The HoNOSCA is a recently developed measure of outcome for use in child and adolescent mental health services focusing on general health and social functioning. The measure is a 15 item questionnaire, to be completed by practitioners, to indicate the severity of each problem, on a scale of 0-4. The measure is made up of two sections. The first section consists of 13 items relating to different types of problems; the second consists of two items relating the parent or young person’s knowledge of the nature of the young person’s difficulties and their information about the services available.

Property Definition HoNOSCA
Reliability Degree to which respondents in a similar sample had similar scores Research on the self-rated HoNOSCA demonstrated satisfactory reliability (Gowers, Levine, Bailey-Rogers, Shore, & Burhouse, 2002)
Test-retest reliability Degree to which the same respondents have the same score after period of time when trait shouldn’t have changed Few studies have reported the test re-test reliability of the HoNOSCA but a review article reported adequate test re-test reliability (Pirkis et al., 2005)
Concurrent validity Correlation of the measure with others measuring the same concept Research on the self-rated HoNOSCA appears to be mixed, with some research finding that the HoNOSCA 
demonstrates satisfactory validity (Gowers et al., 2002), and other research indicating that the HoNOSCA shows good concurrent validity (Pirkis et al., 2005)
Construct validity Degree to which a test measures what it claims to be measuring A review article examining the psychometric properties of the HoNOSCA indicates adequate construct validity (Pirkis et al., 2005)


The practitioner and parent tool can be used in relation to children aged 5-18 years and the self-rated HoNOSCA is for children and young people aged 13-18 years old.


No translations available at present.


The client-rated HoNOSCA should be administered every time a clinician-rated HoNOSCA is completed, to act as a comparison. This would usually be at assessment, six-weekly review and discharge.

The self-rated, parent-rated or clinician-rated HoNOSCA can be downloaded by using the following links:

Scoring and Interpretation

Manual scoring:

• Section A: 13 items rated 0-4 which are added together to create a Total score.
• Section B (optional): 2 items rated 0-4 which are added together to create a total score.

Terms of use

The HoNOSCA is free to use.

Further information

Specific guidelines regarding the terms of use of scoresheets, and other training materials.

HoNOSCA Trainer's Guide


Gowers, S.G., Harrington, R.C., Whitton, A., Lelliott, P., Wing, J., Beevor, A. and Jezzard, R. (1999). A Brief Scale for measuring the outcomes of emotional and behavioural disorders in children: HoNOSCA. British Journal of Psychiatry, 174, 413-416.

Gowers, S.G., Levine, W., Bailey-Rogers, S., Shore, A.,Burhouse, E. (2002). Use of routine, self-report outcome measure (HoNOSCA-SR) in two adolescent mental health services. British Journal of Psychiatry, 180, 266-9.

Pirkis, J. E., Burgess, P. M., Kirk, P. K., Dodson, S., Coombs, T. J., & Williamson, M. K. (2005). A review of the psychometric properties of the Health of the Nation Outcome Scales (HoNOS) family of measures. Health and Quality of Life Outcomes, 3 (76), 1-12.

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