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Towards a standardised brief outcome measure: Psychometric properties and utility of the CORE–OM
Open accessAbstract
Background: An acceptable, standardised outcome measure to assess efficacy and effectiveness is needed across multiple disciplines offering psychological therapies. Aims: To present psychometric data on reliability, validity and sensitivity to change for the CORE–OM (Clinical Outcomes in Routine Evaluation – Outcome Measure). Method: A 34-item self-report instrument was developed, with domains of subjective well-being, symptoms, function and risk. Analysis includes internal reliability, test–retest reliability, socio-demographic differences, exploratory principal-component analysis, correlations with other instruments, differences between clinical and non-clinical samples and assessment of change within a clinical group. Results: Internal and test–retest reliability were good (0.75–0.95), as was convergent validity with seven other instruments, with large differences between clinical and non-clinical samples and good sensitivity to change. Conclusions: The CORE–OM is a reliable and valid instrument with good sensitivity to change. It is acceptable in a wide range of practice settings.
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“The CORE-OM is a well-validated, reliable, and widely used outcome measure of psychological treatments (Barkham et al. 2006;Barkham, Mullin, Leach, Stiles, & Lucock, 2007;Evans et al., 2002).”
From Acceptance and Commitment Therapy for perinatal mood and anxiety disorders: A feasibility and proof of concept study. (2020) · cites this paper as Evans et al., 2002
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Both CORE-OM and CORE-10 have shown good psychometric properties [55, 56].”
From Measuring the Effect of the Early assessment Team (MEET) for patients referred to outpatient mental health care: a study protocol for a randomised controlled trial (2024) · cites this paper as [56]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“The CORE-OM has excellent internal consistency in clinical samples (α=.94) and for each of its subscales (α=.75-.94); it also has good test-retest reliability (P=.83) [73].”
From A Virtual Reality-Assisted Cognitive Behavioral Therapy for and With Inuit in Québec: Protocol for a Proof-of-Concept Randomized Controlled Trial (2023) · cites this paper as [73]
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“The CORE-OM has published evidence of reliability and validity [29,30] and has been used in previous UK mental health trials [31].”
From Development and evaluation of culturally sensitive psychosocial interventions for under-served people in primary care (2014) · cites this paper as [30]
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MethodSelf-citationTowards greater bandwidth for standardised outcome measures
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“The scale is derived from the CORE-OM (Evans et al., 2002) and comprises items on anxiety, depression, trauma, physical problems, functioning and risk.”
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“It is reliable, valid, and acceptable in a broader range of settings (Barkham et al., 2001; Evans et al., 2002; Shepherd et al., 2005).”
BackgroundMonitorización de Resultados en Psicoterapia: Estado Actual y Perspectivas Futuras en Iberoamérica
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“Over 18s: The CORE Outcome Measure (Evans et al., 2002) The CORE Outcome Measure (CORE-OM) is a 34-item measure of psychological distress in adolescents and adults aged over 18 assessing the frequency of experiences related to well-being, functioning, symptoms and risk.”
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“The Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM; Evans et al., 2002) was used to assess subjective well-being, functioning, psychological difficulties, and risk factors, demonstrating high internal consistency with a Cronbach’s alpha of 0.97.”
InfluentialHope-focused Therapy: A Framework Outline
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“Studies have shown high internal reliabilities (Barkham et al., 2005; Evans et al., 2002).”
ResultInfluentialStructure of self-schemas in patients with paranoia
Mihić, L., Novović, Z., Dozois, D. J. A., Bentall, R. P., & Petrovic, T. (2018) · Psihologija · doi:10.2298/psi171120026m · Cited by 3
“Additionally, the average CORE-OM score in the NC group was comparable to the normative values obtained in other studies using student samples (Evans et al., 2002), suggesting an absence of psychiatric problems in this group.”
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“The Clinical Outcomes in Routine Evaluation Outcome Measure (COREOM) is a 34-item measure developed by Evans et al. (2000, 2002) used to assess MHPs.”
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“Recent research has shown that participants find the CORE-OM useful in assessing psychological distress and progress within treatment (Evans et al., 2002).”
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“With its 34 items, the CORE-OM has indicated good psychometric properties [13, 14].”
BackgroundMethodNavigating Loss Together: A Scoping Review of Couples Therapy Interventions for Perinatal Death
Kendrick, J. I. S., & Sterrett-Hong, E. (2023) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228231212653 · Cited by 3
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“Gender effects have been found for the items scores on the YP CORE, with women generally scoring higher than men, and consequently, gender-specific cut-off scores have been recommended by some authors (Evans et al .”
