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: May 2026
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). 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.
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
Use CORE-10 when…
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.
View CORE-10 →Use Relationship Health Profile when…
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.
View Relationship Health Profile →See It in Action
- 1Total clinical score with severity band
- 2Four-domain breakdown — wellbeing, problems, functioning, risk
- 3Scored the moment your client submits
- 4Sendable on a recurring schedule for outcome tracking
What It 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). 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.
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.
Use the CORE-OM 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.