title: The association between waiting for psychological therapy and therapy outcomes as measured by the CORE-OM.
abstract: OBJECTIVE
  To investigate the impact of waiting for psychological therapy on client well-being as measured by the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) global distress (GD) score.
  
  
  METHODS
  Global distress scores were retrieved for all clients referred for psychological therapy in a secondary care mental health service between November 2006 and May 2013 and who had completed a CORE-OM at assessment and first session. GD scores for a subgroup of 103 clients who had completed a CORE-OM during the last therapy session were also reviewed.
  
  
  RESULTS
  The study sample experienced a median wait of 41.14 weeks between assessment and first session. The relationship between wait time from referral acceptance to assessment, and assessment GD score was not significant. During the period between assessment and first session no significant difference in GD score was observed. Nevertheless 29.1% of the sample experienced reliable change; 16.0% of clients reliably improved and 13.1% reliably deteriorated whilst waiting for therapy. Demographic factors were not found to have a significant effect on the change in GD score between assessment and first session. Waiting time was associated with post-therapy outcomes but not to a degree which was meaningful. The majority of individuals (54.4%), regardless of whether they improved or deteriorated whilst waiting for therapy, showed reliable improvement at end of therapy as measured by the CORE-OM.
  
  
  CONCLUSIONS
  The majority of GD scores remained stable while waiting for therapy; however, 29.1% of secondary care clients experienced either reliable improvement or deterioration. Irrespective of whether they improved, deteriorated or remained unchanged whilst waiting for therapy, most individuals who had a complete end of therapy assessment showed reliable improvements following therapy.
  
  
  CONCLUSIONS
  There was no significant difference in GD score between assessment and first session recordings. A proportion of clients (29.1%) showed reliable change, either improvement or deterioration, as measured by the GD score while waiting for therapy. Of the individuals with last session CORE-OMs (54.4%) showed significant improvement following therapy regardless of whether or not they experienced change while waiting for therapy. Limitations include: Problems of data quality, the data were from a routine data set and data were lost at each stage of the analysis. A focus on the CORE-OM limits exploration of the subjective experience of waiting for psychotherapy and the impact this has on psychological well-being.
authors.affiliation: Psychology and Psychotherapy, South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Beck
authors.forename: Mark
authors.initials: M
authors.lastname: Burdett
authors.forename: Helen
authors.initials: H
authors.lastname: Lewis
mesh_terms: D000328:Adult; D003156:Community Mental Health Services / Q000458:organization & administration; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000592:standards*; D010549:Personal Satisfaction; D011594:Psychometrics; D011613:Psychotherapy / Q000379:methods* / Q000592:standards; D012044:Regression Analysis; D015203:Reproducibility of Results; D012959:Socioeconomic Factors; D013315:Stress, Psychological; D011795:Surveys and Questionnaires / Q000592:standards*; D014850:Waiting Lists
keywords: CORE-OM; Psychological Therapy; Waiting times