Clinical Outcomes in Routine Evaluation (CORE-10)
Brief 10-item measure of psychological distress, built for session-by-session outcome monitoring.
Last reviewed: May 2026
The CORE-10 is a brief, 10-item measure of common psychological distress, developed by Barkham and colleagues (2013) as a short form of the CORE-OM. It samples anxiety, depression, trauma, physical problems, functioning and risk over the past week, and is designed for repeated, session-by-session use to track how a client is responding to therapy.
Scoring & Interpretation
Each of the 10 items is rated 0 (not at all) to 4 (most or all of the time) over the past week, giving a total score of 0–40. A clinical cut-off of 11 distinguishes clinical from non-clinical levels of distress. The total maps onto the same severity bands as the CORE-OM clinical score, and a change of around 6 points is considered reliable. The risk item is interpreted on its own as well as within the total.
| Score Range | Severity | Clinical Action |
|---|---|---|
| 0–5 | Healthy | Below clinical range — no distress indicated |
| 6–10 | Low | Subclinical distress — monitor over time |
| 11–14 | Mild | At or above the clinical cut-off (11) — clinical distress |
| 15–19 | Moderate | Clinical range — active intervention indicated |
| 20–24 | Moderate-to-severe | High distress — prioritise and review supports |
| 25–40 | Severe | Severe distress — review risk and intensity of care |
Internal consistency is high (Cronbach’s α ≈ 0.90) and the CORE-10 correlates very strongly with the full CORE-OM (r ≈ 0.94). It is sensitive to change across therapy, with a clinical cut-off of 11 and a reliable change index of approximately 6 points (Barkham et al., 2013).
When to Use This vs Alternatives
Use CORE-OM when…
You want the full 34-item, four-domain picture — wellbeing, problems, functioning and risk — for a baseline assessment or formal review. Many counsellors use CORE-OM at intake and review, and CORE-10 for the check-ins in between.
View CORE-OM →Use Relationship Health Profile when…
The presenting issue is relational. The RHP is a couples battery comparing both partners across satisfaction, communication and trust, rather than tracking one client’s distress over time.
View Relationship Health Profile →See It in Action
- 1CORE-10 total scored the moment your client submits
- 2Clinical-range bands with the cut-off of 11 marked
- 3Distress charted across every recurring check-in
- 4Risk item surfaced for review on its own
What It Measures
The CORE-10 is a brief, 10-item measure of common psychological distress, developed by Barkham and colleagues (2013) as a short form of the CORE-OM. It samples anxiety, depression, trauma, physical problems, functioning and risk over the past week, and is designed for repeated, session-by-session use to track how a client is responding to therapy.
When to Use the CORE-10
Use the CORE-10 as a routine outcome measure — at intake to establish a baseline, then re-administered each session or on a regular schedule to chart change over time. It is brief enough to complete in the waiting room or between sessions, which makes it practical for the recurring check-ins that routine outcome monitoring depends on. Pair it with a fuller measure such as the CORE-OM at assessment and review.
Who It's For
Adults aged 18+ across counselling, psychotherapy and primary-care settings. Self-report — the client completes it themselves. The Young Person’s CORE (YP-CORE) is the equivalent for ages 11–16. Item 6 asks about thoughts of ending one’s life, so any non-zero response should be reviewed for risk regardless of the total.
Frequently Asked Questions
What is the CORE-10?
The CORE-10 is a brief, 10-item self-report measure of psychological distress, developed by Barkham and colleagues in 2013 as a short form of the CORE-OM. It covers anxiety, depression, trauma, physical problems, functioning and risk over the past week, and is designed for session-by-session outcome monitoring.
What is the CORE-10 cut-off score?
Each item is scored 0 to 4, giving a total of 0–40. A score of 11 or above is the clinical cut-off — it indicates clinical levels of distress. A change of around 6 points between administrations is considered reliable. Item 6 (risk to self) is reviewed on its own regardless of the total.
Is the CORE-10 free to use?
Yes. The CORE-10 and the wider CORE family are free to use under the CORE System Trust’s non-commercial licence, applied unaltered with attribution. In ClientForms it is scored the moment your client submits, and can be sent on a recurring schedule.
Use the CORE-10 in your practice
Available on the Free plan. No credit card required. Patients complete it on their phone or computer. Scored the moment they hit submit.