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Resultado y proceso en Psicoterapia Cognitivo-Constructivista Integradora
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Engaging Meaningfully with Outcome Measurement
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“The CORE-10 is a short version of the 34 item CORE – Outcome Measure (Evans et al., 2002; Barkham et al., 2001).”
BackgroundDaphne European Research Project: Italian Validation of Hypothesis Model (SAI-R, CORE-OM and BDI-II)
Testoni, I., Armenti, A., Ronconi, L., Cottone, P., Wieser, M. A., & Verdi, S. (2012) · Padua Research Archive (University of Padova) · doi:10.14658/ijfs-17-1 · Cited by 3
“The CORE-OM (Evans et al., 2002) assesses the effectiveness of the clinical intervention and consists of 34 statements that the patient must evaluate on a 5- point Likert scale, based on how frequently they experienced a certain mood during the last week ; where 0 indicates “Not at all”, 1 = “only…”
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Roche‐Morris, A., & Cheetham, J. (2018) · British Journal of Learning Disabilities · doi:10.1111/bld.12255 · Cited by 3
Paz, C., & Evans, C. (2019) · Revista Brasileira de Psicodrama · doi:10.15329/2318-0498.20190024 · Cited by 3
“For all domains, including well-being, high scores indicate high levels of psychological distress (Evans et al., 2002).”
BackgroundMethodInfluentialSelf-citationHarris, T., Lepper, G., Cheetham, B., Crowther, C., King, D. S., & Ryde, J. (2020) · British Journal of Psychotherapy · doi:10.1111/bjp.12541 · Cited by 3
Firth, N., Bone, C., & Holt, R. (2020) · Health Psychology · doi:10.1037/hea0001021 · Cited by 3
Paz, C., Evans, C., Valdiviezo‐Oña, J., & Osejo-Taco, G. (2020) · Journal of Personality Assessment · doi:10.1080/00223891.2020.1825963 · Cited by 3
“Clinical outcomes in routine Evaluation- Outcome measure (CORE-OM; Evans et al., 2002) This is a 34-item self-report measure of global psychological state.”
MethodResultSelf-citationAttachment style and clinical outcome within a DBT-informed Therapeutic Community
Dunlop, B. J., & McFetridge, M. A. (2020) · Therapeutic Communities The International Journal of Therapeutic Communities · doi:10.1108/tc-06-2020-0014 · Cited by 3
Kehler, T., Kezele, T. G., Fužinac-Smojver, A., & Kauzlarić-Živković, T. (2021) · Paediatria Croatica · doi:10.13112/pc.2021.10 · Cited by 3
“CORE-OM is a 34-item scale designed as a multi-theoretical and multi-diagnostic measure of general psychological distress (14,15).”
Longitudinal Distress among Brazilian University Workers during Pandemics
Zibetti, M. R., Serralta, F. B., & Evans, C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18179072 · Cited by 3
“However, the idea that the pandemic may have caused a rise in distress is suggested by the finding that mean scores in the present study are above the cut-off points for clinical groups obtained before the pandemic in the English and Spanish versions of the instrument [24,35,36].”
ResultSelf-citationRowsell, M., & Stennett-Cox, N. (2009) · Clinical Psychology Forum · doi:10.53841/bpscpf.2009.1.195.42 · Cited by 3
Shepherd, M. A., Evans, C., Cobb, S., & Ghossain, D. (2012) · Clinical Psychology Forum · doi:10.53841/bpscpf.2012.1.233.8 · Cited by 3
Self-citationMedically Unexplained Symptoms
Capek, M. E. Y. (2011) · doi:10.1002/9781119950905.ch18 · Cited by 3
Making sense of CORE System data: Attrition, effectiveness, concordance and information capture
Grant, S. (2006) · European Journal of Psychotherapy & Counselling · doi:10.1080/13642530600712569 · Cited by 3
“Large, highly significant differences have been found on the CORE-OM between clinical and non-clinical samples (Barkham et al., 2001; Evans et al., 2002).”
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Almeida, S. N., Elliott, R., Silva, E. R., & Sales, C. M. D. (2024) · Counselling and Psychotherapy Research · doi:10.1002/capr.12624 · Cited by 2
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Steverson, T., Marsden, J., & Blake, J. (2024) · Clinical Rehabilitation · doi:10.1177/02692155241236602 · Cited by 2
Mikola, T., Lehto, S. M., Honkalampi, K. M., Valkonen‐Korhonen, M., Koivumaa-Honkanen, H. T., Tolmunen, T., Laukkanen, V., Pakarinen, M., & Ruusunen, A. A. (2024) · Food Science & Nutrition · doi:10.1002/fsn3.4417 · Cited by 5
“The maximum score is 136 and the mean score is obtained by dividing the number of total points by the number of answered questions (higher scores indicate more problems) (Evans et al., 2002 ).”
