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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 Outcome

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.

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 – Outcome

415

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

Keywords

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 (PRN) and…

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

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

Keywords

Article
Publication date: 15 June 2020

Lloyd Louis Oates and Nick Firth

Individuals living in areas of higher deprivation are more likely to have requested mental health treatment but are less likely to have received treatment or benefitted from it…

Abstract

Purpose

Individuals living in areas of higher deprivation are more likely to have requested mental health treatment but are less likely to have received treatment or benefitted from it. Less is known about the extent of access equality and treatment outcomes for individuals with a long-term health condition who experience mental health difficulties. The purpose of this paper is to evaluate the extent to which the neighbourhood Index of Multiple Deprivation predicted access to treatment, appointment attendance, treatment completion and clinical outcomes in a British health psychology clinic.

Design/methodology/approach

Retrospective data were used from 479 individuals referred to a health psychology clinic over 12 months. Clinical outcomes were measured using the Clinical Outcomes in Routine Evaluation – Outcome Measure. Patient data were linked with their neighbourhood Index of Multiple Deprivation decile. Data were analysed using correlation, linear regression and Fisher’s exact test.

Findings

There were no significant associations between deprivation and whether an individual attended assessment, attended treatment or completed treatment or between deprivation and patients’ clinical outcomes. Exploratory evidence indicated that individuals from higher deprivation neighbourhoods may be over-represented in clinic referrals, and individuals from lower deprivation neighbourhoods may be under-represented, compared with local population distribution estimates.

Originality/value

This evaluation provides insights into treatment outcomes and deprivation in those with physical health difficulties. Further evaluation using a larger sample and comparing referrals with local prevalence estimates of comorbid mental and physical health problems would enable greater confidence in the conclusion that no evidence of inequality on the basis of neighbourhood deprivation was found.

Details

Mental Health Review Journal, vol. 25 no. 2
Type: Research Article
ISSN: 1361-9322

Keywords

Article
Publication date: 9 March 2022

Thomas Richard Gourley and Luke Yates

Psychometrically sound measures are essential for clinical practice to provide appropriate therapeutic input. Vlissides et al. (2016) reviewed measures used in psychological…

Abstract

Purpose

Psychometrically sound measures are essential for clinical practice to provide appropriate therapeutic input. Vlissides et al. (2016) reviewed measures used in psychological therapies with people who have intellectual disabilities (ID). This paper aims to review the evidence for the psychometric properties of recent clinical measures published since/overlooked by Vlissides et al. (2016).

Design/methodology/approach

A literature search was conducted to identify relevant clinical measures. Experts in the field also were contacted. Twenty papers were identified, relating to five novel clinical measures: psychological therapies outcome scale – intellectual disabilities, clinical outcome in routine evaluation – learning disabilities scale 30, quality of early relatedness rating scale, scale of emotional development – short and the Frankish assessment of the impact of trauma.

Findings

Evidence was found supporting a proportion of the psychometric properties of each measure, and some measures were found to be useful in directing interventions and informing clinical decisions. None of the measures identified, however, are yet to be fully psychometrically investigated, requiring further research.

Originality/value

To the best of the authors’ knowledge, this paper is the first to review the evidence of psychometric properties for these five emerging clinical measures and as such contributes an original perspective on their current state and requirements for future development.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 16 no. 3
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 14 April 2010

Marta Prytys, Naureen Whittinger, Shirley Coventry, Helen Idusohan and June Brown

Insomnia is highly prevalent and has severe negative consequences, yet help‐seeking remains low. Cognitive behavioural therapy for insomnia (CBT‐I) is an evidence‐based treatment…

Abstract

Insomnia is highly prevalent and has severe negative consequences, yet help‐seeking remains low. Cognitive behavioural therapy for insomnia (CBT‐I) is an evidence‐based treatment, which targets factors that perpetuate insomnia over time. Using a format developed by Brown and colleagues (1999) of offering self‐referral psycho‐educational workshops for the community, one‐day CBT‐I workshops were run on a routine basis, throughout 2007, for the general public. These intensive workshop days were led by two clinical/counselling psychologists, and attracted a large number of self‐referrals. Participants completed a battery of measures at the introductory and follow up phases of the workshop programme including measures of insomnia, anxiety and depression. Of the 60 people who self‐referred, the large majority were women, 58% had clinical insomnia as indicated by the Insomnia Severity Index (ISI) and 75% had clinical levels of depression as measured by the Beck Depression Inventory (BDI; scores over 10). At the follow‐up stage, there were significant improvements on all measures, and there was a high degree of participant satisfaction with the workshops. Such large‐scale interventions offer an important, potentially cost‐effective means of disseminating evidence‐based psychological interventions to large numbers of people.

Details

Journal of Public Mental Health, vol. 9 no. 1
Type: Research Article
ISSN: 1746-5729

Keywords

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 and…

303

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

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 between…

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

Article
Publication date: 12 September 2019

Shona Adams and Steven Allan

Rewind is a trauma-focussed exposure technique that is part of Human Givens (HG) therapy. However, there have been no controlled studies examining the effectiveness or…

Abstract

Purpose

Rewind is a trauma-focussed exposure technique that is part of Human Givens (HG) therapy. However, there have been no controlled studies examining the effectiveness or acceptability of Rewind, and a previous study comparing HG therapy outcomes with cognitive behaviour therapy (CBT) benchmarks has yet to be replicated. The paper aims to address these issues.

Design/methodology/approach

This preliminary investigation used an observational, quasi-experimental design. Using both between-subject and within-subject designs, the outcome measures of those who had Rewind in the second session and participants who had treatment-as-usual (TAU) in the second session followed by Rewind in the third session were compared. Pre–post treatment scores were used to evaluate the overall HG therapy and to compare with benchmarks.

Findings

Rewind was more effective than control treatment sessions, with 40 per cent recovered and 57 per cent having reliably improved or recovered after the Rewind treatment session. Rewind sessions were rated as acceptable as other treatment sessions. The effect size of HG therapy was above the CBT Clinical Outcomes in Routine Evaluation Outcome-10 (CORE-10) benchmark of 1.22. The recovery rate for treatment completers was 63 per cent, with 91 per cent recovered or reliably improved and was equivalent to the top quartile of services.

Practical implications

Rewind is a promising alternative trauma treatment, as people need not discuss details of the trauma, multiple traumas can be treated in one session and fewer treatment sessions may be needed.

Originality/value

There are few HG studies reported in the peer-reviewed literature. This preliminary study is the first controlled study of Rewind. The findings are also in line with previous research on HG therapy.

Details

Mental Health Review Journal, vol. 24 no. 3
Type: Research Article
ISSN: 1361-9322

Keywords

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