Hello, Chris
>
>> 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 people
>> 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.
OK. Thank you for pointing that up.
>
>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.
If we are taking money for what we do (and even if we are not) it seems
to me that we are morally and ethically bound to evaluate our practice
continuously. And I appreciate the copyleft aspect of CORE.
>
>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.
I know this, but have heard that the counsellors'/psychologists' data is
stored centrally and cannot be downloaded for future individual use. Is
that so?
>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.
A colleague used CORE (until she couldn't access her own data because it
seemed to have been deleted) to assess and evaluate her own practice.
She found it very useful.
>
>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.
Of course, but I have reservations (informed by experience,
unfortunately) as to whether this 'much richer picture' is given the
importance that it deserves by some purchasers of services.
>
>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.
>
Yes
>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.
True.
>
>Well, back off my soap box and back to some semi-leave for a few more
>days.
Enjoy!
Sue
>
Sue Vogel, BA., MSc., C.Psychol., Dip Couns Psychol.,
1 to 1 Counselling Service
BEDFORD, UK
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