Ouders adviseren in de jeugd-ggz: Het ontwerp van een gestructureerd adviesgesprek

The objective of the study was to develop an evidence-based efficient design for systematic communication in therapy planning in youth mental health care. To survey the availability of such a design in youth mental health care, we investigated the daily routine of therapy planning in all Dutch centres of youth mental health care and specialists’ interest in a ystematic way of counselling. Based on these findings, and with a review of literature, and a Delphi-study amongst experts and stakeholders a design was developed and studied in a randomised controlled way. The randomised controlled trial showed that this design, the Adviesgesprek n dialoog, lead to less decisional conflict and to more acceptance of the recommended interventions compared to care as usual. The therapists of the intervention group judged positively about the procedure, the therapy-planning form and particularly the visualisation method. Parents were also positive about the visualisation. The method supported their comprehension of the information given, their participation in therapy planning and active role in decision-making. The parents also appreciated the information send to them to prepare themselves before the counselling appointment. After training, the therapists of the intervention group preferred shared decision-making more often than their colleagues of the control group. This preference was in accordance with the preferences of most parents (and substantiated by a literature survey). The therapists judged positively on the implementation of the procedure and expected to pursue the use of this structured way of counselling, in particular the dialogue and visualisation aspects of it. We suggest further research of the Adviesgesprek in dialoog in populations of different ages and other health care settings. We concluded that the structured procedure Adviesgesprek in dialoog is suitable for a – to the parents attuned – exchange of information and decision making in youth mental health care. We recommend the implementation of this method as standard procedure for counselling in youth mental health care and to give further training to all professional disciplines involved. We do not expect major difficulties in implementation especially if integrated in the primary care process.

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