Update on CORE

SPR(UK) meeting 15.iii.09Chris EvansNottinghamshire Healthcare NHS Trust

HistoryRooted in SPR:NIMH meetingMHF meetingPilot workEmergent idea:CORE-OMOQOfficial launch 1998

What is the CORE Outcome Measure?34 items on two sides of A4tick box completionfive response levels (0 to 4)pan-theoretical (CORE)simple languagehand scorablecomputer scannableshort forms available

HistoryRooted in SPR:NIMH meetingMHF meeting

HistoryRooted in SPR:NIMH meetingMHF meetingPilot workEmergent idea:CORE-OMOQOfficial launch 1998

RootsOrganisationsSPR, MHF, CPCT, Artemis Trust, NHS, CST, CIMSPeopleMichael Barkham, Frank Margison, Janice Connell, John Mellor-Clark, Kerry Audin MoneyMHF, CPCT, Artemis, NHS (Leeds), HEFCGroupsResearchers, Therapists, users

ComponentsNot just a measure!MeasuresMoneyTo fund itCopyleftTheoryAttitudePeopleScanning & then ITSupport

CORE-OM & its children

MeasurePurposeItemsCORE-OMClinical34CORE-SFa/SFbSessional use18GP-COREGen. population, surveys14CORE-10Screening, sessional10CORE-5Screening, sessional?

CORE-OM & its children (2)YP-CORE13-18 age range10 itemsReplaces teen-CORELD-COREShortLongSCOREShortLong

CORE-OM & its children (2)YP-CORE13-18 age range10 itemsReplaces teen-CORELD-COREShortLongSCOREShortLong

CORE-OM & its children (2)YP-CORE13-18 age range10 itemsReplaces teen-CORELD-COREShortLongSCOREShortLong

SCORE

CORE-OM & its children (3)TranslationsMethodDoneCORE-OM & derivativeCORE-A & CORE-NetUnderwayPlannedNeededStages of use

Translations completedGujaratiNorwegian (Bokmal)ItalianSlovakSwedishIcelandicAlbanian (Tosk)GreekDutchDanishPortugueseBrazilianCroatian

Translations ongoing

WelshSamiSerbianBSLBosnianJapaneseSpanishSomaliCatalanArabicOther SpanishTurkishFrenchKurdishKannadaFinnishGermanLatvianCzechPolishUrduAfrikaansPunjabiXhosaTamilBengali

ComponentsNot just a measure!MeasuresMoneyTo fund itCopyleftTheoryAttitudePeopleScanning & then ITSupport

ComponentsNot just a measure!MeasuresMoneyTo fund itCopyleftTheoryAttitudePeopleScanning & then ITSupport

Theory & attitudeTheory:Get out of the confidentiality closetEmbrace crude quantificationA core only, not a dimensionOutcome = changeAttitudeBottom upShareCompareCore only: complement itSupport each other

ComponentsNot just a measure!MeasuresMoneyTo fund itCopyleftTheoryAttitudePeopleScanning & then ITSupport

Where now?UK/EnglishInternationalGeneral

Where now?UK/EnglishSqueezed to the edge of IAPT but in the DoH MH PROM compendiumIncreasing research useMapped to the BDI-IIHuge datasets

Where now?UK/EnglishInternational 1Developing but money/timeCulturesGeneral

Where now?UK/EnglishInternationalGeneralNew theories of change?New politics and partnership?New psychometrics of change?A New Deal?

Thanks!chris@psyctc.org

*This is a slightly modified and less personal version than the one given in Ravenscar.*The CORE system has long roots back to an NIMH meeting organised by Irene Waskow (now Irene Elkin) and Morris Parloff in 1970. The proceedings for the meeting were later published under the title Psychotherapy Change Measures (1975). That work didnt result in a core battery but proposed the idea. The idea was reborn in the UK through a meeting hosted by the MHF in 1994 and then a grant that led to the CORE-OM and CORE-A and the official launch in 1998.*1994*The pilot work depended to a huge extent on input from the SPR(UK) North group.

It was an emergent idea: after we had developed the CORE-OM we learned of the work of Mike Lambert and his colleagues on the OQ and there were other similar measures and systems appearing at the time.*Like most healthy families and trees, the CORE system had multiple strong roots, some of which are listed here*Self-explanatory slide*As a family, the CORE-OM part of the CORE system has spawned a number of children: shortened forms.

Guess how many items in the CORE-5?!*As well as those direct descendents the CORE-OM has reproduced itself to produce other children.

The YP-CORE has replaced the pilot teen-CORE (if you see a teen-CORE, keep it as it should gain great historical value, but dont use it as it has been superseded by the YP-CORE). Although all the items in the YP-CORE are derived from the CORE-OM they are reworded to simplify them.

The LD-CORE for people with learning disability/difficulties (PWLD) takes simplified items from the CORE-OM but also adds new items tuned to the experiences of PWLD and co-developed with PWLD (the missing heart of the LD experience)

SCORE: Systemic CORE is a measure of family functioning rated by members of families coming for family (systemic) therapy. Though not an official part of the CORE system it was greatly influenced by the CORE System and I was involved in early stages of its development.

Both LD-CORE & SCORE will have shorter and longer versions.*LD-CORE items*Another set of progeny are the translations of the CORE-OM and the shortened forms.*The funding roots of the CORE system were noted earlier. Another financial side is that the CORE instruments are free to copy on paper provided that they are not changed in any way. We estimate that this has saved the NHS many hundreds of thousands of pounds when the costs of competitor measures like the BDI are considered.**Self-explanatory