Recommended validated measures for counselling

We recommend three measurement tools for counselling outcomes: CORE, ITQ and WSAS. These have been chosen as they provide validated, reliable information for both counsellor and client and are free and simple to use.

1. CORE (Clinical Outcomes in Routine Evaluation) Outcome Measure

What is it?

The CORE measurement tool is broad measure of psychological distress and is used across a wide range of situations. It has two forms: the standard CORE-OM  and the shortened CORE-10. A higher score on either measure indicates greater psychological distress.

CORE-OM has 34 questions across 4 different aspects of psychological wellbeing:

  • Wellbeing (4 items)
  • Symptoms (12 items)
  • Functioning (12 items)
  • Risk (6 items)

CORE-10 is a short 10-item version of the CORE-OM to be used as a screening tool and outcome measure where the CORE-OM is considered too long for routine use.

It covers anxiety [2 items]; depression [2 items] trauma [1 item]; physical problems [1 item], functioning [3 items day to day, close relationships and social relationships]; and risk to self [1 item]. The measure has 6 high intensity/ severity and 4 low intensity/severity items.

Why use this scale? 

  • The CORE measurement tool is the gold standard tool for measuring psychological distress.
  • The CORE indicators form the basis for a simple but robust framework for evaluating the quality of therapy service provision.

How to choose between CORE-OM and CORE-10

We recommend that the more thorough CORE-OM measure is used for at least the first and last treatment session. If preferred, the quicker CORE-10 measure can be used in the middle sessions.

Some organisations will use CORE-10 throughout. In this case it is usually accompanied by other measures and clinical interviews at the start and finish of treatment to ensure a complete picture.

Further reading

Excellent blog on the use of CORE measures

2. International Trauma Questionnaire

What is it?

ITQ is a valid and reliable measure of the core features of Post-Traumatic Stress Disorder [PTSD] and Complex Post Traumatic Stress Disorder (c-PTSD)

It is free to use and simple to access

ITQ references the survivors index trauma event and participants are instructed to answer all questions relating to this event.

ITQ questions cover three clusters of PTSD symptoms

  • Re-experiencing here and now
  • Avoidance
  • Sense of threat

ITQ also covers three clusters of ‘Disturbance of Self-organisation’ (DSO)

  • Affective dysregulation
  • Negative self-concept
  • Disturbed relationships

These are accompanied by three items measuring functional impairments in work, social and other aspects of life.

Why use it?

  • It focuses specifically on the features of PTSD and complex PTSD
  • It is simple and straightforward to use

Further reading

For further background and to access the scale

3. Work And Social Adjustment Scale (WSAS)

What is it?

  • WSAS is a reliable and valid measure of a person’s functioning at home, at work or in social activities and relationships
  • It is simple to complete with 5 questions, with a recommended frequency of every 4 weeks
  • WSAS is scored between 0 and 40. The lower the number the better a person is functioning. It is recommended that the tool is used every 4 weeks

Why use this scale?

  • It is simple to complete with only 5 questions
  • It is a well recognised tool to demonstrate regular progress and inform care and support approaches.

It is worth noting that the scale refers to a person’s problem. It is not recommended to change wording in measures as this may affect their reliability and validity. However, if you feel you need to alter, the word ‘problem’ could be amended to challenges or difficulties.

Further reading


Recommended validated measures for wellbeing


Section 5B: Scoring the Scales