CORE10

Name Required

NHS number

Date of birth Required

Contact number Required

Today's date Required

Psychologist (if individual therapy):

Group / course name Required

Over the last week...

I have felt tense, anxious or nervous Required

I have felt I have someone to turn to for support when needed Required

I have felt able to cope when things go wrong Required

Talking to people has felt too much for me Required

I have felt panic or terror Required

I made plans to end my life Required

I have had difficulty getting to sleep or staying asleep Required

I have felt despairing or hopeless Required

I have felt unhappy Required

Unwanted images or memories have been distressing me Required

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Dissociative experience scales (DES)

Generalised anxiety disorder assessment (GAD-7)

Obsessive compulsory inventory (OCI)

Paranoid thoughts scale (ETS)

Patients health questionnaire (PHQ-9)

PCL-5

Work and social adjustment scale (WSAS)

International Trauma Questionnaire (ITQ)

Fears of compassion scale (FCS)

Self-criticising/attacking and self-reassuring scale (FSCRS)

Five Facet Mindfulness Questionnaire - short form (FFMQ-SF)

Warwick Edinburgh Mental Wellbeing Scale (WEMWBS)

Resilience