before Welcome to this limesurvey data entry form for CORE-OM data.  (Created by Chris Evans for CORE System Trust © https://www.coresystemtrust.org.uk/copyright.pdf.) self after THANK YOU FOR YOUR TIME IN COMPLETING THIS QUESTIONNAIRE <p>The CORE-OM is copyright to CORE System Trust: https://www.coresystemtrust.org.uk/copyright.pdf.</p> self

title Data entry admin self before Questions to help with data entry and information governance self Please put your name or ID here (and use the same one every time you are entering data!) during You must put something here.  Please be consistent! self longtext 40 Please put your Email address here so I can contact you if I or the survey administrator (which might be you) needs to. longtext 40

title Demographic questions from CORE-OM self before These are the questions in the box at the top of page one of the CORE-OM self ID of the person who completed the CORE-OM during You <em>must </em>have a value for this.  The format should have been defined by the survey boss/administrator. self longtext 40 This is the name or ID of the service, location or the survey for which the CORE-OM was completed. during If you don't know  what to put here, you need to get your survey boss to tell you! self longtext 40 ID of practitioner/interviewer during This might be the ID of the therapist or other practitioner if this is a clinical survey or it might be the ID of the interviewer if this is a research survey.  Your survey boss should have told you what to use!  It's a mandatory question but if you really don't know, put "-999". self longtext 40 Date the CORE-OM was completed. during This is a mandatory question. self date 10 Age of person completing the CORE-OM during If you really don't know, leave blank. self longtext 40 Gender of the person completing the CORE-OM. during If you really don't know, leave blank. self Female F Male M Other/neither/prefer not to say X longtext 40 Stage at which the CORE-OM was completed. during Only applies in clinical usage.  Leave blank if not known or doesn't apply. self Screening S Referral R Assessment A First therapy session F Pre-therapy (unspecified) P During therapy D Last therapy session L Follow-up 1 X Follow-up 2 Y The number of the therapy/clinical episode. during So if this is first ever episode, enter 1.  Only applies to clinical use/surveys. self longtext 40

title CORE-OM items self before <p>OVER THE LAST WEEK. Please read each question carefully. Think how often you have felt like that in the last week and then select the option which is closest to this.</p> self <p>Over the last week ... I have felt terribly alone and isolated</p> during Please choose the option that fits best with how you have been over the last week (seven days) self Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have felt tense, anxious or nervous Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have felt I have someone to turn to for support when needed Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have felt O.K. about myself Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have felt totally lacking in energy and enthusiasm Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have been physically violent to others Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have felt able to cope when things go wrong Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have been troubled by aches, pains or other physical problems Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have thought of hurting myself Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... Talking to people has felt too much for me Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... Tension and anxiety have prevented me doing important things Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have been happy with the things I have done Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have been disturbed by unwanted thoughts and feelings Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have felt like crying Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have felt panic or terror Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I made plans to end my life Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have felt overwhelmed by my problems Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have had difficulty getting to sleep or staying asleep Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have felt warmth or affection for someone Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... My problems have been impossible to put to one side Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have been able to do most things I needed to Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have threatened or intimidated another person Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have felt despairing or hopeless Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have thought it would be better if I were dead Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have felt criticised by other people Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have thought I have no friends Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have felt unhappy Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... Unwanted images or memories have been distressing me Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have been irritable when with other people Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have thought I am to blame for my problems and difficulties Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have felt optimistic about my future Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have achieved the things I wanted to Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have felt humiliated or shamed by other people Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most Over the last week ... I have hurt myself physically or taken dangerous risks with my health Not at all Not Only occasionally Only Sometimes Some Often Often Most or all the time Most