Outcomes In Routine Evaluation Research Articles

Do Therapists Know When Their Clients Deteriorate? An Investigation of Therapists' Ability to Estimate and Predict Client Change During and After Psychotherapy

ABSTRACTIn routine outcome monitoring, psychotherapists receive feedback from their clients about their self‐reported progress during therapy. This practice is based on research indicating that therapists overestimate their effectiveness and cannot detect and predict negative client change. However, this assumption is based on only a few studies. This study aimed to investigate whether trainee therapists could estimate client deterioration after each session and after therapy and whether they, from session to session, could predict client post‐therapy outcomes. Fifty‐three postgraduate trainee therapists at a university clinic treated 105 clients, with an average of 13.1 sessions. A questionnaire was developed to measure the therapists' estimation of client change at each session and their session‐by‐session prediction of client post‐therapy outcomes. The 10‐item version of the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE‐OM) was used to measure clients' self‐reported change at each session. The data included 96 (91.5%) therapist estimations of client post‐therapy outcomes, 1015 (87.8%) estimations of client change from the second to the penultimate session, and 1140 predictions of post‐therapy outcomes. The study found that at post‐therapy, the therapists were only able to identify one out of eight clients who showed deterioration on the CORE‐10. Additionally, during therapy, they could accurately estimate only six out of 83 sessions in which clients had experienced deterioration on the CORE‐10, and they failed to predict any of the eight clients who ended therapy with deterioration. In conclusion, therapists cannot rely on their clinical judgement alone to assess client progress and outcomes and will depend on routine outcome monitoring to detect client deterioration.

Association of psychological distress with health-related quality of life in Asian adolescents seeking obesity treatment.

There is limited research on the psychosocial health of Asian adolescents undergoing obesity treatment. Our study examined the predictors of psychological distress, disordered eating and poor health-related quality of life (HRQoL) in these adolescents and the associations between them. A total of 82 adolescents aged 11-17 years were recruited from the Weight Management Clinic in KK Women's and Children's Hospital between June 2022 and January 2023. Participants completed the following questionnaires: (a) Young Person's Clinical Outcomes in Routine Evaluation (YP-Core) assessing for psychological distress, (b) Children's Eating Attitude Test (ChEAT) evaluating for disordered eating behaviours, and (c) Pediatric Quality of Life Inventory (PedsQL) measuring HRQoL. Participating adolescents had a mean body mass index of 31.9 ± 5.1 kg/m2. Of the participants, 40% reported significantly symptomatic psychological distress (YP-Core score ≥14) and 16% were at risk of eating disorders (ChEAT score ≥20). A higher YP-Core score was the only significant determinant of poorer HRQoL, after controlling for demographic variables and ChEAT scores. Malay (regression coefficient: 6.6, 95% confidence interval [CI]: 0.6-12.6, P = 0.031) and Indian (regression coefficient: 8.9, 95% CI: 3.8-14.0, P = 0.001) adolescents were more likely to report disordered eating and psychological distress, respectively, as compared to Chinese adolescents. Adolescents whose parent(s) had obesity (regression coefficient: 3.4, 95% CI: 0.1-6.7, P = 0.043) were also more likely to experience greater psychological distress. Understanding the determinants of psychological distress, disordered eating and HRQoL will facilitate targeted screening and management of the psychosocial complications of adolescent obesity.

Effectiveness of group analytic and psychodynamic psychotherapy in routine secondary-care practice

Group psychotherapy has been shown to be effective across a diverse range of participants and settings. However, few quantitative studies have examined outcomes of Group Analytic Psychotherapy (GAP) specifically, or compared this with alternative treatments. In the present study we compare outcomes of weekly group analytic psychotherapy (GAP) and individual psychodynamic psychotherapy (PPT) at a psychotherapy service within the UK’s National Health Service. The service collected Clinical Outcomes in Routine Evaluation (CORE) outcome measures between 2010 and 2020 as part of routine clinical practice, furnishing a large observational dataset (N=600 clients). We found that clients showed clinically significant improvement following either GAP (Cohen’s d=0.77) or PPT (d=0.68), and the rate of change during therapy exceeded that during a pre-treatment waiting period. There were no clinically significant differences in effectiveness between GAP and PPT, of either short-term (<1 year) or long-term (> 1 year) duration. These results support a conclusion that both GAP and PPT are effective in routine clinical practice. We consider the advantages and limitations of quantitative outcome measurement from a group analytic perspective and highlight the possible pitfalls of attempting to optimise therapy based on overly narrow criteria.

