The Therapeutic Engagement Questionnaire (TEQ)

About the Therapeutic Engagement Questionnaire (TEQ)

Therapeutic engagement is considered the key element of mental health nursing. However, despite this recognition until the development of the therapeutic engagement questionnaire (TEQ) there was no metric to measure it objectively in acute inpatient mental health settings. As a result, there was no means to give recognition to the contribution of registered mental health nurses to service user recovery or no objective means of capturing the voice of service users regarding their recovery journey.

The TEQ, was co-produced with mental health service users and nurses and validated as a tool to quantify and give recognition to registered mental health nursing therapeutic engagement activity with service users within a therapeutic environment. It is available in two versions - service user and registered mental health nurse - with a specific scoring system attached. Kingston University holds the copyright for the TEQ.

The TEQ has been implemented by NHS Mental Health Trusts and the private sector in England, and internationally and has led to enhanced and more equitable nurse-service user therapeutic engagement and care quality.

The information gathered by the TEQ has helped to advise nursing staff at all levels of seniority, about the nature of registered mental health nursing therapeutic engagement activity and how it is experienced by service users.

NHS England promotes the TEQ in its Atlas of Shared Learning, emphasising the importance of the TEQ in supporting delivery of the NHS Long Term Plan. It also promotes the TEQ in the ‘mental health nurse's handbook'.

References and supporting material

  1. McAndrew, Sue, Chambers, Mary, Nolan, Fiona, Thomas, Ben and Watts, Paul (2014) Measuring the evidence : reviewing the literature of the measurement of therapeutic engagement in acute mental health inpatient wards. International Journal of Mental Health Nursing, 23(3), pp. 212-220. ISSN (print) 1445-8330
  2. Chambers, M., McAndrew, S., Nolan, F., Thomas, B., Watts, P., Grant, R., & Kantaris, X. (2019). The Therapeutic Engagement Questionnaire (TEQ): a service user-focused mental health nursing outcome metric. BMC Psychiatry, 19(1), 384. doi:10.1186/s12888-019-2326-x
  3. Chambers, M., McAndrew, S., Nolan, F., Thomas, B., Watts, P., & Kantaris, X. (2021). Measuring therapeutic engagement in acute mental health inpatient environments: the perspectives of service users and mental health nurses. BMC Psychiatry, 21(1), 547. doi:10.1186/s12888-021-03561-z
  4. Taylor F, Galloway S, Irons K, Mess L, Pemberton L, Worton K, and Chambers M. (2022). Barriers and enablers to implementation of the Therapeutic Engagement Questionnaire in acute mental health inpatient wards in England: A qualitative study. International Journal of Mental Health Nursing, 31 (1467). doi: 0.1111/inm.13047
  5. Taylor F, Galloway S, Irons K, Mess L, Pemberton L, Worton K, and Chambers M. (2024) Understanding organisational and nursing behaviour changes associated with a therapeutic engagement improvement tool in acute mental health inpatient settings: A qualitative analysis. International Journal of Nursing Studies Advances, 6 (100180) https://doi.org/10.1016/j.ijnsa.2024.100180
  6. NHS England. The Atlas of Shared learning: TEQ Case Study https://www.england.nhs.uk/atlas_case_study/the-development-of-a-therapeutic-engagement-questionnaire-teq-tool/
  7. NHS England. The mental health nurse's handbook. https://www.england.nhs.uk/publication/the-mental-health-nurses-handbook/

How to access the Therapeutic Engagement Questionnaire (TEQ)