Chris EvansUniversidad de Las Américas | UDLA · Department of Psychology
Chris Evans
MRCPsych, MSc, MInstGA
If contacting me, please use Email to chris@psyctc.org.
About
243
Publications
199,682
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Introduction
In 2016 I finished a 32 year clinical career in psychiatry/psychotherapy and marked that by cycling from London to Compostela. That started my personal web site: www.psyctc.org/pelerinage2016/.
My research includes the CORE system (www.coresystemtrust.org.uk/) but many other topics too: www.psyctc.org/psyctc/. I am now a freelance researcher with a visiting chair in the excellent Universidad de Las Américas in Quito, Ecuador and have collaborations in many countries.
Additional affiliations
November 2005 - March 2021
April 2001 - present
CORE System Trust
Position
- Trustee
Description
- In am one of the three trustees in CST which is now an informal association supporting the use of the CORE instruments. See http://www.coresystemtrust.org.uk/ for details and to download the instruments.
January 1998 - March 2003
Publications
Publications (243)
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 provid...
At some point in my 20s, as a naïve trainee in psychiatry, I discovered the word "shibboleth" and its origins as a word that allows one group to identify another group as an outsider group. The wikipedia article (https://en.wikipedia.org/wiki/Shibboleth) is a chilling reminder of what a terrible species homo sapiens can be when dividing into in and...
Psychotherapists’ attitudes and expectations towards routine outcome monitoring can impact the likelihood of its fruitful implementation. While existing studies have predominantly focused on Europe and North America, research in Latin America remains limited. The aim of this study is to explore therapists’ expected benefits and difficulties prior t...
Introduction Data-informed psychotherapy and routine outcome monitoring are growing as referents in psychotherapy research and practice. In Ecuador, standardised web-based routine outcome monitoring systems have not been used yet, precluding data-driven clinical decisions and service management. Hence, this project aims at fostering and disseminati...
Most of the studies about mental health and quality of life of emerging adults have been conducted in developed countries and non-students’ population has been neglected, limiting the generalisation of the results to other socioeconomic realities. This paper reports the results of an observational study on differences between the two cohorts (stude...
Psychological research often seeks general rules applying across individuals, an aim that is in tension with examining that which is unique to any individual. There are general statistical regularities across individuals’ subjective self-report which enable much psychology and psychotherapy research to combine data from self-report questionnaire re...
ABSTRACT
Objective: To present the training and care model used in a university psychological care centre and its outcomes, framed in the Practice-Based Evidence paradigm. Methods: Naturalistic study on the results of 161 clients seen between 2018 and 2020 who completed the Clinical Outcomes in Routine Evaluation — Outcome Measure. Statistically si...
The paper is in both English and Spanish. Contact me if you want the full text. Here are the abstracts:
Over the last 30 years we have seen two models of empirical evidence dominate funding for psychotherapies and for researching the psychotherapies. The first, still the dominant model, ‘Evidence-Based Practice (EBP)’ is based on Randomized Control...
Introduction
Clients with Eating Disorders may be treated as inpatients (IP), day hospital (DH) or community patients (Ambu). The ITAMITED study is following to treatment termination (or end of October 2025) all new clients with EDs presenting between November 2017 and October 2020 to eight centres in Spain.
Objectives
To describe to what extent i...
Introduction
A major revolution in psychiatry since the late 20th and early 21st Century has sought to put the individual client at the heart of intervention, promoting shared decision making. Increasing use of patient reported outcome measures (PROMs) to evaluate interventions and even steer therapies (“power assisted steering for psychotherapy”,...
Objective
Body image is defined as the perception of one's own body. While positive body image has a positive impact on quality of life, self-dissatisfaction may lead to depression, anxiety and low self-esteem. Body image might be quantified and evaluated: relevant instruments include the Body Shape Questionnaire (BSQ) and the Functionality Appreci...
Introduction
Emerging adulthood is a period of instability with changes in personal relationships and often a series of job changes before life trajectories clarify and more lasting decisions are possible. These changes often produce distress, and they might explain why most of the symptoms that impact the individual’s mental health throughout thei...
