Value of HoNOS in assessing patient change in NHS psychotherapy and psychological treatment services

Background Little research on the value of Health of the Nation Outcome Sca les (HoNOS) has occurred in outpatient settings, particularly psychotherapy services. Aims To determine whether HoNOS provides an adequate assessment for psychot herapy services which is sensitive to change. Methods HoNOS ratings from 1688 patients from eight out-patient psychothera py services were collected. Of these, 362 also had ratings posttreatment. M ean scores, pre-to posttreatment differences, and reliable and clinically s ignificant change criteria were calculated for Ho NOS items and for total s cores. Results The mean total HoNOS rating was 8.93, which is comparable to psychi atric out-patients. Only three items showed sufficient variability to use i n assessing pre- to post-treatment change. Conclusions Significant limitations were found in rating items that commonl y present to psychotherapists. The lack of variability in most items limits HoNOS's usefulness in this population. Declaration of interest The authors were funded by the Mental Health Founda tion to develop the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) for out-patient psychotherapy populations.