Loneliness among first-year university students: Evaluating a peer support intervention

Loneliness is a subjective feeling of isolation or lack of companionship that is distinct from anxiety and depression. Loneliness is a significant problem for students that not only affects their wellbeing but also their ability to learn at university. Using a pre-registered protocol, this study investigated the effectiveness of a peer support intervention to ease the transition of first-year students to university life and reduce loneliness. First-year Psychology students were randomly allocated to the peer support intervention (n=20) or a no-intervention control group (n=32). Self-ratings of loneliness and wellbeing were obtained at baseline and 6 months later using the UCLA Loneliness Scale Version 3 and the General Population – Clinical Outcomes in Routine Evaluation (GP-CORE) questionnaires respectively. Despite high initial levels of loneliness, both the intervention and control groups exhibited a significant reduction over time, possibly reflecting the students’ adaptability to new social settings. However, wellbeing concerns remained persistent, highlighting that loneliness and wellbeing may require distinct approaches. The peer support intervention did not produce significant improvements, calling for more structured and effective strategies. The study also faced limitations due to low participant engagement, suggesting the need for additional motivational factors to enhance uptake of the peer support intervention.

Examining the Development of Peer Attachment Based on Parental Attachment, and Collaborative Impacts on Mental Health among Japanese Youth

This study aimed at confirming the factor structure of the Japanese version of Inventory of Parent and Peer Attachment (IPPA) for peers. Furthermore, it examined whether or not peer attachment is significantly influenced by father and/or mother attachment, and to see whether father and mother attachment affects mental health directly and/or indirectly via peer attachment for each gender among Japanese youth. The targets of this study were 433 (men: 149, women: 284) Japanese college students who completed every item of the Japanese version of father, mother, and peer IPPAs, as well as Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM) to evaluate their mental health. Confirmatory Factor Analysis (CFA) was conducted to confirm the factor structure of the Japanese version of peer IPPA. Structural Equation Modelling (SEM) was utilized to see whether or not peer attachment is significantly influenced by father and/or mother attachment, and whether or not peer attachment mediates between parental IPPA and mental health. A bi-factor model, constituted by one general factor and three specific factors forming the original IPPA developed by Armsden & Greenberg (1989), was supported by excluding one item from the specific factor Alienation. SEM revealed that the mental health of both male and female respondents was significantly influenced by peer attachment. Among males, its platform was built by attachment only to the father, whereas among females, it was built by both father and mother attachment.

Study protocol for a pragmatic randomised multiple baseline trial evaluating Knowledge Insight Tools (KIT), a cognitive behavioural therapy-informed school-based counselling intervention for children and young people in UK secondary schools with low mood and anxiety.

There is a pressing need to offer more accessible, evidence-based psychological interventions to secondary school students who are increasingly reporting difficulties with anxiety and low mood. The aim of this pragmatic randomised multiple baseline trial is to evaluate the efficacy of a school-based counselling intervention called Knowledge Insight Tools (KIT) for reducing anxiety and low mood in UK secondary school students. KIT is a flexible intervention delivered individually and informed by cognitive behavioural therapy (CBT). We will use a randomised multiple baseline design whereby young people will be randomly allocated to a baseline wait period of 3, 4, 5, 6, 7, or 8 weekly measurements, followed by receiving up to 10 weekly sessions of KIT delivered by trained, school-based practitioners. We aim to recruit 60 young people aged 11-18 who are primarily experiencing problems with low mood and/or anxiety from secondary schools across England and Scotland. We will assess child-reported anxiety, mood, and general psychological distress/coping with the Young Person's Clinical Outcomes in Routine Evaluation (YP-CORE), recorded at each session during the baseline and intervention phases. We will also assess child-reported anxiety and low mood with the Revised Children's Anxiety and Depression Scale (RCADS) at the beginning and end of treatment; practitioner-reported treatment fidelity with the KIT Fidelity Checklist; and practitioner-reported feasibility with an end-of-treatment Implementation Survey. We will analyse within-person and between-person change in YP-CORE scores across the baseline and intervention phases using visual analysis and piecewise multilevel growth curve models. We will also analyse pre-post changes in YP-CORE scores using randomisation tests, and reliable and clinically significant change using the RCADS scores. The KIT trial is a pragmatic, randomised multiple baseline trial aimed at evaluating a school-based, individual CBTcounselling intervention for reducing anxiety and low mood in UK secondary school students. Results will directly inform the provision of KIT in school-based counselling services, as well as the growing evidence-base for school-based CBT interventions. ClinicalTrials.gov NCT06188962. Retrospectively registered on 02/01/24.

