Open Access Research article

Development of an intervention program to increase effective behaviours by patients and clinicians in psychiatric services: Intervention Mapping study

Bauke Koekkoek12*, Berno van Meijel3, Aart Schene4 and Giel Hutschemaekers15

Author Affiliations

1 ProPersona Mental Health Care, Pro Persona Centre for Education and Science, Wolfheze

2 Altrecht Mental Health Care, Zeist, The Netherlands

3 InHolland University for Applied Sciences, Research Group Mental Health Nursing, Amsterdam, The Netherlands

4 Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands

5 Radboud University, Academic Centre of Social Sciences, Nijmegen, The Netherlands

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BMC Health Services Research 2010, 10:293  doi:10.1186/1472-6963-10-293

Published: 25 October 2010



Health clinicians perceive certain patients as 'difficult' across all settings, including mental health care. In this area, patients with non-psychotic disorders that become long-term care users may be perceived as obstructing their own recovery or seeking secondary gain. This negative perception of patients results in ineffective responses and low-quality care by health clinicians. Using the concept of illness behaviour, this paper describes the development, implementation, and planned evaluation of a structured intervention aimed at prevention and management of ineffective behaviours by long-term non-psychotic patients and their treating clinicians.


The principles of Intervention Mapping were applied to guide the development, implementation, and planned evaluation of the intervention. Qualitative (individual and group interviews), quantitative (survey), and mixed methods (Delphi-procedure) research was used to gain a broad perspective of the problem. Empirical findings, theoretical models, and existing evidence were combined to construct a program tailored to the needs of the target groups.


A structured program to increase effective illness behaviour in long-term non-psychotic patients and effective professional behaviour in their treating clinicians was developed, consisting of three subsequent stages and four substantial components, that is described in detail. Implementation took place and evaluation of the intervention is being carried out.


Intervention Mapping proved to be a suitable method to develop a structured intervention for a multi-faceted problem in mental health care.