Can you measure counselling?
What does it mean to measure counselling?
Measuring the outcome of a course of counselling is extremely complicated, varied, and personal process. Through my research I have learned that it is important first to have a clear goal when administering an outcome measure survey to understand how it can benefit the counsellor/client relationship. Unfortunately, sometimes the goal is bureaucratic and needs to justify funding or services. This reason feels false to me and I worry will lead to unclear, forced responses that do not give a clear and accurate picture of the counselling process.
How do you measure counselling?
I have taken some time to review and critique four common outcome-based measures: CORE-10, WEMWBS, PHQ-9 and PSYCHLOPS and reflect on their relevance to practicing effective counselling. I’ll spread this out over a few posts, so for now, we’ll just take a look at the CORE 10 form, which is quite popular. These are all Practise-Based Evidence outcome measures which are ‘studies which use pre- and post- measures to look at the effects of an intervention in a particular client group, without the use of a control/comparison group.’ (Roth, 2013). According to the BACP, these (among others) have a statistically proven track record of ‘Reliable post-intervention improvement for counselling in three quarters of clients, and demonstrated person-centred counselling to be an effective intervention for clients with common mental health problems’ (Roth, 2013).
CORE-10
The CORE outcome measure (CORE-10) is ‘a session by session monitoring tool with items covering anxiety, depression, trauma, physical problems, functioning and risk to self. The measure has six high intensity/ severity and four low intensity/ severity items.’ (corc.uk.net). It seems that the largest reason this measure is used is that it draws on items that tap a broader range of activities, in particular, the area of functioning and relationships (Barkham, 2013 p.10). For use in a large system such as the NHS, the widest net must be cast, and the CORE-10 does this well.
According to Barkham, the CORE-10 has a fairly simple psychometric structure, and has broad coverage not only of depression and anxiety but of a wider spread of problems including general, social, and close relationships as well as risk to self (Barkham, 2013 p.9). The research supports the idea that this outcome measure is reliable and relevant to counselling practise as it can be used with a wide variety of client problems and measures the impact of psychological problems, not just that a problem exists.
How do I use measures in my counselling practice?
In conclusion, I would ideally prefer not to use an outcome measure at all with clients. I believe they are so flawed and that each client and situation is so different and constantly changing, that measuring anything is impossible. In my own experience of being a client – 10 years from when I was 18 – I know that there is always something to learn about oneself if you are willing to explore. This means that counselling could always have an impact and, in my experience,, that impact is always changing with age, time, environment, and so much more that although there may have been a deemed successful outcome in previous therapy, it doesn’t mean there can’t be others and that you are done with benefiting from therapy.
