Self-Determination Theory to observe healthcare professionals’ counselling in chronic care encounters: Development of the COUNSEL-CCE tool

Veerle Duprez*, Leen Haerens, Dorien Wuyts, Sofie Verhaeghe, Regina van Zanten, Emma K. Massey, Ann Van Hecke

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)


Objective: To develop and psychometrically evaluate an observation tool to rate healthcare professionals’ engagement in need-supportive and need-thwarting counselling in chronic care encounters. Methods: The observation tool was developed through three stages (January 2018 – June 2019). First, a set of items was developed according to essential components of need-supportive and need-thwarting counselling as identified in Self-Determination Theory. Second, content validation by five experts. Third, ecological validation using video-recorded real-life consultations. For the psychometric evaluation (June – October 2019), the tool was used by three observers to code 55 units of real-life encounters. Results: The Coding and Observing Need-Supportive Counselling in Chronic Care Encounters (COUNSEL-CCE) consists of 44 items clustered into nine theoretically underpinned behavioural approaches. Psychometric testing indicated acceptable to good consistency in scoring between observers and strong consistency within observers. Conclusion: The COUNSEL-CCE captures person-oriented alongside process-oriented aspects during chronic care encounters. A person-oriented approach expresses counselling that is responsive to individual preferences and needs, whereas a process-oriented approach indicates the necessity to support competency building within patients, and is more instrumental of nature. Practice implications: COUNSEL-CCE is a valuable observation tool to assess (graduate) healthcare professionals’ counselling style and address if, and how, counselling evolves as a result of professional training.

Original languageEnglish
Pages (from-to)1773-1780
Number of pages8
JournalPatient Education and Counseling
Issue number7
Publication statusPublished - Jul 2021

Bibliographical note

Funding Information:
Ghent University and Erasmus MC - Chiesi Pharmaceuticals BV.

Publisher Copyright:
© 2020 Elsevier B.V.


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