Add scores (0-4) under the headings below...

Then...

Record scores at...

Outcome measures (T1, initial) after inital assessment
Outcome measures (T2, 3 months)
Outcome measures (T3, treatment close) after end of treatment.

Scale

0 = no problem
1 = minor problem requiring no action
2 = mild problem but definitely present
3 = moderately severe problem
4 = severe to very severe problem

Areas to score

1.Problems with disruptive, antisocial or aggressive behaviour

Include physical or verbal aggression, antisocial behaviours such as lying, cheating, thieving etc.

2.Problems with overactivity, attention or concentration

Include restlessness, fidgeting, inattention, problems with concentration due to any cause including depression, drugs.

3.Non-accidental self-injury

Include self-cutting, suicide attempts etc.

4.Problems with alcohol, substance/solvent misuse

Take into account current age and societal norms. Don't include aggressive/disruptive behaviour due to alcohol or drug use rate at item 1

5.Problems with scholastic or language skills

Include problems in reading, spelling, speech or language, including those due to specific disorders or problems.

6.Physical illness or disability problems

Include problems that limit or prevent movement, impair sight or hearing, side effects from medication/drug/alcohol use.

7.Problems associated with hallucinations, delusions or abnormal perceptions

Include odd and bizarre behaviour associated with hallucinations and delusions., suspicious/paranoid thoughts.

8.Problems with non organic somatic symptoms

Include problems with gastrointestinal symptoms, sleep problems, chronic fatigue.

9.Problems with emotional and related symptoms

Include depression, anxiety, worries, fears, phobias, obsessions, compulsions etc.

10.Problems with peer relationships

Include problems forming satisfying peer relationships, withdrawal from social relationships, social rejection as result of bullying/aggressive behaviour.

11.Problems with self care and independence

Rate problems with basic self-care such as dressing, washing, feeding, include poor levels of functioning due to lack of motivation etc.

12.Problems with family life and relationships

Include parent-child & sibling relationship problems, emotional abuse, poor communication, criticism, enmeshment, overprotection etc.,

13.Poor school attendance

Include truancy, school withdrawal

Record scores at...

Outcome measures (T1, initial) after inital assessment
Outcome measures (T2, 3 months)
Outcome measures (T3, treatment close) after end of treatment.