Abstract #55  -  Implementing motivational interviewing techniques in the Dutch response to STIs and HIV.
Authors:   Presenting Author:   Mrs Marjo Taal - Soa Aids Nederland
Additional Authors:  Mrs Marjo Taal, Mr Ralph Spijker,
Aim: Since 2004, five different kinds of initiatives have been undertaken to encourage the use of motivational interviewing as an intervention in public healthcare in the Netherlands. The objective was to offer a uniform, evidence-based counselling method that can be used at STI and HIV test consultations for at-risk groups. Behavioural change is – even among professionals themselves – a complex process, so we decided to adopt a multi-faceted approach.
Method / Issue: Research: The ETC project was carried out with partner organisations involved: Rutgers Nisso Groep, GGD Public Health Services of Amsterdam, Utrecht University and STI Aids Netherlands, between 2004 and 2006. The aim of this study was to develop a counselling model that: gave guidance and was client-led, provided support for behavioural change, could define a risk profile, and was easy to use as well as effective. The project included research, using a so-called experimental design, among several hundred people attending an Amsterdam STI clinic. Results showed that a counselling model using motivational interviewing has a more positive effect on safe sex behaviour and social-cognitive determinants than the methods currently used. From semi-structured interviews with a group of STI nurses, it emerged that the counselling model makes the consultation more structured and improves communication with the patient. Education and educational material: In the same period, nurses at the Amsterdam STI clinic received newly-developed training in motivational interviewing. This later became a national training programme. A training manual on motivational interviewing called ‘Counselling with the STI AIDS Interviewing Model’ (2007) was also developed during the study. 85% of all STI nurses working in Dutch public healthcare have now been trained. Training policy: Since 2009, training in motivational interviewing is a compulsory part of the national quality profile for the response to STIs and HIV. Coaching: All teams in each public healthcare region of the Netherlands have appointed coaches for motivational interviewing who are trained using the manual. The coaches form a network of enthusiastic professionals who sustain interest in the concept of motivational interviewing at the workplace, while providing a link to STI AIDS Netherlands for this specific discipline. Audiovisual support: A DVD (2009) with model counselling using motivational interviewing – both good and bad practices – was produced and launched at a national symposium for STI nurses working in public healthcare. All the scripts were written and pre-tested by professionals active in the field. STI AIDS Netherlands will include the film material in its training courses and future e-learning programmes. Film material with English subtitles is available for demonstration purposes.
Results / Comments: This multi-faceted approach with the use of different methods has proved successful for the implementation of motivational interviewing. The lessons learned from the process it entailed are: the importance of cooperation between experts, professionals, policy makers and managers; developing material together with professionals in the field broadens support for its implementation; an integrated package of research, training, policy, networking, and developing different kinds of material is necessary to effect behavioural change among professionals; the material is suitable for use in a future e-learning programme.
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