Questions from the CORC inbox (April to July)
Questions that we receive into the CORC inbox can be a common query for many, and this quarterly feature aims to share our response providing wider knowledge. We also share these each month in the CORC newsletter.
If you have had similar challenges to any of the questions posed and have found a way to overcome them, please do get in touch and let us know.
We welcome any further questions or views around each topic we share. If you have a question, please also get in touch at corc@annafreud.org.
July 2024
Inclusion of questions from ESQ
Some of the questions in the ESQ don’t apply to the way that we work. For example, question 9: My appointments are usually at a convenient time (e.g. don’t interfere with school, clubs, college, work). Is it okay to remove this?The ESQ is an established way to capture anonymised feedback from service users about their experience of their care and support. It was developed to provide a consistent approach to gathering service user experience.
If a question isn’t relevant to the way a service provides support, then it makes sense to omit that question. However, it’s useful to be aware that this will affect any scoring that might be undertaken on completed ESQ’s.
You would still be able to compare responses or scores on those individual questions that are relevant and useful to your service but the total scores would not be comparable with scores from other services using the full version of the ESQ.
The way that CORC commonly presents analysis of the ESQ for services that submit their data to us for analysis is:
June 2024
EDE Questionnaires used with young people
We receive a number of queries about which version of the EDE to use with different age groups of young people. Questions include: Which version of the Eating Disorder Questionnaire (EDE) should we use with young people?
How should we transition from using the EDE-A for under 14s to the EDE-Q for over 14s during their time with us in service? i.e. are the scores equivalent so we could track their journey smoothly from one measure to the next? Or would you recommend if someone starts on the EDE-A to continue to use it whilst in the service? The EDE-Q is evidenced for use with those aged 14 years and over, whilst the EDE-A (adolescent) version of this, is adapted for use with younger people aged 12-14 years. Whilst there is a good amount of research evidence for the use of the EDE-Q, the EDE-A isn’t well researched.
It makes sense to use the EDE-Q where possible with young people over 14 years alongside other relevant and suitable measures. This is also helpful for older young people who may well transition to adult services that use the EDE-Q at 17/18 years.
If using the EDE-A for those aged 12-14 years then consistency is important. To ensure consistency, then services may choose to continue using the EDE-A for those young people who continue to access the support after turning 14 years. If and when a young person begins a new episode of care then the EDE-Q could be introduced and used.
It's helpful to be aware that changing from the EDE-A to the EDE-Q version means it’s not possible to consistently measure change as they are different measures.
Regardless of which version used, we recommend exploring the use of other measures alongside the EDE to get a fuller understanding of what is happening for a young person.
Please see the CORC webpage for the EDE measure for information on the differences between the different versions of the measure along with lots of other useful information.
April 2024
Anomalies with ORS / CORS:
"Currently we are using the [C]ORS and some anomalies can arise, such as when a young person scores within the normal range at first session but with high levels of distress apparent. Can you help us to understand this?"
This question demonstrates the importance of using measures with children and young people, as part of a collaborative discussion. CORC recommends that measures are used as part of a curious and explorative approach to providing support, where the questionnaires are explained to the child or young person, and the results are reviewed and discussed with them. In this way such anomalies can be explored.
There are various possible reasons for this scenario, particularly at the start of treatment when the therapeutic relations has yet to develop. These could include the young person not understanding why they have been asked to complete the measure, mistrust about how their responses will be used (and who might see them), confusion over the questions and how to answer them, as well as motivations to not give honest responses; including wanting to appear better than they are. It could also be that the professional’s perspective and the young person’s perspective aren’t aligned; the young person appears distressed but doesn’t feel distressed.
All of these can provide opportunities to discuss, explore and understand
Additionally, a principle of using measures that we at CORC routinely talk about is that questionnaires should be used as part of a wider understanding of a child or young person’s strengths, difficulties and needs, including the professionals perspective and information from the child’s network such as parents or teachers.
We recommend that staff take part in training and continual professional development to hone their skills and practice with using measures meaningfully with children and young people – such as these provided by CORC