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 Scales (HoNOS) has occurred in outpatient settings, particularly psychotherapy services. Aims To determine whether HoNOS provides an adequate assessment for psychotherapy services which is sensitive to change. Methods HoNOS ratings from 1688 patients from eight out-patient psychotherapy services were collected. Of these, 362 also had ratings posttreatment. Mean scores, pre-to posttreatment differences, and reliable and clinically significant change criteria were calculated for Ho NOS items and for total scores. Results The mean total HoNOS rating was 8.93, which is comparable to psychiatric out-patients. Only three items showed sufficient variability to use in assessing pre- to post-treatment change. Conclusions Significant limitations were found in rating items that commonly 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 Foundation to develop the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) for out-patient psychotherapy populations.