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Psychlops (Psychological Outcome Profiles)


What it is​

Psychlops is a person-centred, patient-generated outcome measure designed to assess and track psychological distress during and after talking therapy. Unlike standardised measures that ask about a fixed set of symptoms, Psychlops invites the individual to identify and describe their own most pressing concerns in their own words, and then rate the severity of those concerns on a structured scale.

This idiographic approach means that Psychlops captures what matters most to the individual client, rather than fitting their experience into predefined categories. Research has shown it to be a sensitive measure of therapeutic change, often capturing improvements not detected by standardised tools. It is widely used in primary care, community mental health, and counselling settings, and has also been adapted for use with children and in humanitarian settings.

How is it used​

  • Suitable for adults aged 18 and over (a children's version — Psychlops Kids — is available for younger populations)
  • Takes approximately 5 minutes to complete
  • Completed before therapy begins, at one or more mid-therapy points, and at the end of therapy
  • Asks the individual to identify their most troubling problem and a secondary concern, rate the severity of each, and rate the impact on their day-to-day functioning
  • At follow-up administrations, a self-rated overall change item is also included
  • Freely available from the Psychlops website for use in clinical practice and research

The questionnaire covers three domains:

  • Problem — the issue of greatest concern to the individual, described in their own words and rated for severity
  • Function — the impact of problems on daily functioning, described and rated
  • Wellbeing — a single item assessing overall sense of wellbeing

What do the scores mean?​

Each domain item is rated on a 0–5 scale, giving a total score range of 0 to 12 (combining the two problem items and the function item; the wellbeing item is scored separately). Higher scores indicate greater distress and functional impairment.

Key score thresholds (Sales et al., 2022):

  • Caseness cut-off: 6.41 — scores above this threshold indicate a level of distress consistent with clinically significant psychological difficulties
  • Reliable change index: 4.63 — a change of 4.63 points or more between two administrations represents a statistically reliable improvement or deterioration, beyond what would be expected by chance

Psychlops has demonstrated high responsiveness to change (Cohen's d = 1.48), and functions as a measure of a single underlying construct described as personal distress. It has good internal consistency, construct validity, and convergent validity with established measures including the CORE-OM and HADS.

Because the content of each individual's Psychlops is unique, scores are best interpreted alongside the qualitative content of what the person has written — the free-text responses often provide clinically valuable information about the nature and context of the individual's difficulties.

Developer​

Psychlops was developed by Mark Ashworth and colleagues, including Jeremy Christey, at King's College London and in partnership with Depression Alliance and Primary Care Mental Health Education (PRIMHE).

References:

Ashworth, M., Shepherd, M., Christey, J., Matthews, V., Wright, K., Parmentier, H., & Godfrey, E. (2004). A client-centred psychometric instrument: The development of 'PSYCHLOPS' ('Psychological Outcome Profiles'). Counselling and Psychotherapy Research, 4(2), 27–33.

Ashworth, M., Robinson, S., Godfrey, E., Shepherd, M., Evans, C., Seed, P., Parmentier, H., & Tylee, A. (2005). Measuring mental health outcomes in primary care: The psychometric properties of a new patient-generated outcome measure, PSYCHLOPS (Psychological Outcome Profiles). Primary Care Mental Health, 3, 261–270.

Sales, C. M. D., Alves, P. C. G., Evans, C., & Ashworth, M. (2022). The psychometric properties of PSYCHLOPS, an individualized patient-reported outcome measure of personal distress. Journal of Clinical Psychology, 78(6), 1115–1130.