Basic Research Tools

This chapter introduces a wide range of process and outcome measures that are used in therapy research. It is important to know about these tools both in relation to understanding research articles that you come across, and in terms of considering them as potential resources in your own research or practice.

The following table provides links to some widely-used open-access research tools. When reflecting on your experience of completing measures, consider the following questions:

  • in what ways do different measures focus on different aspects of outcome and process – what are the implications of this for findings of research that uses these tools?
  • how might the experience of completing a measure influence the client in terms of thinking about themselves in a particular way – and how might this have an effect on therapy as well as on research findings?
  • what is not being measured, that might be important?
  • what is the heuristic value of the measure? To what extent does it have the potential to generate information that could usefully feed into the process of therapy, or provide the client with a valuable episode of learning and self-reflection?
  • what are the time/resources implications of each measure?

Outcome measures

Instrument

Factors assessed

Internet source

CORE outcome measures (5, 10 or 34 items)

Overall level of psychological difficulties

Detailed information and licensing: http://www.coreims.co.uk/

Copy of CORE-OM (34 item version):

https://www.coresystemtrust.org.uk/instruments/core-om-information/

Outcome Rating Scale (ORS; 4 items)

Global psychological difficulties

https://scott-d-miller-ph-d.myshopify.com/collections/performance-metrics/products/performance-metrics-licenses-for-the-ors-and-srs

Free licence for individual practitioners following registration

PHQ-9 (9 items)

Depression

https://www.corc.uk.net/outcome-experience-measures/patient-health-quest...

GAD 7 (7 items)

Generalized Anxiety Disorder

https://adaa.org/sites/default/files/GAD-7_Anxiety-updated_0.pdf

Hospital Anxiety and Depression Scale (HADS)

Overall difficulties – anxiety and depression subscales

https://www.svri.org/sites/default/files/attachments/2016-01-13/HADS.pdf

PSYCHLOPS

Individualised measure

http://www.psychlops.org.uk

Change Interview

Client’ experience of change

http://www.drbrianrodgers.com/research/client-change-interview

Goals measure

 

https://pluralisticpractice.com/tools-and-measures/

Strathclyde Inventory

Person-centred, experiential outcome measure

On-line measure:

https://therapymeetsnumbers.com/strathclyde-inventory/

Further information:

https://pureportal.strath.ac.uk/en/studentTheses/the-strathclyde-invento...

 

Process measures

Instrument

Factors assessed

Internet source

Helpful Aspects of Therapy (HAT) Form

Open-ended descriptions and ratings of most/least helpful events in session

http://wwwdata.unibg.it/dati/corsi/64031/65316-HAT%203.2reg.pdf

Working Alliance Inventory – short form

12-item scale: client-therapist agreement around bond, goals and tasks and overall quality of alliance

https://wai.profhorvath.com/downloads

Cooper-Norcross client preference scale

 

https://pluralisticpractice.com/tools-and-measures/

Session Evaluation Questionnaire

21 items: depth, smoothness, positivity, arousal

http://www.users.muohio.edu/stileswb/

Relational Depth Frequency Scale

 

https://pluralisticpractice.com/wp-content/uploads/2019/06/RDFS-C.pdf

Session Rating Scale (SRS)

Global satisfaction with session

https://scott-d-miller-ph-d.myshopify.com/collections/performance-metrics/products/performance-metrics-licenses-for-the-ors-and-srs

Free licence for individual practitioners following registration

Agnew Relationship Measure

Quality of therapy relationship

https://novopsych.com.au/assessments/feedback-informed/agnew-relationshi...

Barrett-Lennard Relationship Inventory

Empathy, congruence, willingness to be known, warmth

https://onlinelibrary.wiley.com/doi/pdf/10.1002/9781118789070.app1

Geller Therapeutic Presence scale

 

Copy of scale: https://www.sharigeller.ca/_images/pdfs/Therapeutic_Presence_Inventory_Client_copyright.pdf

 

Further information:

https://www.sharigeller.ca/publications.php

Articles on pros and cons of different research tools

Sales, C. M., Neves, I. T., Alves, P. G., & Ashworth, M. (2018). Capturing and missing the patient's story through outcome measures: A thematic comparison of patient‐generated items in PSYCHLOPS with CORE‐OM and PHQ‐9. Health Expectations, 21(3), 615–619.

One of the major debates within this field has been the use of standard fixed tools such as CORE and PHQ, as against individualised measures that are grounded in the client’s definition of their problems

Galasiński, D. (2008). Constructions of the self in interaction with the Beck Depression Inventory. Health,12, 515–533.

Looks in depth at the client experience of completing a widely-used symptom measure

Malpass, A., Dowrick, C., Gilbody, S., Robinson, J., Wiles, N., Duffy, L., & Lewis, G. (2016) Usefulness of PHQ-9 in primary care to determine meaningful symptoms of low mood: a qualitative study. British Journal of General Practice, 66(643), e78–e84.

Looks in depth at the client experience of completing a different widely-used symptom measure

Topic for reflection and discussion

The importance of conversations about tools. As you explore the world of therapy measures, scales and forms, keep in mind that most researchers and practitioners tend to specialise in a subset of measures that they get to know well, and that serve their own particular purposes. The more you use a measure, the more you will understand what it can and cannot do.

In order to deepen your familiarity and depth of knowledge around a measure it can be useful to share experience with other researchers and therapists who use it. At the same time, it is important to continue to extent your tool horizon, by learning about further measures and similarly discussing them with colleagues. Once you have gained confidence and competence around at least a couple of tools, it becomes easier to expand your repertoire because you are able to compare new instruments to your existing baseline knowledge and criteria. People in other occupations – doctors, plumbers, IT specialists – are forever sharing notes about new tools. Therapists and therapy researchers do this much less often, and miss out on not being able to access a massive reservoir of practical knowledge.