BackgroundCunningham, A., Golden, D. D. L. H., Pink, M., Truszkowska, E., Byrne, T., Murphy, C., Strahann, A., Doyle, C., Kasemiire, A., & Frawley, T. (2024) · Journal of Advanced Nursing · doi:10.1111/jan.16498 · Cited by 2
“The study uses a validated scale (Barkham et al. 2006; Evans et al. 2002) which demonstrates abatement of symptoms of mental health illness, with evidence of improvements in all CORE-OM items.”
Richardson, T. H., Sood, M., Large, J., & McCloud, T. L. (2024) · Journal of Public Mental Health · doi:10.1108/jpmh-08-2024-0105 · Cited by 3
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“The primary outcome was the level of psychological distress at the end of the 10-week trial (T2), as evaluated using the 34-item Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM) [25], a reliable and valid self-report measure of change in psychotherapy [25,26].”
Zurita‐Calderón, S., Valdiviezo‐Oña, J., Evans, C., & Paz, C. (2025) · Counselling and Psychotherapy Research · doi:10.1002/capr.70023 · Cited by 2
Self-citationMonteiro, M., Elliott, R., Nogueira, D. C. O. A., Mesquita, E. M., & Cunha, C. A. C. (2025) · Psychotherapy Research · doi:10.1080/10503307.2025.2522386 · Cited by 4
“…Connor et al., 2000), the Personal Questionnaire (PQ; Elliott et al., 2016), the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM; Evans et al., 2002), the Inventory of Interpersonal Problems (IIP; Maling et al., 1995), and the Strathclyde Inventory (SI; Freire et al., 2007).”
Malta, G. D., Vos, J., Bond, J., van Rijn, B., & Cooper, M. (2025) · Psychotherapy Research · doi:10.1080/10503307.2025.2551073 · Cited by 2
“Using hierarchical regression with a sample of 42 clients, Price (2012) identified that the presence of RD, as measured with the RDI-Revised, could explain approximately 14% of the variance in reductions in psychological distress at the end of therapy (CORE-OM; Evans et al., 2002).”
Caldarelli, G., Affuso, G., Cosenza, M., Barone, L., Pizzini, B., & Troncone, A. (2025) · Counselling and Psychotherapy Research · doi:10.1002/capr.70062 · Cited by 3
Vos, J., Broglia, E., van Rijn, B., Peristeri, M., Barkham, M., & Stiles, W. B. (2026) · Counselling and Psychotherapy Research · doi:10.1002/capr.70067 · Cited by 2
Self-citationUsing a stepped-care approach to help severely obese children and young people
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Intensive Transactional Analysis Psychotherapy (ITAP): A case series study
Messina, I., Scottà, F., Benelli, E., Marchi, A., & Sambin, M. (2019) · Counselling and Psychotherapy Research · doi:10.1002/capr.12277 · Cited by 2
A Grounded Theory Analysis of the Experience of Therapy in the Context of Negative Change
Hart, C., Boellinghaus, I., Holttum, S., Shepherd, M., O’Brien, C., & Salter, D. (2021) · SAGE Open · doi:10.1177/21582440211023198 · Cited by 2
“Alternatively, the CORE-OM (Clinical Outcomes in Routine Evaluation, Evans et al., 2002) includes interpersonal items, which might give a more rounded measure of functioning than symptom-specific measures.”
MethodMolebatsi, K., Ng, L. C., & Chiliza, B. (2021) · Pilot and Feasibility Studies · doi:10.1186/s40814-021-00904-1 · Cited by 2
Evans, C. (2022) · Studies in Psychology Estudios de Psicología · doi:10.1080/02109395.2022.2127235 · Cited by 2
“…describimos la medida central, el CORE-OM de 34 ítems (Clinical Outcomes in Routine Evaluation – Outcome Measure – Resultados clínicos en la evaluación de rutina – medida de resultados) en Evans et al. (2000), y una exploración psicométrica inicial bastante exhaustiva en Evans et al. (2002).”