Clinical Utility of the CORE-OM and CORE-10

This study explores the clinical utility of the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM), and the Clinical Outcomes in Routine Evaluation–10 (CORE-10). This is an exploratory, naturalistic longitudinal study conducted in two psychotherapy services that offer training for psychology students in Ecuador. These services provide affordable and free short-term psychotherapy based on a constructivist approach. In total, 259 adult clients presenting non-severe mental disorders and symptoms and/or relational problems were included, 147 were women (57%); ages ranged from 18 to 66 with mean 28.70 years. At first contact we collected socio-demographic data and responses to the Clinical Outcomes in Routine Evaluation- Outcome Measure, Outcome Questionnaire-45.2 and the Schwartz Outcome Scale-10-E. Data were analyzed with statistical estimation using bootstrap 95% confidence intervals to assess clinical utility and psychometric adequacy of the measures for similar services and clients. The measures showed good acceptability and adequate internal consistency, similar to findings from the United Kingdom and Spain. There were strong correlations between all scale scores of the CORE-OM except for risk. Adequate convergent validity was found for the CORE-OM with the other two measures. There were no significant gender, age, or education effects for initial scores. Comparing help-seeking and non-help-seeking populations, large effect sizes were found for the CORE-OM total, non-risk, and risk scores, and medium effect size for the CORE-10 scores. Cut-off scores for the CORE-OM and CORE-10 were 1.26 and 1.51, respectively. The measures showed sensitivity to change with large effect sizes for all scores, except for risk, which shows a medium effect size. The CORE-OM and CORE-10 are suitable for clinimetric use, the former for broad assessment of psychological state and the latter for tracking changes in psychotherapy. Recommendations are made for assessment structure designs and data interpretation for routine use particularly in Latin America.

Videoconferencing CBT: a mixed-methods analysis of outcomes amongst young people depending on current self-harm risk status

PurposeA notable number of young people self-harm, with only a minority receiving professional support. Evidence suggests that therapy can help recovery from self-harm, but little is known about the experiences of those who self-harm and participate in therapy delivered via videoconferencing.Design/methodology/approachRisk assessments were examined for evidence of self-harm and used to identify two groups for analysis: young people who had self-harmed in the past six months and those who had not. A mixed methods analysis was then conducted to examine process and outcome data for these two groups. Data included a number of sessions attended, late-cancelled and missed without notice; and patient-reported outcome measure scores (Young Person-Clinical Outcomes in Routine Evaluation and Revised Children’s Anxiety and Depression Scale). End-of-treatment reports were subsequently analysed using thematic analysis.FindingsThose with current self-harm risk appeared to start therapy with lower well-being. No notable differences in progress were found between groups on quantitative outcomes. There was greater reporting of poorer clinical outcomes in the reports of those with current self-harm risk, including two unique types of barriers to effective therapy: “general difficulties” (e.g. poor well-being limiting engagement, specific components of therapy being challenging) and “CBT was not preferred”.Originality/valueLower baseline well-being could explain the greater ongoing care needs and lower well-being post-therapy among those with current self-harm risk, despite both groups appearing to make similar levels of therapeutic progress quantitatively. Recent self-harm does not appear to reduce the utility of videoconferencing cognitive behavioural therapy; however, clients’ individual needs should be carefully considered.

