Client Satisfaction Survey (CSS)

This survey measures the level of satisfaction a client has with a mental health service, both satisfaction with their practitioner and their experience in general.It has eight questions measuring satisfaction in four domains:   

  1. Practitioner 
  2. Reception staff (optional)
  3. Scheduling
  4. Quality of life improvements.

It is designed for clinicians and outpatient practices to gain feedback on how they can improve their service. Scores are benchmarked against a sample of outpatient psychology clinics. It is designed to be administered post discharge or after the first six sessions.


The CSS was developed by NovoPsych (Buchanan & Hegarty, 2023) and was validated with over 4,700 responses collected between 25 March 2015 and 15 March 2023 from Australian private psychology clinics.

Using EFA four factors of satisfaction were found:

  1. practitioner (questions 1,2,3,6, & 8)
  2. reception staff (question 7 – OPTIONAL)
  3. scheduling (question 5)
  4. quality of life improvements (question 4)

Responses were highly skewed, with 43% of respondents giving the maximum satisfaction rating, indicating ceiling effects and/or a high level of satisfaction among respondents. Negatively skewed data is common for satisfaction measures. Normative data was computed using 4,449 responses, and found that 88% of respondents were satisfied with the service they received, defined as an average score of “agree” or higher on the CSS.

Normative data was computed, converting raw scores to percentile scores. Given that question 7 is optional (regarding reception staff), seperate norms were computed for people who don’t respond to that question.

The scores (for both the total score and individual questions) have a strong negative skew – that is, many responses are quite high and there was a definite ceiling effect. Therefore, some of the percentiles are presented as > XX. The presence of > indicated that the maximum score was given, and a indicates the percentile for the group of respondents with the maximum score.


A total score between 0 and 40 is presented, where higher scores indicate higher levels of satisfaction. Scores are also presented for individual questions as they address different aspects of client satisfaction.

Percentiles are displayed for the total score and for individual questions, comparing the respondent’s score with benchmark data. A percentile of 50 indicates a typical pattern of responding compared to the benchmark data, and indicates a high level of satisfaction (given that most respondents in the benchmark sample were satisfied).

The maximum score of 40 corresponds to a percentile of 71, indicating that the respondent is in the top 29% of satisfaction compared to the normative sample. Percentiles of 17 correspond to a score of 32, which indicate the respondent, on average, “agreed” with the statements. Scores 31 or below (percentiles 12 or below) are indicative of dissatisfaction and suggest reflection on that client’s experience is warranted. 

When the maximum score was given the percentiles are presented with a “>” symbol and “Top XX%”, indicating that the respondent is in the top percentile category. Likewise, when the minimum score was given the percentiles are presented with a “<” symbol and “Bottom XX%”, indicating that the respondent is in the bottom percentile category.

Optional Questions 9 and 10 ask the respondent to write areas of strength and suggestions for improvement, so careful review of these responses are suggested.


Buchanan, B., & Hegarty, D., (2023). The Client Satisfaction Scale. Measuring Patient’s Experiences in Private Psychology Practices.