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What approaches for promoting shared decision-making are used in child mental health?

A scoping review by H. Cheng, D. Hayes, J. Edbrooke-Childs, K. Martin, L. Chapman & M. Wolpert in Clinical Psychology & Psychotherapy

28 July 2017

Shared decision making (SDM) is the process in which patients and clinicians work together to make decisions about care and treatment. The benefits of SDM have been promoted across different health settings. However, its implementation is complex, especially for children and young people with mental health issues. This paper identified and described the various SDM approaches – tools, techniques and technologies – used in child and youth mental health.

Electronic journal databases and other literature (e.g. reports and conference proceedings) were searched. Of the 8,153 initial results, 22 were eligible for final inclusion in this review. These 22 could be grouped into six approaches:

  • Therapeutic techniques
  • Psychoeducational information
  • Decision aids
  • Action planning or goal setting
  • Discussion prompts
  • Mobilising patients to engage.

The approaches were also assessed for quality against the nine essential elements of SDM:  1) patient values/preferences, 2) options, 3) professional knowledge/recommendations, 4) make or explicitly defer a decision, 5) define/explain the problem, 6)  check/clarify understanding, 7) benefits/risks, 8) discuss patient ability/self‐efficacy, and 9) arrange follow‐up. The six approaches featured one to seven of the nine elements.

The review suggests that a range of approaches is being developed to support shared decision making in child and youth mental health. Rigorous evaluation of the effectiveness of these approaches is needed, particularly from the perspective of the children and young people.