Chapter 23: Assessment and Monitoring of Symptoms in the Treatment of Psychological Problems

AUTHORS: D. Edwards, C. Young

ABSTRACT: This chapter considers the clinical application of brief symptom measures in South African contexts. Although typically developed in the USA and UK, these measures can assist South African clinicians to assess the severity of their clients’ presentations, to track the progress of psychological therapy from one session to the next and to evaluate therapy outcomes. There is evidence for their value not only for research but also for practice, as such systematic tracking of symptoms improves clinical outcome. While many competing measures have been developed over the years, a few dominate in the literature and even fewer have been used and at least partially validated in South Africa. This chapter summarizes recent local validation studies on the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM), and of the Xhosa translations of the Beck Depression Inventory-II (BDI-II), the Beck Anxiety Inventory (BAI) and the Beck Hopelessness Scale (BHS).  Other disorder-specific measures that have been used in local contexts include the Alcohol Use Disorders Identification Test (AUDIT) and a number of trauma scales such as the Posttraumatic Diagnostic Scale (PDS), the Impact of Events Scale (IES), the Posttraumatic Cognitions Inventory, and the Traumatic Grief Inventory (TGI). The utility of these scales in everyday settings, and their interpretation in conjunction with other assessment data are examined by reference to clinical examples, including published case studies.  Problems encountered in the translation of scales as well as their use in local multicultural and multilingual contexts are discussed.

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