This is a useful comment Chris, thanks.
In our counselling work here at Sheffield Hallam University, part of our evaluation is to ask our clients what they thought of the service
they received - including asking them what impact the counselling has had on their ability to study, or if staff, to work effectively; and
whether they would have considered withdrawing from their studies/taken sick leave without the counselling. The results from these two
questions seem to impress our managers/funders...
Regards
Vicky Seddon
Learner Support Team Manager
Student Services Centre
Sheffield Hallam University
Sheffield S1 1WB
[log in to unmask]
Phone +44(0)114 225 2136
Fax +44(0)114 225 2187
-----Original Message-----
From: Chris Evans [mailto:[log in to unmask]]
Sent: 29 April 2003 12:35
To: [log in to unmask]
Subject: Re: GHQ-12 et al
On 9 Apr 2003 at 12:44, VOGEL wrote:
> In this era of evidence-based practice, I am required by the local PCT
> to provide some sort of statistical evidence of the success or failure
> of the sessions I offer. My first choice would be CORE but it has
> its drawbacks. I have not the time to spend analysing the results
> myself and payment for analysis by the CORE team would have to come
> out of my own pocket so, frankly, I am not inclined to do that.
>
> So, this is a cry for help: Does anyone use GHQ-12 routinely in their
> work? What are the pro's and cons of it? It seems rather a blunt
> instrument to me, and one which shows psychiatric 'caseness' rather
> than the nuances of distress or disturbance. Are other peopl
> required to use questionnaire assessments in their work with clients?
> If so, what do you use?
Whoops -- been too busy to cope with the list for months, just clearing out in my week of semi-work and couldn't resist responding to this
as one one of the designers of the CORE-OM (and to a lesser extent the CORE-A). Bear in mind that allegiance.
I do believe there's some argument, if we taking taxpayers' monies, to show some interest in evaluating outcome of our work. CORE was
designed to be just a core: not a whole, perhaps its greatest advantage over most other measures, including all variants of the GHQ, Beck's
measures, the IIP (sadly), is that it's copyleft. That's to say that we assert our copyrights on it and will sue someone stealing it or
changing it without our permission, however, we grant anyone perfect right to copy it and use it as much as they like for free provided that
they don't change it or make a direct profit out of copying it.
Surely the CORE-OM takes little more adding up (34 items) than the GHQ-12? Scores on the two are highly correlated with a little more fine
detail in the domain scores (problems, well-being, functioning, and risk) on the CORE. Leeds PTRC will process batches of CORE-A and
CORE-OM forms for people essentially at cost and CIMS (CORE Information Management Systems) have written a PC based program to handle data
input and analysis from both CORE measures but again, at a cost. Currently CIMS are the only people licensed to implement the CORE measures
in software: no profit to us, the trustees of CORE System Trust (CST) who hold the copyright, and negligible to John and Alex and their
associates in CIMS though their work does pay hunks of their mortgages. Useful, if rather CIMS oriented information on the CORE system at:
http://coreims.co.uk/
we're hoping to get a complementary site up for CST any month soon!
I'd strongly endorse sensible contributions about how most counsellors and therapists will probably see impressive looking improvements as
the general run if they use any such measure and you can usually then bring sensible funders into discussion with you about the people who
didn't improve and put more nuance in.
If you are, as some people are, keen to monitor therapy tightly by such numerical measures then the point of the CORE, complementing Paul's
point, is that it is designed to be supplemented by measures that might be particularly pertinent such as PTSD or eating disorder measures.
> (PS: Something inside me kicks against the requirement for
> assessments of this nature. They lack nuance, for one thing, and are
> too closely allied to the medical model - that quantifiable results
> are the only 'good thing' - for my comfort. However, I have to feed
> this particular beast what it seems to want...)
I sympathise strongly and believe that it's crucial to emphasise to any funding body the partial nature of the CORE picture and how vital it
is that it's complemented by the much richer picture that you and the clients have of what happened.
Most conscientious medics think likewise even if "what" they're treating, e.g. blood sugar level for a diabetic, or blood oxygen in a life
threatening asthmatic crisis, are much more readily measurable, more clearly unidimensional, and central to treatment: all support by one
human of another is complex.
However, the things that doctors, therapists and counsellors have done under the cloak of confidentiality, and the frequent contempt all
three groups show for having to argue their funding case, doesn't do us any favours in the long term. Anyone in private practice works only
to the laws of contract and their conscience, those of us who work with others' money have it a bit more complex.
Well, back off my soap box and back to some semi-leave for a few more days.
Chris
--
Chris Evans <[log in to unmask]>
Consultant Psychiatrist in Psychotherapy,
Rampton Hospital; Associate R&D Director,
Tavistock & Portman NHS Trust;
Hon. SL Institute of Psychiatry
*** My views are my own and not representative
of those institutions ***
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