Table 2 Matrix of intervention objectives for each target group
Target group | Determinant (selected) | Performance objectives | Change objectives |
|---|---|---|---|
Patient & Social system | Unusual help-seeking style | - Patient decides to negotiate expectations with clinician - Patient and professional reach or maintain a positive working alliance | - Decides to accept increased autonomy offered by mental health care professionals - Uses this autonomy to discuss treatment form and content with professional |
Professional | Professional pessimism | - Professional expresses a neutral view on behaviour, disorder and treatment results of his/her patients - Professional and patient reach or maintain a positive working alliance | - Decides to consider own view of patient's behaviour, disorder and treatment results as partly responsible for ineffective chronic illness behaviour. - Decides to follow training and supervision on how to look at patient behaviour more neutrally. - Actively participates in supervision meetings on this subject. Supports colleagues in using such skills |
Psychiatric service/Psychiatric profession | Lack of view on problems | - Service or treatment team expresses a coherent view on the treatment of non-psychotic chronic patients | - Develops and endorses a view of chronicity of non-psychotic patients as partly caused by mental health care itself - Offers training and supervision to increase professionals' skills and attitudes - Enables regular evaluative meetings of skills of professionals and effects on patients - Enables supervision meetings for professionals to offer mutual support and further development of a mutually shared view |