Evaluation of perinatal anxiety assessment measures: a cognitive interview study

BackgroundAnxiety in pregnancy and postpartum is highly prevalent but under-recognised. To identify perinatal anxiety, assessment tools must be acceptable, relevant, and easy to use for women in the perinatal period.MethodsTo determine the acceptability and ease of use of anxiety measures to pregnant or postpartum women (n = 41) we examined five versions of four measures: the Generalised Anxiety Disorder scale (GAD) 2-item and 7-item versions; Whooley questions; Clinical Outcomes in Routine Evaluation (CORE-10); and Stirling Antenatal Anxiety Scale (SAAS). Cognitive interviews were used to examine ease of comprehension, judgement, retrieval and responding.ResultsAll measures were acceptable. Some items were deemed less relevant to the perinatal period e.g., difficulties sleeping. Ease of comprehension, judgement, retrieval and responding varied, with all measures having strengths and weaknesses. The SAAS and CORE-10 had the lowest mean number of problematic components. The GAD had the highest mean number of problematic components​. Non-binary response options were preferred. Preferences for time frames (e.g. one week, one month) varied. Qualitative data provides in-depth information on responses to each measure.ConclusionsFindings can be used to inform clinical guidelines and research on acceptable anxiety assessment in pregnancy and after birth.

Psychometric properties of the Spanish version of the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) in Chile

Objective To examine the psychometric properties of the Spanish version of the 34-item Clinical Outcomes in Routine Evaluation—Outcome Measure questionnaire (CORE-OM). Method Psychometric exploration was conducted in two samples: non-clinical (n = 706) and clinical (n = 420) participants. The non-clinical sample comprised a subgroup of community members (n = 308) and students (n = 398). The clinical sample consisted of self-reported patients (n = 209) and outpatients (n = 211). The analysis included both internal and test-retest reliability, convergent validity, and principal component analysis. A reliable change index and clinical cut-off scores were established for assessing clinically significant change. Results The Spanish CORE-OM demonstrated good internal consistency and test-retest reliability, along with satisfactory convergent validity against the 45-item Outcome Questionnaire (OQ-45.2). There were strong differentiations between the clinical and non-clinical samples and the four sample subsets. The outpatient group reported the highest scores, while the community group exhibited the lowest scores. There were no marked gender effects. All observed patterns aligned closely with the established Spanish referential data. Conclusion Our findings provide support for the utilization of the Spanish CORE-OM as a measure for tracking psychotherapeutic progress in the context of Chile.

Exploring the factor structure of a Chinese version of the CORE-OM: insights from network approach and bifactor modeling

ABSTRACT Objective The Clinical Outcomes in Routine Evaluation (CORE-OM) is a measure of clinical outcomes that has been widely used in mental health research. Nevertheless, the exploration of the factor structure of the CORE-OM yields diverse results. This study aims to explore the factor structure with an innovative method known as exploratory graph analysis (EGA) and supplemented with bifactor modeling. Method A Chinese version of the CORE-OM was administrated to a total of 1361 clinical college students. We first examined the factor structure of the CORE-OM using EGA, and then compared the model derived by EGA with other models using CFA to find the most reasonable model. Results The result of EGA indicated a four-factor model of CORE-OM. The CFA further suggested a bifactor model with a four-factor structure combined with a general factor. The bifactor modeling suggested a significant proportion of shared variance among the variables was attributed to the general factor. The four-factor bifactor model exhibited a satisfactory fit to the data. Conclusion The results confirm the robustness and parsimonious nature of a four-factor bifactor model for the Chinese version of CORE-OM. It is suitable for measuring intrapersonal psychological distress, positive emotions, interpersonal problems, and risk-related issues among the Chinese population.

Evaluating changes in functioning and psychological distress in visitors of the @ease youth mental health walk-in centres.

