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.

This article investigates the psychological well‐being of students from all faculties across their undergraduate degree from pre‐registration to semester two of year three at one UK university. Data were collected on seven occasions, with 66% of students who began their studies between 2000 and 2002 taking part in the project. Psychological well‐being was assessed using the General Population Clinical Outcomes in Routine Evaluation (GP‐CORE). Results show that greater strain is placed on well‐being once students start university compared to pre‐university levels. Levels of strain are generally highest during semester one, with significant reduction in levels of distress from semester one to semester two being observed in both year one and year three. At no time did levels of distress fall to pre‐registration levels. Given these results show university to be a time of heightened distress, there is a need to ensure that students receive the support necessary throughout their studies to enable them to successfully complete their degree course, enabling them to negotiate the transition to university and then ultimately into the workforce.

Background: There is a need for a generic, short, and easy‐to‐use assessment measure for common presentations of psychological distress in UK primary care mental health settings. This paper sets out the development of the CORE‐10 in response to this need. Method: Items were drawn from the CORE‐OM and 10 items were selected according to a combination of usefulness, coverage of item clusters, and statistical procedures. Three CORE‐OM datasets were employed in the development phase: (1) a primary care sample, (2) a sample from an MRC platform trial of enhanced collaborative care of depression in primary care, and (3) a general population sample derived from the Office of National Statistics Psychiatric Morbidity Follow‐up survey. A fourth dataset comprising a sample from an occupational health setting was used to evaluate the CORE‐10 in its standalone format. Results: The internal reliability (alpha) of the CORE‐10 was .90 and the score for the CORE‐10 correlated with the CORE‐OM at .94 in a clinical sample and .92 in a non‐clinical sample. The clinical cut‐off score for general psychological distress was 11.0 with a reliable change index (90% CI) of 6. For depression, the cut‐off score for the CORE‐10 was 13 and yielded sensitivity and specificity values of .92 (CI=.83–1.0) and 0.72 (CI=.60–.83) respectively. Conclusion: The CORE‐10 is an acceptable and feasible instrument that has good psychometric properties and is practical to use with people presenting with common mental health problems in primary care settings.

Can different therapists, motivated by different theories and working in different settings, find a single measure - a 'core' - for monitoring their work? This paper introduces the Clinical Outcomes in Routine Evaluation (CORE) outcome measure, its philosophy, practice and utility. The measure is brief and acceptable to clients and therapists. It covers well being, problems/symptoms, life functioning and risk to self and others. It is easy to score by hand and is computer scannable. It measures individual differences on entry into therapy and change. Analyses of over 2,000 responses show good reliability and convergent validity against longer and less general measures; small gender effects; large clinical/non-clinical differences and good sensitivity to change. Referential clinical and non-clinical distributions and reliability enable calculation of clinically significant and reliable change criteria. Two short forms are available for frequent use within therapy and a centrally supported system will scan questionnaires and provide standardised reports and raw data.

Study question How effective is supported computerised cognitive behaviour therapy (cCBT) as an adjunct to usual primary care for adults with depression? Methods This was a pragmatic, multicentre, three arm, parallel randomised controlled trial with simple randomisation. Treatment allocation was not blinded. Participants were adults with symptoms of depression (score ≥10 on nine item patient health questionnaire, PHQ-9) who were randomised to receive a commercially produced cCBT programme (“Beating the Blues”) or a free to use cCBT programme (MoodGYM) in addition to usual GP care. Participants were supported and encouraged to complete the programme via weekly telephone calls. Control participants were offered usual GP care, with no constraints on the range of treatments that could be accessed. The primary outcome was severity of depression assessed with the PHQ-9 at four months. Secondary outcomes included health related quality of life (measured by SF-36) and psychological wellbeing (measured by CORE-OM) at four, 12, and 24 months and depression at 12 and 24 months. Study answer and limitations Participants offered commercial or free to use cCBT experienced no additional improvement in depression compared with usual GP care at four months (odds ratio 1.19 (95% confidence interval 0.75 to 1.88) for Beating the Blues v usual GP care; 0.98 (0.62 to 1.56) for MoodGYM v usual GP care). There was no evidence of an overall difference between either programme compared with usual GP care (0.99 (0.57 to 1.70) and 0.68 (0.42 to 1.10), respectively) at any time point. Commercially provided cCBT conferred no additional benefit over free to use cCBT or usual GP care at any follow-up point. Uptake and use of cCBT was low, despite regular telephone support. Nearly a quarter of participants (24%) had dropped out by four months. The study did not have enough power to detect small differences so these cannot be ruled out. Findings cannot be generalised to cCBT offered with a much higher level of guidance and support. What this study adds Supported cCBT does not substantially improve depression outcomes compared with usual GP care alone. In this study, neither a commercially available nor free to use computerised CBT intervention was superior to usual GP care. Funding, competing interests, data sharing Commissioned and funded by the UK National Institute for Health Research (NIHR) Health Technology Assessment (HTA) programme (project No 06/43/05). The authors have no competing interests. Requests for patient level data will be considered by the REEACT trial management group Trial registration Current Controlled Trials ISRCTN91947481.