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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.

This study aims to describe and to compare the reliability and accuracy of different methods of measuring psychiatric symptom changes in the context of substance use.

A group of 60 patients in routine methadone treatment were followed‐up during a “watchful wait” period of four to six weeks. Diagnoses of common mental disorders meeting International Classification of Diseases (ICD‐10) criteria were established using the CIS‐R structured diagnostic interview. Brief questionnaires for depression (PHQ‐9) and anxiety (GAD‐7) were used to measure symptom changes between test and retest. It was hypothesised that the accuracy of symptom changes measured using brief questionnaires may be compromised by methodological artefacts such as poor specificity, regression to the mean and measurement error. These assumptions were tested empirically.

It was demonstrated that measuring change using conventional cut‐offs in brief symptom questionnaires tends to overestimate the prevalence of common mental disorders and the rates of improvement. Using higher cut‐off scores calibrated in samples of alcohol and drug users, in combination with a reliable change index results in more conservative and reliable estimates of symptom change.

This paper presents a considered discussion on the relative merits and limitations of alternative psychiatric symptom measurement methods. These methodological recommendations may be of interest to research and clinical practice concerned with evaluating changes in comorbid depression and anxiety. Important questions are also raised about the modest degree of symptom changes typically observed during a watchful wait period.

Traditionally evaluators of offending behaviour programmes have examined group-level mean change in treatment targets without acknowledging the potential variability of change at an individual level. Clinically significant change, although used widely in the therapy literature generally, has only recently been examined within forensic therapeutic contexts. This chapter provides an overview of key concepts, and the published literature in which clinically significant change has been examined within forensic samples is reviewed. It is concluded that although this technique has the potential to validate programme theory, it is yet to be used to its full potential within a forensic context.

Data gathered from routine clinical settings is complementary to evidence garnered from controlled efficacy trials. The purpose of this paper is to present individual-level analysis of changes in a group of patients discharged from psychological therapy within an outpatient pain service. The service had recently shifted from a traditional cognitive-behavioural approach to one underpinned by Acceptance and Commitment Therapy.

Reliable and clinically significant change methodology was applied to CORE-10 outcomes for 27 patients discharged during 2013-2014. Outcomes were compared to 2012-2013. A patient satisfaction questionnaire was administered and functional outcomes were collated.

Outcomes were not adversely affected by the shift in service focus as clients demonstrating reliable improvement increased from 2012-2013; 81 per cent reliably improved, 44 per cent made a clinically significant improvement. Increases in returning to work/unpaid activities at post-treatment were noted. The service met a number of NICE quality standards concerning the “relational” aspects of care.

Clinical effectiveness is evaluated through one outcome measure thereby limiting conclusions. The longer term effectiveness of the service remains unclear. Narrow demographic information limits an assessment of any systematic biases in findings. Little is known about treatment drop-outs.

A number of recommendations concerning data collection and future service evaluations are made.

Returning to paid or unpaid activities has a high public health impact.

This paper contributes towards the evidence base for using psychological therapies with clients experiencing chronic pain and related distress. Importantly, the paper complements evidence for general efficacy (from large-scale controlled studies) through an evaluation of real-world effectiveness (i.e. practice-based evidence).

There is no specific recommended treatment for the co-morbid presentation of post-traumatic stress disorder (PTSD) and substance use disorder in the United Kingdom (UK). Seeking Safety (SS), a group-based treatment that targets symptoms of both disorder, has emerging evidence in the USA but lacks evidence from UK-based samples. The purpose of this study was to explore UK service users’ experience of attending SS and evaluate its impact on mental health symptomology and substance misuse.

A mixed method approach was used to evaluate the acceptability of SS for a small sample (n = 7) of adult users of a substance misuse service in the UK. Thematic analysis was used to explore their experiences, derived from individual semi-structured interviews. The authors also calculated the number of participants who achieved reliable and/or clinically significant change in mental health symptomology and substance misuse from data routinely collected by the service.

Seven overarching themes emerged: strengthening the foundations of the self, the evocation and management of emotions, safety and validation provided relationally, readiness and commitment, content and delivery, Seeking Safety is Not an Island and ending. Most participants with data available both before and after the group made reliable (three out of four) and clinically significant (two out of three) change for depression and anxiety symptomology; however, this was less evident for PTSD symptomology with two out of three making reliable change and one out of three making clinically significant change.

