measure was a useful tool in a forensic therapeutic setting, despite issues regarding the CORE's factor structure. The study also found that the service assessed matched the benchmarks laid down by the CORE systems group regarding levels of change brought about by therapeutic interventions, further indicating the benefits of CORE. The study discusses these issues and possible recommendations for aiding better integration of CORE's findings within therapy and broader clinical practice.

Details

The British Journal of Forensic Practice, vol. 12 no. 2
Type: Research Article
ISSN: 1463-6646

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Article
Publication date: 16 November 2012

Lauren Breese, Lesley Maunder, Eunice Waddell, David Gray and Jim White

The principle of equivalence states that the provision of healthcare in the community should be extended into prisons. Stress control is a psychoeducational intervention…

Abstract

Purpose

The principle of equivalence states that the provision of healthcare in the community should be extended into prisons. Stress control is a psychoeducational intervention that has had success in the community and has been adapted for use in different settings. The purpose of this paper is to establish whether stress control can be beneficial in a custodial setting.

Design/methodology/approach

Stress control was evaluated by looking at clinical effectiveness, satisfaction, attrition rate, cost effectiveness and suitability of the materials for use in a custodial environment. In total, 14 prisoners completed six sessions of stress control. Data were obtained using two clinical scales and an evaluation questionnaire.

Findings

Participants' anxiety significantly decreased and their wellbeing increased after completing Stress Control. Prisoners were satisfied with the intervention and there was a small attrition rate.

Research limitations/implications

The audit had a small sample size, there were no control conditions and measures were self report. There was a selection bias arising from the exclusion criteria. A large‐scale randomised controlled trial should be conducted to further test effectiveness.

Practical implications

The adapted materials are effective and appropriate for use in a custodial setting. There can be improved access for psychological therapy for a prison population, a cost effective intervention, acceptable to a prison population and evidence based. Further recommendations for future developments are discussed.

Originality/value

The applicability of an established programme for mood management to custodial settings is an area of significance to forensic practice.

Details

The British Journal of Forensic Practice, vol. 14 no. 4
Type: Research Article
ISSN: 1463-6646

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Article
Publication date: 7 September 2012

David Palmer, Sarah Pittaway, Lindsey Cook, Sandra Garner, Sue Holtum, Jackie Sansom and Charu Bassi

The purpose of this paper is to evaluate the impact of guided self‐help cognitive behavioural therapy (CBT) for mothers with depression and/or anxiety undertaken in two…

Abstract

Purpose

The purpose of this paper is to evaluate the impact of guided self‐help cognitive behavioural therapy (CBT) for mothers with depression and/or anxiety undertaken in two Sure Start children's centres in the London Borough of Bexley.

Design/methodology/approach

A quantitative study was carried out involving 23 participants who attended an initial appointment with a Psychological Well‐being Practitioner and who were assessed and allocated to a guided self‐help CBT intervention (either workbooks or computer‐based). In addition, in‐depth interviews were undertaken with nine participants who had completed the programme.

Findings

The study finds that guided self‐help CBT produced a significant clinical benefit for participants with mild to moderate depression and/or anxiety. Narratives with participants also highlighted improved confidence and self‐esteem, positive thinking and better coping strategies, which may have a positive impact on their children and families. This research also demonstrated the importance of a partnership approach to providing therapeutic interventions for vulnerable groups such as those in this study.

Originality/value

The findings represent a “snap‐shot” of the positive effects of guided self‐help CBT for those suffering maternal depression. They demonstrate the need to recognise and support the therapeutic social milieu, particularly in settings that are familiar and accessible. In addition, psychological interventions that include facilitative holistic working and inter‐agency working can be particularly effective.

Details

Journal of Children's Services, vol. 7 no. 3
Type: Research Article
ISSN: 1746-6660

Keywords

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Article
Publication date: 20 November 2020

Brendan James Dunlop and Mark Andrew McFetridge

There is evidence that attachment style and clinical outcomes are related within Therapeutic Communities (TCs). This paper aims to examine any possible relationships…

Abstract

Purpose

There is evidence that attachment style and clinical outcomes are related within Therapeutic Communities (TCs). This paper aims to examine any possible relationships between self-reported adult attachment style, therapy programme engagement and measures of psychological distress and dissociation on admission and discharge within a residential TC.

Design/methodology/approach

Ex-clients of the TC were contacted by post and invited to take part in this service evaluation. Additional data were sourced from a database of routinely collected outcome measures. Of 281 ex-clients, the final sample in this study was N = 32.

Findings

When attachment style is conceptualised dimensionally, participants identified most strongly with a fearful attachment style, and least with a preoccupied or secure style. A range of attachment styles were reported. A significant association was apparent between self-reported secure attachment and reduced levels of psychological distress upon discharge from the TC. The potential for changes in client attachment patterns following TC membership is discussed.

Research limitations/implications

The small sample size and correlational nature of this study means that results should be interpreted cautiously. Nevertheless, results are of clinical relevance for inpatient or residential therapy programmes (including TCs). Such programmes should routinely assess client attachment style to ensure appropriate interventions and adaptions are implemented.

Originality/value

To the best of the authors’ knowledge, to date, this is the first known study to report on the relationship between self-reported adult attachment style and psychological outcomes specifically for women with self-defeating behaviours within a TC.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 42 no. 1
Type: Research Article
ISSN: 0964-1866

Keywords

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