What is the CORE-OM used for?

The CORE-OM is used to measure global psychological distress in adults entering and moving through psychological therapy. Clinicians administer it at intake, during treatment, and at discharge to gauge severity, monitor change over time, and support decisions about a client's care. It also screens for risk to self and others.

How many items does the CORE-OM have?

The CORE-OM contains 34 items spread across four domains: subjective wellbeing with 4 items, problems and symptoms with 12 items, general functioning with 12 items, and risk to self and others with 6 items. Each item asks how the client has felt over the past week using a five-point scale.

How is the CORE-OM scored?

Add the item responses and divide by the number of completed items to get a mean score from 0 to 4. Multiplying that mean by ten produces a clinical score from 0 to 40, which most services report. Higher scores reflect greater distress, and prorating handles a small number of missing items.

What is the clinical cutoff on the CORE-OM?

A clinical score of 10, equal to a mean of 1.0, is the widely used cutoff separating non-clinical from clinical levels of distress. Scores of 10 and above fall in the clinical range and are banded as mild, moderate, moderate to severe, and severe to guide interpretation and further assessment.

Is the CORE-OM free to use?

The CORE-OM is copyrighted by the CORE System Trust and can be downloaded at no cost under a license you accept before use. The license permits routine clinical use but prohibits altering the wording or format of the questionnaire. Always confirm the current terms directly with the CORE System Trust.

How often should the CORE-OM be administered?

The CORE-OM is designed for repeated use, typically at the first session, at intervals during therapy, and at the final session. Regular administration lets clinicians track whether distress is improving and quantify change. The shorter CORE-10 is often used for frequent session-by-session monitoring between fuller CORE-OM assessments.

CORE-OM Outcome Measure | Template & auto-scoring

The CORE-OM (Clinical Outcomes in Routine Evaluation, Outcome Measure) is a 34-item self-report questionnaire that measures global psychological distress in adults. Covering subjective wellbeing, problems and symptoms, general functioning, and risk to self and others, it gives clinicians a broad snapshot of a client's distress at intake and tracks change across a course of therapy.

Why healthcare providers use the CORE-OM

Pan-theoretical measure. It is not tied to a single diagnosis or model, so it works across therapeutic approaches and client presentations.
Tracks change over time. The measure is built for repeated administration, so clinicians can quantify treatment response session by session.
Captures risk. A dedicated risk domain surfaces thoughts of self-harm and harm to others so concerns are not missed.
Broad coverage. It reaches beyond symptoms to include wellbeing and everyday functioning, giving a fuller picture of distress.
Widely validated. Extensive normative and psychometric data support interpretation and comparison against general population benchmarks.

Which settings use the CORE-OM?

Psychotherapy and counselling services. Practitioners use it as a routine outcome measure at the start and end of therapy.
Primary care talking therapies. Stepped-care and NHS talking therapies programs use it to measure recovery across large caseloads.
University and student counselling. Campus services adopt it to monitor distress and demonstrate outcomes in young adult populations.
Community mental health teams. Multidisciplinary teams use it to track distress and risk alongside other assessments.

What does the CORE-OM measure?

The CORE-OM measures the severity of psychological distress over the past week across four domains. Because the questionnaire is copyrighted, the domains are described here rather than reproduced. The domains combine into a single global distress score that clinicians interpret alongside the risk items.

Subjective wellbeing. Four items covering general sense of wellbeing and optimism.
Problems and symptoms. Twelve items covering anxiety, depression, physical problems, and trauma-related distress.
General functioning. Twelve items covering close relationships, social functioning, and day-to-day coping.
Risk to self and others. Six items covering thoughts and behaviors related to self-harm and harm to others.

Scoring the CORE-OM

Number of items: 34 items across four domains.
Per-item scale: each item is rated 0 to 4, from not at all to most or all of the time.
Total score range: the mean all-items score runs 0 to 4; multiplied by ten it becomes a clinical score of 0 to 40.
Score direction: higher scores indicate greater psychological distress.

Scores guide clinical decision-making and do not replace clinical judgment. The bands below use clinical scores (mean multiplied by ten), where a score of 10 marks the recognized clinical cutoff. Interpret any score alongside the risk items and the client's wider context, and consider further assessment where indicated.

Score	Interpretation	Suggested next step
0 to 4	Healthy	Monitor
5 to 9	Low level, below clinical cutoff	Watchful waiting
10 to 14	Mild	Consider further assessment
15 to 19	Moderate	Consider further assessment
20 to 24	Moderate to severe	Consider further assessment
25 to 40	Severe	Consider further assessment or prompt review

Best practices for administration

Administer at the first session to set a baseline, then repeat at regular intervals and at discharge.
Ask the client to answer every item, since a high number of omissions makes the score less reliable.
Always review the risk items directly rather than relying on the global score alone.
Keep the wording and format unchanged to stay within the CORE System Trust license.
Share results with the client to support collaborative discussion of progress and next steps.

How Zentake helps with the CORE-OM

Automatic scoring. Zentake calculates the mean and clinical scores on submit, so there is no hand-tallying.
Longitudinal tracking. Re-send the measure on a schedule and view change over time across a course of therapy.
Risk flagging. Concerning responses on the risk items are surfaced to staff for review.
Before the visit. Patients at mental health practices complete the measure from home on any device.
HIPAA compliant. Responses are encrypted, with a signed BAA on every plan.

References

Evans, C., Connell, J., Barkham, M., et al. (2002). Towards a standardised brief outcome measure: psychometric properties and utility of the CORE-OM. British Journal of Psychiatry, 180, 51 to 60. Instrument details and licensing are provided by the CORE System Trust.

Clinical cutoff and severity band data draw on Connell, J., Barkham, M., et al. (2007), Distribution of CORE-OM scores in a general population, clinical cut-off points, British Journal of Psychiatry, 190, 69 to 74.

Last updated: August 2026

CORE-OM Outcome Measure