PSYCHLOPS has been designed as a mental health outcome measure. It is highly sensitive to detecting change after a course of therapy.
There are no normative data for PSYCHLOPS. This means that it is hard to interpret the meaning of baseline scores. Conventional outcome measures can be used to define cut-offs, above which a client may be deemed to be suffering significant psychological distress. PSYCHLOPS measures the score for a unique problem. This score cannot be compared with the score for another person’s problem. The initial score for PSYCHLOPS is unique to each individual. The main purpose of the score is to measure within-person i.e. the change in score for the items chosen by the patient.
All of the responses in PSYCHLOPS are scored on a six point scale ranging from zero to five. A score of zero indicates the least psychological difficulty whereas a score of five indicates the most.
Not every question is used for scoring. The outcome score is obtained from Questions 1b, 2b, 3b and 4.
Total scores are obtained by adding the individual six point scores for each domain. There are three domains. The maximum score is six points per domain, producing a maximum possible total score of eighteen. The domains are as follows:
Problem Domain Q1b = 5; Q2b = 3. Both Problem domain questions answered so score is halved, i.e. score = 4.
Problem Domain Q1b = 6; Q2b – no answer. Only one Problem domain answered so score = 6
The change score is the central quantitative outcome measure of PSYCHLOPS. The change score is simply the difference between the total pre-therapy score and the post-therapy score.
To calculate the score, simply subtract the post-therapy score from the pre-therapy score. If the score falls, the client has improved. If the score rises, the client has got worse (at least in terms of this particular form of self report).
Questions 1a, 2a and 3a require a freetext response from the client in the freetext box. This information is useful in defining the types of problems and difficulties of clients.
Questions 1c and 2c summarise the duration of the problem. Responses provide useful information but they do not form part of the outcome score.
Question 5 only features on the post-therapy form. It is the validation question. The response to this question (about how the client feels in themself having completed therapy) should bear some similarity to the responses to the other four questions. Thus, it would be expected that the scores of those who say that they are ‘much better’ after therapy would have improved more than those saying they are ‘a little better’.
Mark Ashworth Honorary Senior Lecturer Department of General Practice and Primary Care Chair, STaRNet Mental Health Interest Group May 2007
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