Bereaved people frequently report perceiving the continued presence of the person they lost in the form of a voice, a vision, a felt presence or any other sensory perception. This report explores this psychological phenomenon, experiences of presence, using narrative interviewing and analysis. Ten people were interviewed, in English or Spanish, usi...
As SAGE say: "This book sets in context the role of outcome measurement research - taking you step-by-step through the research process and beyond to consider the wider professional and ethical issues involved. This book will provide you with everything you need to know and more, helping you develop the skills and knowledge you need to become a suc...
The present study aimed to examine changes in mental distress in Brazilian university workers during the pandemic. All workers (n ≃ 1850) of an institution were invited to respond to a survey that took place in three stages, with collections in May (n = 407), June/July (n = 258), and August (n = 207) 2020, and included questions on demographic, hea...
There is an increasing need of outcome measures for young people suitable to evaluate treatments and routine settings. However, measures must show suitable psychometric characteristics for such use. This is the first psychometric evaluation of the Italian version of the Core Young Person Clinical Outcomes in Routine Evaluation (YP-CORE). Data are r...
The literature on measure translation tends to hold, overtly or covertly, a questionable assumption about the possibility of exact translation and almost completely ignores issues of within language variation. Equally, psychometric methods used to assess cross-cultural validity after translation focus on large sample tests of cross-sectional measur...
The aim of the present study was to compare scores from the English and the Spanish versions of two well-known measures of psychological distress using a within-subject approach. This method involved bilingual participants completing both measures in four conditions. For two groups of people, measures were offered in the same language both times an...
Background: Body image can be defined as individual perception of own body and related behaviors. Body dissatisfaction may lead to low self-esteem, depression and anxiety. Body image can be evaluated and quantified. Among various number of instruments assessing body image, there are: Body Shape Questionnaire-34 (BSQ-34) and Functionality Appreciati...
One of the key challenges that counsellors and psychotherapists may now find themselves encountering is that of working with clients whose native language is not English. This is of particular importance when using psychological assessment tools published in English to ascertain difficulties in a client's native language and utilising these tools t...
Introduction
Eating disorders (EDs) are complex pathologies which require equally complex treatment strategies. These strategies should be multidisciplinary, personalised interventions, performed in appropriate settings along a healthcare continuum from inpatient to community care. Personalisation, and the complexity of levels of care and intervent...
The study aimed to explore mental distress during COVID-19 quarantine in a sample of university workers in Brazil. The survey included sets of questions about demographics, health, and support, an open question about major concerns, and the Clinical Outcome Routine Evaluation (CORE-OM), a measure of mental distress. A total of 407 professionals, me...
This study is part of a larger exploration of ‘talk and cure’ that combines the examination of talk-in-interaction with nonverbal displays and measurements of the client’s and therapist’s autonomic arousal during therapy sessions. A key assumption of the study is that psychotherapy entails processes of intersubjective meaning-making that occur acro...
Mass crises are disruptive to people's mental health. The study aimed to explore mental distress during COVID-19 quarantine in a sample of university workers in Brazil. The survey included sets of questions about demographics, health, and support, an open question about major concerns, and the Clinical Outcome Routine Evaluation (CORE-OM), a measur...
Experiencing the continued presence of the deceased is common among the bereaved, whether as a sensory perception or as a felt presence, and has been increasingly researched from psychological and psychiatric perspectives during the last five decades. Such experiences have been also documented in the ethnographic literature but, despite the extensi...
The Schwartz Outcome Scale-10 is a 10-item measure that has proven utility for assessing well-being and mental health and measuring change over time. Although there is a Spanish translation of the measure created in the United States for the Latino population, its acceptability and psychometric properties have not been studied in unilingual Spanish...
Background:
The Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) is a pan-theoretical and pan-diagnostic measure of mental health designed to cover issues that people wish to change in psychotherapy. The objective of this study was to explore the psychometric properties of the Spanish translation of the CORE-OM, in a country, Ecua...
