Audit & Research

There is much use of the phrase ‘Evidence Based Practice’ in the NHS. The evidence is often obtained from randomised, double blind, clinical trials performed by clinicians working very strictly to a formalised treatment protocol. As clinical hypnosis is tailored to an individual, who also very often has multiple problems, this may not be very relevant to the delivery of service in a normal clinical setting. One way forward is the development of ‘Practice Based Evidence’.

Combining Research & Therapy by Peter Naish (based on presentation given at the 2016 annual conference).

The use of audit is absolutely vital in the improvement of standards and outcomes. It can serve many functions:

  • To inform the therapist in the treatment of an individual
  • Demonstrating variations between different therapists in treating different conditions
  • To inform a department of its overall outcome results
  • Comparison with other departments
  • Comparison of psychological therapy with psychotropic medication

Many audit/evaluation tools are complicated, expensive to purchase a licence to use and need to be registered with the issuing body.

When time is short we need simple tools that can be used easily and that demonstrate a benefit of our therapy. It is almost impossible to get even the briefest of case reports published without including some data.

The Society wishes to encourage members in collecting audit data so that many individual cases pooled together will carry much greater weight, in order to present some meaningful data to bodies such as NICE on the treatment of various conditions – if you would like to take part in this project please contact National Office. Depending on the response we will focus on specific conditions and elect a member to co-ordinate this with help from National Office and the R&D team.

You may already use some form of audit tool but we suggest that you consider the following either in addition or instead of your usual outcome measures:
 

Clinical Outcome Routine Evaluation (CORE – Psychological Therapies Research Centre, Leeds University 1999)

Measures global distress in four domains – wellbeing, problems, functioning and risk of self-harm or of harm to others. It is self-administered and can be used at the start and end of therapy to give outcomes. The 32 point CORE questionnaires are free but one has to pay for analysis. One of our members has developed an Excel spreadsheet that displays a graph from the before and after treatment values.

CORE questionnaire download

CORE scoring sheet (female) download

CORE scoring sheet (male) download

Depression, Anxiety, Stress Scale (DASS) 

The DASS is a set of three self-report scales designed to measure the negative emotional states of depression, anxiety and stress. 

In addition to the basic 42-item questionnaire, a short version, the DASS21, is available with 7 items per scale. Note also that an earlier version of the DASS scales was referred to as the Self-Analysis Questionnaire (SAQ). As the scales of the DASS have been shown to have high internal consistency and to yield meaningful discriminations in a variety of settings, the scales should meet the needs of both researchers and clinicians who wish to measure current state or change in state over time (e.g., in the course of treatment) on the three dimensions of depression, anxiety and stress. Further information can be found at www2.psy.unsw.edu.au/groups/dass//

To download DASS 42, DASS 21 and the scoring template free visit: www2.psy.unsw.edu.au/groups/dass/down.htm

Modified Dental Anxiety Scale (MDAS)
A PDF version of the Modified Dental Anxiety Scale and associated references, the MDASForm (a Word version of the Modified Dental Anxiety Scale), and the Modified Dental Anxiety Scale scoring are available to download from www.st-andrews.ac.uk/dentalanxiety/
HADS
One has to buy the licence to use it and it tends to underscore clinical depression.
Measure Yourself Medical Outcome Profile (MYMOP)
If using MYMOP you are asked to register and give your data to add to the database. MYMOP allows the client and therapist to keep track of where a client is in relationship to their problems and goals.
www.bris.ac.uk/primaryhealthcare/resources/mymop/

Psychological Outcomes Profile (PSYCHLOPS) – www.psychlops.org.uk/
The Scaling Question
Can be used in or out of hypnosis to measure where a client feels they are, between their imagined goal at 10, and the opposite at 0. They then ask themselves (and write down the answers) two questions. What am I doing that is stopping me falling one place down my scale? What do I need to do today to start to move up one place on my scale? The written answers can build up a maintenance programme for the client. Where the client puts themselves on the way towards various goals or emotional states can be noted at each session by the therapist and gives some idea of progress.