Highly accessible youth initiatives worldwide aim to prevent worsening of mental health problems, but research into outcomes over time is scarce. This study aimed to evaluate outcomes and support use in 12- to 15-year-old visitors of the @ease mental health walk-in centres, a Dutch initiative offering free counselling by trained and supervised peers. Data of 754 visitors, collected 2018-2022, included psychological distress (Clinical Outcomes in Routine Evaluation 10 (CORE-10)), social and occupational functioning (Social and Occupational Functioning Assessment Scale (SOFAS)), school absenteeism and support use, analysed with change indicators (first to last visit), and mixed models (first three visits). Among return visitors, 50.5% were female, 79.4% were in tertiary education and 36.9% were born outside of The Netherlands (one-time visitors: 64.7%, 72.9% and 41.3%, respectively). Moreover, 29.9% of return visitors presented with suicidal ideations, 97.1% had clinical psychological distress levels, and 64.1% of the latter had no support in the previous 3 months (one-time visitors: 27.2%, 90.7% and 71.1%, respectively). From visit 1 to 3, psychological distress decreased (β = -3.79, 95% CI -5.41 to -2.18; P < 0.001) and social and occupational functioning improved (β = 3.93, 95% CI 0.51-7.36; P = 0.025). Over an average 3.9 visits, 39.6% improved reliably and 28.0% improved clinically significantly on the SOFAS, which was 28.4% and 8.8%, respectively, on the CORE-10, where 43.2% improved in clinical category. Counselling satisfaction was rated 4.5/5. Reductions in psychological distress, improvements in functioning and high counselling satisfaction were found among @ease visitors, forming a basis for future research with a control group.

The Hummingbird Project year 2: decreasing distress and fostering flourishing in a pragmatic pre-post study.

Multi-component Positive Psychology Interventions (mPPIs) in secondary schools have been shown to improve mental health outcomes for young people. The Hummingbird Project mPPI is a six-week program of workshops designed to introduce a variety of positive psychology (PP) concepts to secondary school-aged children in schools to improve well-being, resilience, and hope. The effects on mental distress, however, were not explored. The current study, therefore, was designed to replicate the effects of the Hummingbird Project mPPI on positive mental health and to also explore the effects on symptoms of mental distress. Secondary school-aged children (N = 614; mean age = 11.46 years) from a sample of secondary schools located across the North West of England (N = 7) participated in the study; the majority of children were in Year 7 (94%). The PP concepts explored included happiness, hope, resilience, mindfulness, character strengths, growth mindset, and gratitude. The results showed significant improvements associated with the mPPI in well-being (as measured by the World Health Organization Well-Being Index; WHO-5), hope (as measured by the Children's Hope Scale; CHS), and symptoms of mental distress (as measured by the Young Person's Clinical Outcomes in Routine Evaluation; YP-CORE) from pre- to post-intervention. While acknowledging the limits due to pragmatic concerns regarding the implementation of a control group, the effectiveness of the Hummingbird Project mPPI on well-being was replicated alongside reducing the symptoms of mental distress. Future evaluation, however, will need to implement more robust designs and consider follow-up duration to assess the longer-term effects of the Hummingbird Project mPPI.

An evaluation of survive and thrive: a 10-week group psychoeducational course for adult interpersonal trauma survivors in Scotland

ABSTRACT Emerging evidence supports a phased approach to trauma treatment, including manualised group-based interventions, to facilitate symptom reduction resulting from complex trauma sequelae. This study investigates the efficacy of Survive and Thrive, a 10-week group psychoeducational course for adult survivors of interpersonal trauma. Between August 2019 and February 2022, participants were enrolled on the course. The Clinical Outcomes in Routine Evaluation—Outcome Measure (CORE-OM) and Difficulties in Emotion Regulation Scale—Short Form (DERS-SF) were administered pre-intervention and immediately post-intervention. In addition, thematic analysis was applied to qualitative feedback. Results revealed significant reductions in CORE-OM and DERS-SF scores post-intervention, with minimal variability in scores attributed to group delivery (either face-to-face or online). The thematic analysis demonstrated that normalising trauma symptoms and providing coping skills positively impacted participants’ experiences. At the same time, the breadth and nature of the content were observed to be an occasional barrier to engagement. In summary, this study proposes that group-based psychoeducational interventions are generally effective for those with mild-to-moderate symptoms of complex trauma. However, further evidence is needed to offer more nuanced recommendations for identifying individuals who may benefit the most from these interventions.