The complexity of Eating Disorders (EDs) generates high personal and economic costs to patients, families, and the society. Various treatments have shown some effectiveness in EDs 1 , but outcomes are still far from satisfactory. Clinical guidelines have mainly relied on controlled efficacy studies to strengthen internal validity, compromising the...
This paper describes three linked reactions to the COVID-19 pandemic, a mix of pragmatic change and reflection that can be seen as action research. Our case studies, stories, come from the UK, Spain and Ecuador and describe three different but overlapping actions all focused on making available or using online questionnaires and drawing on counsell...
Objectives
Experiences of presence, involving the sensory perception or felt presence of the deceased, are common amongst the bereaved (30–60%). Despite them being predominantly comforting and reassuring, a minority (approximately 25%) report ambivalent or distressing experiences. The study’s aim was to explore how psychotherapy is practised with t...
Objective: To conduct a scoping review of measure utilization in Latin America. We relate the findings to the needs of the region and give recommendations for measure usage in LA.
Methods: Six electronic databases (PubMed, Web of Science, CINAHL, PsychInfo, SCOPUS, and SCIELO) were searched to identify peer-reviewed literature. In total, 207 studie...
Psykologia, 54(4), 274-287. The 10-item version of the Clinical Outcomes in Routine Evaluation (CORE-10) is a generic, short measure of psychological distress. The purpose of the present study was to examine psychometric properties of the Finnish version of the CORE-10 and establish clinical cut-off scores for psychological distress, anxiousness, a...
Aim
To explore the constructions users of mental health services have of outcome and change measures, contrasting those of hospital psychiatric patients with psychotic experiences versus psychotherapy clients in private practice who have not had psychotic experiences.
Method
Twenty‐four participants, 12 from each setting, were interviewed about th...
Latin American mental health services are moving from the psychiatric hospital model to a community-based model. The effectiveness of these new services needs to be evaluated and that can be done through routine outcome monitoring. The present communication introduces the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM), a free i...
Depression is one of the main reasons for youth accessing mental health services, yet we know little about how symptoms change once youth are in routine care. This study used multilevel modeling to examine the average trajectory of change and the factors associated with change in depressive symptoms in a large sample of youth seen in routine mental...
To develop the Chinese version of Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) and examine its psychometric properties, we investigated a sample of 689 non-clinical and 309 clinical participants and found this measurement had good acceptability, internal reliability, test-retest reliability and convergent validity; it had moder...
Aims:
1) Describe the challenges and success implementing comprehensive data in a complex multicentre psycotherapy centered service.
2) From the Y1 baseline data to present a comprehensive picture of the state of clients entering integrated treatments mainly for Eating Disorders (ED).
3) Analyse the psychometrics of the self-report measures notin...
La marcada complejidad de los Trastornos de la Conducta Alimentaria (TCA) requiere consecuentemente programas de tratamiento altamente complejos. Estos deben garantizar la continuidad asistencial a través de diferentes dispositivos coordinados, ser suficientemente personalizados y flexibles y combinar diferentes componentes terapéuticos. 325 pacien...
Desde finales del siglo XX la práctica basada en la evidencia ha sido el paradigma de referencia para establecer la eficacia de los tratamientos sin que ello estuviera exento de controversia. Algunos autores cuestionan seguir un modelo de investigación médico que tiene limitaciones importantes al aplicarse a la investigación en psicoterapia. Por ot...
Aim. To describe the challenges and success in implementing comprehensive data collection. To learn from the first year of data collection, focusing mainly on the baseline data as many clients are in continuing therapy and present a comprehensive picture of the state of patients entering integrated treatments for Eating Disorders (ED). To analyse a...
Objective:
The Relational Depth Frequency Scale (RDFS) was developed to measure the frequency of specific moments of profound contact and engagement in psychotherapy.
Method:
Following an initial process of item generation and rating, Three-Step Test Interviews were conducted with eight therapists and clients to further refine potential items. S...
