The instrument has 12 items measuring four domains of behaviour, impairment, symptoms and social functioning (Wing et al., Each item is scored from 0 (no problem) to 4 (severe problem) yielding a total score in the range of 0 (best) to 48 (worst) (Table 4.11). Scores at the second point in time can be more challenging to obtain if there are issues of staff changes or patient access (Jacobs, 2009).