The reliability, validity and clinical utility of the Clinical Outcomes in Routine Evaluation – ten-item version (CORE-10) in post-acute patients with stroke

Objective To explore the validity, reliability, and clinical utility of the Clinical Outcomes in Routine Evaluation – ten-item version (CORE-10: a ten-item questionnaire designed to measure psychological distress) in a stroke inpatient sample and calculate reliable and clinically significant change scores. Setting A post-acute stroke rehabilitation ward in the East of England. Participants A total of 53 patients with stroke, capable of completing the CORE-10 as part of their routine clinical assessment. Exclusion criteria included moderate to severe aphasia and/or alexia. Main measures Alongside the CORE-10, the Patient Health Questionnaire – 9, the Hospital Anxiety and Depression Scale, the Centre for Epidemiological Studies-Depression Scale, and the Beck Depression Inventory Second Edition were used as concurrent measures. Results To assess reliability, the internal consistency and test–retest reliability of the CORE-10 were calculated. The average number of days between CORE-10 test–retest administrations was 2.84 (SD = 3.12, Mdn = 1). Concurrent validity was assessed by examining correlations between the CORE-10 and comparable measures, and clinical utility was assessed using the criteria of Burton and Tyson (2015). The internal consistency (Cronbach’s alpha) for the CORE-10 was .80, and test–retest reliability interclass correlation coefficient was .81. Total score correlations between the CORE-10 and concurrent measures ranged from r = .49 to r = .89. The CORE-10 achieved the maximum score (i.e. 6/6) on criteria for clinical utility. Calculations demonstrated a reliable change index of nine points and a clinically significant change cut point of 12 on the CORE-10. Percentiles for CORE-10 total scores are reported. Conclusions This study provides preliminary support for the CORE-10 as a valid and reliable measure that has clinical utility for screening distress in inpatients with stroke.

Psychometric properties of the Chinese version of Young Person’s Clinical Outcomes in Routine Evaluation (YP-CORE)

ABSTRACT In China there is an increasing need for suitable measures to evaluate clinical outcomes in adolescents’ psychological counselling processes. To satisfy this purpose, this study evaluated the Young Person’s Clinical Outcomes in Routine Evaluation (YP-CORE)’s psychometric properties in a Chinese context with two groups: psychiatric outpatients (clinical group: n = 232) and middle-school student controls (non-clinical group: n = 441). All the participants completed the YP-CORE, Strengths and Difficulties Questionnaire (SDQ) and the depression subscale of the Revised Child Anxiety and Depression Scale (RCADS). The results found that the YP-CORE was highly acceptable and reliable with a two-factor solution consistent with original UK model. There were significant differences in mean YP-CORE scores by gender and age band, as well as distinct clinically significant change cut-off points. These findings suggest that the Chinese version of the YP-CORE is psychometrically acceptable for use in Chinese context.

Assessment of perinatal anxiety: diagnostic accuracy of five measures.

Anxiety in pregnancy and after giving birth (the perinatal period) is highly prevalent but under-recognised. Robust methods of assessing perinatal anxiety are essential for services to identify and treat women appropriately. To determine which assessment measures are most psychometrically robust and effective at identifying women with perinatal anxiety (primary objective) and depression (secondary objective). We conducted a prospective longitudinal cohort study of 2243 women who completed five measures of anxiety and depression (Generalized Anxiety Disorder scale (GAD) two- and seven-item versions; Whooley questions; Clinical Outcomes in Routine Evaluation (CORE-10); and Stirling Antenatal Anxiety Scale (SAAS)) during pregnancy (15 weeks, 22 weeks and 31 weeks) and after birth (6 weeks). To assess diagnostic accuracy a sample of 403 participants completed modules of the Mini-International Neuropsychiatric Interview (MINI). The best diagnostic accuracy for anxiety was shown by the CORE-10 and SAAS. The best diagnostic accuracy for depression was shown by the CORE-10, SAAS and Whooley questions, although the SAAS had lower specificity. The same cut-off scores for each measure were optimal for identifying anxiety or depression (SAAS ≥9; CORE-10 ≥9; Whooley ≥1). All measures were psychometrically robust, with good internal consistency, convergent validity and unidimensional factor structure. This study identified robust and effective methods of assessing perinatal anxiety and depression. We recommend using the CORE-10 or SAAS to assess perinatal anxiety and the CORE-10 or Whooley questions to assess depression. The GAD-2 and GAD-7 did not perform as well as other measures and optimal cut-offs were lower than currently recommended.