Background
There is paucity in availability of valid and reliable measures of psychopathology that can be routinely applied with an intellectual disability (ID) population in clinical practice. The psychometric properties of the Clinical Outcome Routine Evaluation‐Learning Disabilities 30‐Item version (CORE‐LD30) are examined.
Method
The CORE‐LD30...
Background There is paucity in availability of valid and reliable measures of psychopathology that can be routinely applied with an ID population in clinical practice. The psychometric properties of the Clinical Outcome Routine Evaluation-Learning Disabilities 30-Item version (CORE-LD30) are examined. Method The CORE-LD30 was administered to 271 se...
Introduction:
Given the increasing prevalence of mental health problems in the general population, it is indispensable to use assessment tools aimed to assess the outcome of therapeutic interventions in order to refine the process of psychological rehabilitation.
Method:
We describe the process of adaptation into Spanish and a first psychometric...
Background
Life events are recognised to link low socio‐economic status ( SES ) with impaired mental health. Despite attention to patients’ historical environmental circumstances in psychotherapeutic practice, events that occur over the course of counselling and psychotherapy (‘intercurrent’ events) seem to have received little attention in researc...
Introducción. Ante la creciente prevalencia de proble-mas de salud mental en la población general, resulta impres-cindible el uso de instrumentos de evaluación destinados a evaluar el resultado de las intervenciones terapéuticas, con el fin de facilitar el proceso de rehabilitación psicológica.
Metodología. Se expone el proceso de adaptación al es...
Objectives:
To raise awareness and propose a good practice guide for translating and adapting any hearing-related questionnaire to be used for comparisons across populations divided by language or culture, and to encourage investigators to publish detailed steps.
Design:
From a synthesis of existing guidelines, we propose important consideration...
The Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) is a 34-item self-report measure designed to monitor changes in psychiatric patients. It has been translated into 25 languages, including Finnish. This is the first psychometric exploration of Finnish CORE-OM data. The aim of the study is to examine acceptability, internal consis...
Objective To raise awareness and propose a good practice guide for translating and adapting any questionnaire to be used for comparisons across populations divided by language or culture.Design Relevant methodological literature across ENT/Audiology and other healthcare fields was reviewed. The collective experience from the authors, members of the...
Background: An increasing need exists for suitable measures to evaluate treatment outcome in adolescents. YP-CORE is a pan-theoretical brief questionnaire developed for this purpose, but it lacks studies in different cultures or languages.
Aims: To explore the acceptability, factor structure, reliability, validity, and sensitivity to change of the...
Given the increasing prevalence of mental health problems in the general population, it is necessary to use assessment tools aimed at collecting psychological information of the person, (re)designing appropriate therapeutic interventions, and ultimately promoting adequate psychological rehabilitation. For that purpose, the Young Person’s – Clinical...
Objective
The objective of this paper is to assess the reliability and validity of the Spanish translation of the Clinical Outcomes in Routine Evaluation – Outcome Measure, a 34-item self-report questionnaire that measures the client’s status in the domains of Subjective well-being, Problems/Symptoms, Life functioning, and Risk.
Method
Six hundred...
Introduction:
The Clinical Outcome in Routine Evaluation - Outcome Measurement (CORE-OM) was developed in the 1990s, with the aim of assessing the efficacy and effectiveness of mental health treatments.
Objective:
To adapt the CORE-OM for use in the Brazilian population.
Method:
The instrument was translated and adapted based on the international...
Background:
Many outcome measures for young people exist, but the choices for services are limited when seeking measures that (a) are free to use in both paper and electronic format, and (b) have evidence of good psychometric properties.
Method:
Data on the Young Person's Clinical Outcomes in Routine Evaluation (YP-CORE), completed by young peop...
Pharmacotherapy and psychotherapy are the two dominant mental health treatment modalities, but they are often taught and practised very separately leading to polarisation which may fragment treatment delivery. This paper presents results from a small qualitative study of interfaces between these modalities as described by medical and non-medical pr...