To the best of the authors’ knowledge, this was the first study exploring the experiences of UK attendees of a SS group as an approach to treating comorbid PTSD and substance misuse.

The Behavior Problems Inventory-Short Form (BPI-S) is a shorter version of the Behavior Problems Inventory-01. In this paper, BPI-S population norms are reported from a total administrative population of adults with intellectual disability (ID). To facilitate the use of the BPI-S in clinical services to assess behavior change, the purpose of this paper is to describe how to use BPI-S clinically significant and reliable change (RC) scores.

Data were gathered on 265 adults with ID known to services. Proxy informants completed the BPI-S on challenging behaviors over the previous six months. Clinically significant cut-off values and RC scores were calculated using the Jacobson and Truax’s (1991) method.

BPI-S clinical reference data are presented to provide benchmarks for individual and group comparisons regarding challenging behavior. Examples demonstrate how to use clinical norms to determine change.

Behavior change is a major goal of researchers and practitioners. Data from the present study can make the BPI-S a valuable tool for determining change in challenging behavior following service input or intervention.

Whilst well used in research, the BPI-S may be less extensively used in practice. This present study provides data to enable researchers and practitioners to use the BPI-S more widely in assessing clinical outcomes, such as intervention research and service evaluation.

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).

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.

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.

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.

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.

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.

Data shows that there is an increasing number of young people in the UK needing access to mental health services, including crisis teams. This need has been exacerbated by the current global pandemic. There is mixed evidence for the effectiveness of crisis teams in improving adult functioning, and none, to the authors’ knowledge, that empirically examines the functioning of young people following intervention from child and adolescent mental health services (CAMHS) crisis teams in the UK. Therefore, the purpose of this paper is to use CAMHS Crisis Team data, from an NHS trust that supports 1.4 million people in the North East of England, to examine a young person's functioning following a crisis.

This service evaluation compared functioning, as measured by the Outcome Rating Scale (ORS), pre- and post-treatment for young people accessing the CAMHS Crisis Team between December 2018 and December 2019.

There were 109 participants included in the analysis. ORS scores were significantly higher at the end of treatment (t(108) = −4.2046, p < 0.001) with a small effect size (d = −0.36). Sixteen (15%) patients exhibited significant and reliable change (i.e. functioning improved). A further four (4%) patients exhibited no change (i.e. functioning did not deteriorate despite being in crisis). No patients significantly deteriorated in functioning after accessing the crisis service.

Despite a possibly overly conservative analysis, 15% of patients not only significantly improved functioning but were able to return to a “healthy” level of functioning after a mental health crisis following intervention from a CAMHS Crisis Team. Intervention(s) from a CAMHS Crisis Team are also stabilising as some young people’s functioning did not deteriorate following a mental health crisis. However, improvements also need to be made to increase the number of patients whose functioning did not significantly improve following intervention from a CAMHS Crisis Team.

This paper evaluates a young person’s functioning following a mental health crisis and intervention from a CAMHS Crisis Team in the North East of England.

The purpose of this paper is to investigate the changes in posttraumatic stress disorder (PTSD) symptomatology during treatment in a drug and alcohol therapeutic community.

A repeated measures design was employed that looked at PTSD, depression, anxiety, and stress at a pre- and post-timepoint. A second sample was then evaluated at time of program completion to seven months post-treatment.

PTSD symptomatology significantly decreased in individuals who had undertaken treatment, and continued to decline post-treatment. This finding was irrespective of any PTSD-specific treatment.

PTSD specific treatment is not necessary to lower the symptomatology. Furthermore, this provides evidence that PTSD and substance use disorders are so highly intertwined that the comorbidity can almost be considered a single, diagnosis.

This is a partial replication of previous research which had not previously been replicated. This research also adds to the limited research which looks at PTSD from the perspective of drug and alcohol rehabilitation.

This paper aims to provide a rationale for the development of a community‐based group for men with intellectual disability who have been involved in sexually inappropriate behaviour but may not have been charged.

The group was based on a cognitive behavioural model: group process and adaptations are briefly described. The group has been run on two occasions and preliminary data on outcome are provided.

Participants show a reduction in attitudes consistent with offending, an increase in sexual knowledge, and a more external locus of control on completion of the group. One of the 12 men who attended was recorded as offending again within 18 months of group completion; however, three moved to less well supervised placements.

It is concluded that this style of treatment has some advantages over other models and may be more effective, yet further research is required.