Change counselling in diabetes: the development of a training programme for the diabetes team

Skills in counselling for behaviour change may help staff working in diabetes care to facilitate self management in people with diabetes. A feasibility study was conducted to define the essential competencies (attitudes, knowledge and skills), training methods, and assess whether this approach was practicable in a diabetes resource centre. Semi structured interviews with staff were routinely conducted throughout the duration of the study. The findings suggest that the stages of change model, motivational interviewing and behavioural techniques are relevant to work in this area. Acquiring the competencies was harder to achieve than anticipated, though most were evident after one years training. The most valued training methods were individual supervision and video examples. However, the competencies were difficult to apply in the clinical setting given time constraints, the strength of existing staff routines and the patients' readiness to change. The lessons learned and suggestions for future work are presented.