Background:
The development of transdiagnostic standardized measures of psychological distress have contributed to the development of practice-based evidence networks. The translation and validation of such measures cross culturally is important if such research is to be generalized across health care systems in different countries.
Method:
Tran...
The validity and utility of psychiatric diagnoses have long been a bone of contention between and within different professional and patient groups. This was clearly shown by the nearly 70 rapid responses to a 2001 BMJ article that proposed that post-traumatic stress disorder was a social construct
The Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM) is a scale designed as a multi-theoretical and multi-diagnostic measure of general psychological distress. It can be used at all levels of psychological care, from triage to monitoring the effects of psychotherapy.
The aim of this study was to assess the psychometric properties...
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Aim: This article gives an overview of the setting up of the Art Therapy Practice Research Network (ATPRN) in 2000, amidst a culture resistant to research. The authors discuss their experiences in changing this culture and encouraging art therapists to become practitioner/researchers. They identify learning points that may be helpful for other prof...
Aims and method To explore experiences of psychiatrists considering medication for patients with personality disorder by analysis of transcribed, semi-structured interviews with consultants.
Results Themes show important relational processes in which not prescribing is expected to be experienced as uncaring rejection, and psychiatrists felt helples...
Background:
Assessments of personality disorder (PD) by clinicians or researchers are not always congruent with the problems that clients view as most salient. This can result in disagreement over areas for change, leading to dissatisfaction and the risk of treatment attrition.
Method:
The sample comprised 141 treatment-seeking adults with PD. E...
Previous research has argued that the mental well-being of d/Deaf people is poorer than that of hearing populations. However, there is a paucity of valid and reliable mental health instruments in sign language that have been normalised with d/Deaf populations. The aim of this study was to determine the reliability of the Clinical Outcomes in Routin...
The SCORE index of family functioning and change is an established measure, with strong psychometric properties, of the quality of family life. We report the sensitivity to therapeutic change of the short form, the SCORE ‐15. Data are reported from 584 participants aged above 11 years, representing 239 families. All couples and families had been re...
We are broadly in agreement with the thrust of Dr Das’s analysis. In our original article, we cited Arthur Kleinman’s call for ‘medicine in general’ to go beyond a technicalised understanding of ‘caregiving’ and we also noted the resonance between our position and that of Iona Heath in relation to general practice.
We agree entirely that ‘an active...
Abstract
In recent years cognitive therapy has become increasingly popular as a
treatment for many forms of mental illness. This therapy is presented as
scientific, rational and relatively easy to learn and use. In this paper we seek to demonstrate the particular philosophy of mind at work within the cognitivist framework and the ethical assumptio...
Background
The Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM) is a 34-item instrument developed to monitor clinically significant change in out-patients. The CORE-OM covers four domains: well-being, problems/symptoms, functioning and risk, and sums up in two total scores: the mean of All items, and the mean of All non-risk item...
Background: There is a need for a generic, short, and easy-to-use assessment measure for common presentations of psychological distress in UK primary care mental health settings. This paper sets out the development of the CORE-10 in response to this need. Method: Items were drawn from the CORE-OM and 10 items were selected according to a combinatio...
Una serie de editoriales en este documento han argumentado que la psiquiatria esta en medio de una crisis. Las varias soluciones propuestas estarian todas involucradas en el fortalecimiento de la identidad de la psiquiatria como esencialmente "neurociencia aplicada" Aunque sin descontar la importancia de las ciencias del cerebro y la psicofarmacolo...
Purpose
The purpose of this paper is to establish staff and patient opinions on the acceptability, feasibility, and utility of using the Clinical Outcomes in Routine Evaluations – Outcome Measure (CORE‐OM) in secure hospitals.
Design/methodology/approach
Patients and nurses (male patients and their key workers) from high, medium and low secure hos...
This article discusses translation issues arising during the production of a British Sign Language (BSL) version of the psychological
outcome measure “Clinical Outcomes in Routine Evaluation–Outcome Measure” (CORE-OM). The process included forward translation,
meeting with a team of translators, producing a second draft of the BSL version and back...