The Outcomes Stars are evidence-based tools designed to both support and measure change when working with people. Since 2003 their origin, history and development is a story of collaboration.
A Star for homelessness, with St Mungo’s and the London Housing Foundation
Triangle developed a prototype tool for St Mungo’s (a homelessness charity in the UK) in 2003. Originally, this was purely a tool for measuring outcomes for clients, but later work carried out by Triangle with other UK homelessness charities showed that the Star also had exciting potential as a keywork tool.
Triangle then developed the Journey of Change, made the scales suitable for service users as well as workers, wrote guidance and worked with Jellymould Creative on clear, user-friendly design. The first Outcomes Star, for homelessness, was published online in December 2006, by the London Housing Foundation.
A growing family of Stars
Triangle worked in collaboration with the Mental Health Providers Forum in the UK to develop and publish the Mental Health Recovery Star in 2007-08. Then, in 2009-10, developed and published the Work Star, Teen Star and Family Star in collaboration with the London Borough of Camden and other local authorities. Since then, Triangle has collaborated with over 60 organisations and published two-three new Stars each year, building on learning from each one to continually improve the Star’s usability and applicability across a wide range of clients and settings.
Supporting implementation with new tools and services
Learning from the experience of many organisations, Triangle started to invest more in support, training and new tools to help organisations to implement the Star well, and introduced a licencing model for the Stars. The aim is to enable organisations to make the most of the Star to improve keywork, help supervision to be more outcomes-focused, learn from Star data and provide evidence for commissioners and other funders. Developments include the Star Online web application, other tools to support people in using the Star well and a wider range of training courses, including having difficult conversations, the Star and keyworking skills and workshops for managers.
Triangle also introduced the Outcomes Star in Australia and now supports collaborators translating and working with the Star in a growing number of countries including Denmark, Canada, Finland, Italy, New Zealand and Hong Kong.
Psychometric properties and the evidence of validity and reliability
Since the development of the first Star a number of independent researchers have investigated its use and effectiveness and peer-reviewed articles have been published demonstrating the psychometric properties of the Star as well as its validity as a key-work tool. Details of these articles and a summary document (‘The Outcomes Star: Unpacking the evidence’) can be found on the Research pages. Triangle is now investing in its own research and Dr Anna Good, our research specialist, is examining the psychometric properties of the Star, including developing a suitable methodology for testing inter-rater reliability, and examining responsiveness to change and convergence with other measures. The inter-rater methodology and pilot results were published in a peer reviewed journal in 2014. The results of the research will be published in academic articles and in the development guides for new versions of the Star. Our psychometric factsheets for each version of the Star are ongoing, to view the existing reports, please visit the Research pages.
Take-up of the Star and endorsements
The Outcomes Star is widely used by voluntary organisations large and small, local authorities and NHS trusts in the UK. It is also well established in Australia and starting to be used in many other countries, including the USA, Canada and New Zealand. By 2016, versions had been translated into 10 languages, including Danish, French, Italian, Dutch and Chinese, with more in the pipeline.
- The Star is mentioned in many governmental documents, outcome manuals and guides, including:
- The Department of Health’s White Paper in 2009, New Horizons: A shared Vision for Mental Health, announced funding to implement the widespread use of the Mental Health Recovery Star, so that it is now fast becoming the industry standard tool.
- The National Social Inclusion Programme’s Outcomes Framework for Mental Health Services (2009) lists three “recognised social inclusion outcomes measurement tools”, two of which are the Homelessness Star and the Mental Health Recovery Star.
- The Chartered Institute of Housing has built the Homelessness Star into its new qualification for workers in homelessness services.
A working paper funded by the Cabinet Office in 2013 concluded that the Outcomes Star “ideally facilitates the interaction between counsellor and client” and “is instrumental in helping the desired outcomes to be achieved” (Arvidson & Kara, 2013).
- Since 2014 the Outcomes Star has been included in the Ministry of Justice’s “Effective Practice Library” for Youth Justice.
By 2016, over 60 organisations had collaborated on or funded the development of versions of the Star. Here are a few examples:
- Governmental bodies, including NESTA and the Department of Health
- Leading sector bodies, including the Mental Health Providers Forum and Alcohol Concern
- NHS trusts, including Cheshire & Wirral and Avon & Wiltshire
- Local authorities, including Camden, Westminster and Warrington borough councils
- Voluntary and independent sector service providers including Action for Children, Family Action, United Response and Groundwork UK
- Charitable foundations including the BIG Lottery and the Aldridge Foundation.