BackgroundMethodSelf-citationPreditores do Sofrimento Psíquico de Profissionais da Saúde Pública durante a COVID-19
Monteiro, J. K., Consoli, J., da Silva, K. J. S., Pires, K. N., Silva, L. C., Guerin, M., Gregoviski, V. R., Zibetti, M. R., & Serralta, F. B. (2023) · Revista Psicologia Organizações e Trabalho · doi:10.5935/rpot/2023.3.24699 · Cited by 2
“…Fui humilhado ou ridicularizado em relação ao trabalho) sobre situações de violência/assédio moral ( α de Cronbach = 0,70) durante a pandemia; a escala de Conflito Trabalho-Família (Carlson et al., 2000); e o Clinical Outcome Routine Evaluation-Outcome Measures (CORE-OM-Evans et al., 2002).”
McKenna, L., & Vogt, F. (2024) · Springer eBooks · doi:10.1007/978-3-031-35647-6_45 · Cited by 2
Yirmiya, K., Constantinou, M., Simes, E., BATEMAN, A. W., Wason, J. M. S., Yakeley, J., McMurran, M., Crawford, M., Frater, A. P., Moran, P., et al. (2024) · Psychological Medicine · doi:10.1017/s003329172400062x · Cited by 4
“For Internalizing difficulties, the 12-item CORE-OM Problems and Symptoms subscale (Barkham et al., 2001) was utilized, which has been validated and found reliable (Evans et al., 2002).”
MethodDeng, X., Wang, Y., Zhi, D., Xu, L., & Li, Z. (2024) · Psychotherapy Research · doi:10.1080/10503307.2024.2344829 · Cited by 2
“In a study by Evans et al. (2002) involving clinical and non-clinical participants from the UK, a three-factor model exhibited the optimal fit, comprising factors of “posi-tively worded items,” “negatively worded items,” and “risk items.””
Valdiviezo‐Oña, J., Ortíz, E. L., Paz, C., González, E. H., Macías-Esparza, L. K., & Güitrón, C. M. (2024) · Acta Universitaria · doi:10.15174/au.2024.3952 · Cited by 2
“Otros estudios con una versión más larga de los instrumentos de la familia CORE, como el CORE-OM de 34 ítems, tampoco indican la presencia de diferencias significativas en género en las puntuaciones totales del cuestionario en España (Trujillo et al. , 2016) y tampoco en Ecuador (Paz et al. , 2020); sin embargo, sí se…”
BackgroundLeandertz, M., & Ala-Ruona, E. (2024) · Approaches An Interdisciplinary Journal of Music Therapy · doi:10.56883/aijmt.2024.395 · Cited by 2
Pocobello, R., Camilli, F., Ridente, P., Caloro, G., Balice, M. G., Tibaldi, G., Macario, M., D’Alema, M., Gulino, E., & el Sehity, T. J. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1428689 · Cited by 2
Wozniak, E. E., Hare, D. J., Gregg, L., & Wittkowski, A. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1424010 · Cited by 2
Ching, B. C. F., Hahn, J. S., Corrie, S., Thomas, R., & Alba, A. (2025) · BJPsych Open · doi:10.1192/bjo.2024.868 · Cited by 2
Outcome measurement in mental health services in Norway
Ruud, T. (2010) · Cambridge University Press eBooks · doi:10.1017/cbo9780511760686.010 · Cited by 2
Violência de gênero. Testando um modelo: espontaneidade, bem-estar psicológio e depressão
Testoni, I., Armenti, A., Ronconi, L., Wieser, M. A., Zamperini, A., Verdi, S., & Evans, C. (2013) · Revista Brasileira de Psicodrama · Cited by 2
Self-citationIntroducing a routine outcome and feedback measure in an Australian university counselling service
O'Brien, M. A., & Mooney, A. G. (2010) · Griffith Research Online · Cited by 2
The Challenge of Developing a Brief Intervention Service for Couples
Nyberg, V., McCann, D., & Glausius, K. (2015) · Journal of Couple & Relationship Therapy · doi:10.1080/15332691.2014.981655 · Cited by 2
Conflictos cognitivos en una muestra comunitaria: un estudio exploratorio
Saúl, L. Á., López-González, M. A., Feixas, G., Rubio‐Garay, F., & Domínguez-Simón, M. J. (2014) · RECERCAT (Consorci de Serveis Universitaris de Catalunya) · Cited by 2
Joice, A., Freeman, L. N., & Toplis, L. (2011) · Cited by 2
A Validity Study on Outcome Questionnaire-30 (OQ-30) with Korean Clients
손난희, & SungKyungYoo (2012) · Korea Journal of Counseling · doi:10.15703/kjc.13.1.201202.1 · Cited by 2
Procesos Narrativos en Psicoterapia: diferencias entre clientes con buen y mal resultado
Botella, L., & Cutura, J. M. (2015) · Acción Psicológica · doi:10.5944/ap.12.2.15766 · Cited by 2
Stratton, P., Bland, J., Janes, E., & Lask, J. (2012) · Vandenhoeck & Ruprecht eBooks · doi:10.13109/9783666404443.355 · Cited by 2
Relational dynamics between psychotherapy clients and clinic administrative staff: A pilot study
Sandage, S. J., Moon, S. H., Rupert, D., Paine, D. R., Ruffing, E. G., Kehoe, L. E., Bronstein, M., & Hassen, S. C. (2017) · Psychodynamic Practice · doi:10.1080/14753634.2017.1335226 · Cited by 2
“Evans et al. (2002) found the functioning subscale yielded alphas of .86 in a non-clinical sample and .87 in a clinical sample.”
