Child and adolescent service experience (ChASE): Measuring service quality and therapeutic process


Dr Crispin Day, Centre for Parent and Child Support, South London and Maudsley NHS Foundation Trust/Child and Adolescent Mental Health Service Research Unit, Kings College, Institute of Psychiatry, Michael Rutter Centre, De Crespigny Park, Camberwell, London SE5 8AZ, UK (e-mail:


Objectives. Dissatisfaction with services has been associated with poorer child mental health outcomes, early treatment termination as well as disagreements over the nature of mental health difficulties, reasons for referral and therapy goals. The development of straightforward, reliable, and accurate methods of eliciting service users’ views is essential within child and adolescent mental health care. This paper describes the development of the child and adolescent service experience (ChASE), a tool to measure children and young people's service experience

Design. The study comprises a non-experimental, cross-sectional design.

Methods. Participants were 132 mental health service users aged 8–18 years. Participants and their main carer completed the ChASE, Parent Satisfaction Questionnaire (PSQ) (Stallard, 1996) and Strengths and Difficulties (SDQ) Impact Supplement. Clinicians completed the SDQ Impact Supplement and provided clinical activity data. A sub-sample of participants completed the ChASE on a second occasion, 6 weeks after the completion of the first questionnaire.

Results. Scrutiny of ChASE data indicated high levels of completion. Principal axis factoring identified three factors within the ChASE: Relationship, Privacy, and Session Activity. The ChASE has good internal consistency and test–retest reliability. Significant correlations were found between the ChASE and carer satisfaction, service use, and youth clinical outcomes.

Conclusions. The ChASE is a short, psychometrically robust tool for routine measurement of children, and young people's experience of mental health services, which users can complete easily. The results underline the importance of alliance factors to children and young people and their association with clinical improvement as well as the potential for the ChASE to be used a measure of children's therapeutic progress and alliance.