Evaluating Open Dialogue in Italian mental health services: evidence from a multisite prospective cohort study.

This longitudinal study aimed to quantitatively document and evaluate the implementation and outcomes of the Open Dialogue (OD) approach within Italian Mental Health Departments (MHDs), focusing on the ratings of OD-network meetings by patients and their families and assessing the clinical outcomes over a span of 12 months. Over the course of the study, 58 patients participated in 517 OD-network meetings, demonstrating a high level of satisfaction with the care received, as evidenced by the Session Rating Scale (SRS) and Outcome Rating Scale (ORS). Clinically, significant improvements were observed in the Global Assessment of Functioning (GAF), Clinical Outcomes in Routine Evaluation (CORE-OM), and the Lubben Social Network Scale (LSNS), indicating enhanced psychological and social functioning. The SRS scores showed that satisfaction with the meetings increased over time, while the ORS indicated that both patients and their social networks perceived gradual improvements throughout the therapy. The OD approach within Italian MHDs was successfully implemented and well-received by patients and their social networks, yielding significant clinical improvements. These findings suggest the feasibility and effectiveness of integrating the OD model into the Italian public mental health system, supporting its potential for broader application in diverse healthcare settings. The study highlights the importance of continuous engagement and evaluation to maintain high standards of practice and suggests that OD can be a valuable addition to existing mental health care practices, promoting recovery through inclusive, dialogue-based interventions.

Evaluation of a community-based intervention for youth mental health in rural Ireland.

This study aimed to provide information about pathways to care and clinical response to community-based brief interventions for improving youth mental health through evaluating the Mindspace Mayo service. Participants were 1,184 individuals aged 12-25 years (Mean = 17.92, SD = 2.66) who engaged with the Mindspace service. Demographic information included gender, age and living situation. The Clinical Outcome in Routine Evaluation (CORE) was used to measure psychological distress before and after attending the Mindspace service between February 2015 and 2022. On average, individuals received six sessions of therapeutic support. Analyses indicated that most referrals were made by either a parent (40%) or self-referral (38%). The most frequent reason for referral was mood and anxiety-related issues. Across the entire sample, reductions in CORE scores were both statistically and clinically significant. Neither the source of the referral nor living situation significantly predicted intervention response. Complexity of issues presented at referral significantly predicted a reduction in psychological distress post-intervention in young people aged over 17 years. This study highlighted the value of primary care mental health services for young people aged 12-25 years, and underlined the importance of recording electronic data to track referral pathways, reasons for referral and the intervention outcomes over time.

The mediating role of flourishing on religious faith and psychological distress: a pilot survey

ABSTRACT Flourishing is a growing topic in positive psychology, and the positive influences of flourishing have been well documented. Although recent literature has shown that religion has an impact on one’s physical and psychological well-being in positive ways, the relationship between religiosity and flourishing has surprisingly not been studied. The present study aimed to explore the relationship of religious faith with flourishing and psychological distress. An online survey has successfully recruited 267 participants from UK and Taiwan. The survey used standardised inventories including the PERMA Profiler, the Santa Clara Strength of Religious Faith Questionnaire, and the Clinical Outcome in Routine Evaluation to measure flourishing, religious faith and psychological distress respectively. Results show that participants with strong religious faith do have higher levels of flourishing. Yet Path Analysis shows that participants who have stronger religious faith is indirectly related to lower psychological distress through the mediating effect of flourishing. Suggestions for future research and implications of the findings are discussed.