The Therapeutic Environment Scales (TESS) is designed to measure the occurrence of various processes in a therapeutic environment. It is theoretically driven with 9 subscales of inter-personal behaviour that may influence the environment. These consist of (a) positive reinforcement for acts of courage at the time they occurred, (b) extinction of unhelpful behaviours, (c) communication, honesty and genuineness, (d) feeling safe with others, (e) belongingness and shared responsibility to others, (f) compassion, (g) inconsistency in behaviour, (h) accommodation of unhelpful behaviours, (i) emotional expression. It has three main sections: Part 1 examines the respondent’s relationship with staff; Part 2 asks about their relationship with other members who are not staff; and Part 3 asks the respondent about their own actions within the community. Each section addresses the same processes and subscales, but from these different perspectives of the behaviour of clients, staff or one’s own behaviour. Processes that do not relate to interactions within the community are only assessed in Part 3 with four additional subscales that focus on one’s own behaviour (a) goal setting and tasks, (b) structured activity, (c) democracy and influence, (d) keeping to and questioning boundaries. This last subscale on “Boundaries” is less reliable on the Cronbach’s alpha and should be used with caution.
Responses on all items are given on a 7-point Likert scale from ‘Strongly disagree’ to ‘Strongly agree’ and refer to the past week.
The total for each subscale is averaged (i.e. divided by the number of items in the subscale).
Lastly there are a number of items that are reverse scored. These are
B (3) “Staff reacted to my unhelpful behaviours in a way that upset me or made me feel uncared for “
D (1) “I was scared to express my needs to some staff”
D (4) “I felt some staff were rather bullying and intimidating”
F (6) “I felt some staff did not have time for my problems”
B (3) “Members reacted to my unhelpful behaviours in a way that upset me or made me feel uncared for “
D (1) “I was scared to express my needs to some members”
D (4) “I felt some members were rather bullying and intimidating”
F (6) “I felt some members did not have time for my problems”
K (3) I reacted to the unhelpful behaviours of other members in a way that upset them
N (6) I did not have time for other members’ problems
The scale may be used freely but must be cited in a publication. Please do send me the results of your environment and with a short description of your environment (e.g population served, therapeutic modality, age range) and when it was taken so we may benchmark different types of environments. To ensure stability it is best to repeat the measures at least three times say 2 months apart.
It can be used without my permission so long as you cite it in any publication.
Download the paper and scale from KCL
Veale, D, Miles, S, Naismith, I, Gilbert, P. (2016). Development of a Compassion Focused and Contextual Behavioural Environment and validation of the Therapeutic Environment Scales (TESS). BJPsych Bulletin, 40, 12-19. http://dx.doi.org/10.1192/pb.bp.114.048736