Kerry Audin

Service profiling and outcomes benchmarking using the CORE-OM: Toward practice-based evidence in the psychological therapies.

To complement the evidence-based practice paradigm, the authors argued for a core outcome measure to provide practice-based evidence for the psychological therapies. Utility requires instruments that are acceptable scientifically, as well as to service users, and a coordinated implementation of the measure at a national level. The development of the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) is summarized. Data are presented across 39 secondary-care services (n = 2,710) and within an intensively evaluated single service (n = 1,455). Results suggest that the CORE-OM is a valid and reliable measure for multiple settings and is acceptable to users and clinicians as well as policy makers. Baseline data levels of patient presenting problem severity, including risk, are reported in addition to outcome benchmarks that use the concept of reliable and clinically significant change. Basic quality improvement in outcomes for a single service is considered.

Measuring, monitoring and managing the psychological well-being of first year university students

ABSTRACT This paper profiles the psychological well-being of students in their initial year of university. There were three aims: to measure the impact of arrival at university on the psychological well-being of first year students, to monitor (i.e. profile) the shape of psychological well-being across the first year, and to investigate how students manage their well-being in relation to the use of university counselling services. Data were collected on four occasions, with 84% of all first year students at a UK university (4,699 students) completing the questionnaire on at least one occasion. Psychological well-being was assessed using the GP-CORE, a general population form of the CORE-OM. Results show that greater strain is placed on well-being once students start university compared to levels preceding entry. This strain rises and falls across the year but does not return to pre-university levels. Items tapping depression and anxiety suggest that the first year of university is a time of heightened anxiety but not a particularly depressive time. The findings are discussed in relation to students’ experience of higher education and how to match student needs with university counselling service provision.

Student debt and its relation to student mental health

The present paper provides an analysis of the relationship between attitudes toward debt and mental health among university undergraduates. Data were collected from the same cohort of students across their three years of university, with responses from 2146, 1360 and 1391 first, second and third year students, respectively. Mental health was measured using the General Population version of the Clinical Outcomes in Routine Evaluation (GP-CORE). Attitudes toward debt were measured using items that tapped current financial concerns and worry about debt on leaving university. Results showed that students become more concerned about their finances as they progress through university, that there was no relationship between anticipated debt and mental health and that attitudes toward debt were related to mental health levels. Students who were identified as having high financial concerns possessed significantly worse CORE-GP scores than students with low financial concern in all three years of university. In all three years students with high financial concerns felt more ‘tense, anxious or nervous’, more ‘criticised by other people’ and found it more ‘difficult getting to sleep or staying asleep’ than students with low financial concerns. There was also evidence that students with high worry about their debt anticipated leaving university with higher amounts of debt than low debt worry students. These findings are discussed in relation to the pattern of increased student debt in UK higher education.

Rationale and development of a general population well-being measure: Psychometric status of the GP-CORE in a student sample

This paper presents the rationale, development, and psychometric status of a non-clinical self-report measure for the general population (GP) – including students – derived from the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) and hence termed the GP-CORE. In contrast to the CORE-OM, the GP-CORE does not comprise items denoting high-intensity of presenting problems or risk and thereby increases its acceptability in a non-clinical population. Uniquely, over half the items in the GP-CORE are positively keyed. Analyses showed the GP-CORE to have good reliability, to distinguish between clinical and non-clinical populations, and have convergent validity against the full version. Norms for student populations are presented. It is suggested that the GP-CORE has considerable utility as a means of tapping the psychological well being of students and can then interface with counselling and mental health services using the CORE-OM.

How Social Class Differences Affect Students' Experience of University

The present paper outlines the experiences reported by students from different social class backgrounds who have recently graduated from university. Students from manual skilled and partly skilled backgrounds were classed as disadvantaged, while students from professional or intermediate backgrounds were classed as advantaged. Data were collected from the same cohort of students on seven occasions across their university career. Students completed questions about their family background, paid employment, financial concerns, participation in recreational activities, perceptions of academic quality and perceptions of social support. Results showed that students from disadvantaged backgrounds were less likely to have parents that attended university, more likely to have been in paid employment, less likely to have participated in non‐academic activities and spent fewer evenings per week socializing compared with students from advantaged backgrounds. Also, there was some evidence of less positive perceptions of social support among disadvantaged students. However, there were no social class differences in ratings of teaching quality and all students reported high levels of financial concern. These findings are discussed in relation to proposed changes to the way higher education is funded in Britain and the implications these changes will have on recruiting students from disadvantaged backgrounds.

Student well-being in a computing department

We describe a project exploring the relationships between factors in the learning environment, student well-being and learning outcomes, in the context of a Computing department. A range of established psychometric tests identified areas of unhelpful stress in the working environment and measures were implemented to rectify these. A significant improvement in measured student well-being followed.

Practice-Based Evidence for a Brief Time-Intensive Multi-Modal Therapy Guided by Group-Analytic Principles and Method

Group analysts are increasingly being called upon to provide effectiveness evidence, which may be critical to the development of group analysis as a therapeutic intervention in National Health Service provision of psychotherapies. This article describes a practice-based outcomes research initiative conducted in a time-limited group-analytic programme. The research was manageable and informative for profiling patients before therapy, recording benefits during therapy, and measuring outcomes at the end of the programme. Results suggest that the therapeutic programme is effective in terms of yielding decreased symptoms and improved mental health, but longer follow-up is needed to measure benefits in interpersonal functioning. The research was conducted by clinicians in collaboration with academic researchers and demonstrates the benefits of a positive clinician-researcher relationship. Carrying out the research has helped the clinicians to address the national agenda of evidence-based practice and accountability.

How to develop inter-organisational research networks in mental health: A systematic review

Background: Inter-organizational mental health research networks are increasingly encouraged by the Department of Health although the literature suggests that there is little evidence about what leads to effectiveness of these networks. Method: For the first phase of the project we have constructed a framework of relevant factors in the structure, process and outcome of inter-organizational research networks. We then used this to conduct a systematic review to summarize the evidence for best practice in these areas of research networks. Computerized databases were searched for studies of practice research networks. Results: Twenty-eight studies were included after assessment by two reviewers. Research outcomes, collaboration and recruitment of participants were the most represented areas. No high quality studies were found for any areas. Conclusions: Implications for development of mental health research networks and further research in terms of the structure, process and outcomes of networks are presented. This review highlights the need for high quality studies to determine best practice for inter-organizational research networks. Declaration of interest: None.