Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM)
The full 34-item CORE measure — four domains of distress folded into a single clinical score.
Last reviewed: July 2026
- Full name
- Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM)
- Measures
- The CORE-OM (Clinical Outcomes in Routine Evaluation – Outcome Measure) is a 34-item measure of global psychological distress, developed by the CORE System Group (Evans, Barkham, Mellor-Clark and colleagues, 1998–2000).
- Format
- 34 items · ~8 min · Self-report
- Score range
- 0 to 40
- Reliability
- Internal consistency is high across the total and most domains (Cronbach’s α ≈ 0.75–0.94), with good test-retest reliability and strong sensitivity to change in routine practice (Evans et al., 2002; Barkham et al., 2001).
- Population
- Adults aged 18+ in counselling, psychotherapy and mental-health settings.
- Interpretation
- 0–5Healthy
- 5–10Low level
- 10–15Mild
- 15–20Moderate
- 20–25Moderate-to-severe
- 25–40Severe
Scoring & Interpretation
Each item is rated 0 (not at all) to 4 (most or all of the time) over the past week. The clinical score is the mean of the completed items multiplied by 10, giving a 0–40 score that is comparable to the CORE-10 total. A clinical cut-off of 10 distinguishes clinical from non-clinical distress (with small gender differences), and the four domains can be read separately to see where distress sits.
| Score Range | Severity | Clinical Action |
|---|---|---|
| 0–5 | Healthy | Below clinical range — no distress indicated |
| 5–10 | Low level | Subclinical distress — monitor over time |
| 10–15 | Mild | At or above the clinical cut-off (10) — clinical distress |
| 15–20 | Moderate | Clinical range — active intervention indicated |
| 20–25 | Moderate-to-severe | High distress — prioritise and review supports |
| 25–40 | Severe | Severe distress — review risk and intensity of care |
- Internal consistency is high across the total and most domains (Cronbach’s α ≈ 0.75–0.94), with good test-retest reliability and strong sensitivity to change in routine practice (Evans et al., 2002; Barkham et al., 2001).
- The clinical cut-off is 10 on the 0–40 clinical score.
When to Use This vs Alternatives
| Instrument | Measures | Items | Reach for it when |
|---|---|---|---|
| CORE-OM This page | Global distress, 4 domains | 34 | The comprehensive option you are reading about |
| CORE-10 | Global distress, brief | 10 | You need a brief measure for frequent, session-by-session check-ins. The CORE-10 tracks the same clinical score in 10 items, so it slots between CORE-OM assessments without adding burden. |
| Relationship Health Profile | Couple functioning, 10 dimensions | 93 | The work is with a couple rather than an individual. The RHP compares both partners across satisfaction, communication and trust, where the CORE-OM measures one person’s distress. |
Global distress, 4 domains · 34 items
Global distress, brief · 10 items
You need a brief measure for frequent, session-by-session check-ins. The CORE-10 tracks the same clinical score in 10 items, so it slots between CORE-OM assessments without adding burden.
Couple functioning, 10 dimensions · 93 items
The work is with a couple rather than an individual. The RHP compares both partners across satisfaction, communication and trust, where the CORE-OM measures one person’s distress.
See It in Action
Sample: a completed CORE-OM, scored and interpreted.
Moderate psychological distress.
By domain
- Well-being
- 8/16
- Problems
- 24/48
- Functioning
- 22/48
- Risk
- 4/24
On ClientForms the total, its band and every domain flag are scored for you and ready to read or export as a PDF.
See the dashboard view
Synthetic sample for illustration — not a real patient.
What It Measures
It spans four domains — subjective wellbeing, problems and symptoms, life functioning, and risk to self and others — and folds them into one clinical score for a structured, whole-picture read of how a client is doing.
- Wellbeing
- Subjective sense of wellbeing over the past week, including optimism and how the person is coping.
- Problems and Symptoms
- Common symptoms of anxiety, depression, trauma and physical problems.
- Life Functioning
- Day to day functioning at home, in close relationships and in social roles.
- Risk
- Risk to self and to others, reviewed in its own right as well as within the total.
When to Use the CORE-OM
Use the CORE-OM when you want more than a single-domain score — typically at intake to establish a full baseline and at review to measure change across all four domains. Its risk domain makes it useful where risk needs explicit monitoring. For frequent session-by-session check-ins between assessments, the briefer CORE-10 is more practical and tracks the same clinical score.
Who It's For
Adults aged 18+ in counselling, psychotherapy and mental-health settings. Self-report — the client completes all 34 items themselves. The Young Person’s CORE (YP-CORE) is the equivalent for ages 11–16. The six risk-domain items are reviewed in their own right, not only as part of the total.
Frequently Asked Questions
What is the CORE-OM?
The CORE-OM is a 34-item self-report measure of psychological distress covering four domains — wellbeing, problems and symptoms, life functioning, and risk. Developed by the CORE System Group, it gives a single clinical score for a whole-picture read of how a client is doing, and is widely used as a routine outcome measure in counselling.
How is the CORE-OM scored?
Each of the 34 items is scored 0 to 4 over the past week. The clinical score is the mean of the completed items multiplied by 10, giving a 0–40 figure. A clinical cut-off of 10 separates clinical from non-clinical distress, and the four domains can be read separately. In ClientForms this is calculated the moment your client submits.
What is the difference between the CORE-OM and CORE-10?
The CORE-OM is the full 34-item measure with four domains, used for baseline and review. The CORE-10 is the brief 10-item short form for frequent session-by-session monitoring. They share the same 0–40 clinical-score scale, so many counsellors use CORE-OM at intake and review and CORE-10 in between.
Is the CORE-OM free to use?
Yes. The CORE-OM and the wider CORE family are free to use under the CORE System Trust non-commercial licence, applied unaltered with attribution. On ClientForms you send it to a client, who completes it on their phone, and the clinical score, the four domains and the risk items come back scored for you, ready to read or export.
Stop scoring the CORE-OM by hand.
The total, the bands and the domain flags you just worked through, scored and laid out for you. New accounts get 30 days of full Professional access, no card.