MethodBalancing clinical risk with countertransference management protects alliance
Barreto, J. F., & Matos, P. M. (2017) · Research in Psychotherapy Psychopathology Process and Outcome · doi:10.4081/ripppo.2017.279 · Cited by 2
“Overall, our sample’s CORE-OM scores lie between non-clinical and clinical typical values according to available data from previous studies (Evans et al., 2002), suggesting moderate clinical severity.”
ResultIntegrating Mental Health into a Primary Care System: A Hybrid Simulation Model
Aringhieri, R., Duma, D., & Polacchi, F. (2018) · AIRO Springer series/AIRO Springer Series · doi:10.1007/978-3-030-00473-6_7 · Cited by 2
“A success consists in a remission of the patient’ symptoms with a decrease in the number of visits to the GP: in our case study, the success of a treatment is measured adopting the CORE-OM self-evaluation scale [6], which evaluates the improvement of the patient’s life quality.”
Wilson, K., Power, K., Graham, L., Reid, L. M., Duncan, K. A., & Shand, S. (2021) · Journal of Aggression, Maltreatment & Trauma · doi:10.1080/10926771.2021.2013379 · Cited by 2
“The test-retest reliability of subscales has been found to be acceptably high (0.87– 0.91) with the exception of “Risk” (0.64) (Evans et al., 2002).”
BackgroundInfluentialPaz, C., Osejo-Taco, G., & Evans, C. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-056361 · Cited by 2
Self-citationMerizzi, A., Biasi, R., Zamudio, J. F. Á., Lobb, M. S., Rosa, M. D., & Santini, S. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19063260 · Cited by 2
“CORE–OM is widely used in psychotherapy research and clinical settings for its good reliability and test-retest stability [96].”
MethodTerry, R., Shepherd, M. A., Simonds, L. M., & Sperlinger, D. J. (2007) · Clinical Psychology Forum · doi:10.53841/bpscpf.2007.1.176.10 · Cited by 2
Castillo, J. M., Valavanis, S., & Algorta, G. P. (2020) · Psychoanalytic Psychotherapy · doi:10.1080/02668734.2020.1802615 · Cited by 2
Tucker, J. R. (2012) · Iowa State University Digital Repository (Iowa State University) · doi:10.31274/etd-180810-2887 · Cited by 2
Rewiring efficacy studies to increase their relevance to routine practice
Barkham, M., Leach, C., Shapiro, D. A., Hardy, G. E., Lucock, M. P., & Rees, A. (2005) · Mental Health and Learning Disabilities Research and Practice · doi:10.5920/mhldrp.2005.2111 · Cited by 2
Self-citation
Metadata
- Authors
- Evans, C., Connell, J., Barkham, M., Margison, F., McGrath, G., Mellor-Clark, J., & Audin, K.
- Affiliations
- The Tavistock and Portman NHS Foundation Trust (GB)
- University of Leeds (GB)
- Corresponding author
- Evans, Chris
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2002-01
- Volume
- 180
- Issue
- 1
- Pages
- 51-60
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2114350740
- Cited by
- 934
- References
- 24
- Citations by year
- 2026: 40 · 2025: 56 · 2024: 54 · 2023: 51 · 2022: 47 · 2021: 55 · 2020: 59 · 2019: 45 · 2018: 59 · 2017: 47 · 2016: 46 · 2015: 55 · 2014: 43 · 2013: 43 · 2012: 49
- FWCI
- 14.89
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Leeds
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- CORE-OM, outcome measures, psychometric properties, reliability statistics, validity, sensitivity to change, psychotherapy, subjective well-being, clinical symptoms, functioning, risk, self-report measures
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Mental Disorders, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Psychiatric Status Rating Scales, Psychometrics, Sensitivity and Specificity, Sex Factors, Reproducibility of Results, Treatment Outcome
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