Shared Decision-Making and Evidence-Based Practice

Adams, Jared; Drake, Robert E.

doi:10.1007/s10597-005-9005-8

Cited by 261 publications

(220 citation statements)

References 114 publications

(105 reference statements)

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“…The themes of providing young people time to organize their thoughts, providing increased input in the disclosure process, and the increased ability of the professional to formulate early treatment plans are important elements within a shared decision-making model [47]. In medical practice there has been a move towards shared decision-making based on the belief that providers have the expertise to suggest viable alternative treatment options, but that only patients can place a value on living with the costs associated with the diagnosis and the side effects of various treatments and, therefore, should be given increased input into their healthcare decisions [48].…”

Section: Discussionmentioning

confidence: 99%

“…In medical practice there has been a move towards shared decision-making based on the belief that providers have the expertise to suggest viable alternative treatment options, but that only patients can place a value on living with the costs associated with the diagnosis and the side effects of various treatments and, therefore, should be given increased input into their healthcare decisions [48]. However, the uptake of explicit shared decision-making in mental healthcare has been slow, with some professionals questioning the competence of people with mental health problems to make rational decisions about their own healthcare [47]. Statements by clinicians in the current study show that this belief is still held by many.…”

Section: Discussionmentioning

confidence: 99%

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Health Professionals’ Attitudes towards Electronic Psychosocial Assessments in Youth Mental Healthcare

Bradford

Rickwood²,

Boer³

2014

Health

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Psychosocial assessments can help mental health professionals establish good therapeutic relationships while simultaneously conducting holistic assessments of their young clients. Using technology to conduct assessments may increase disclosure by young people; however, the uptake of new technologies into current face-to-face practice has been slow. In the current study, we were interested in exploring the attitudes of mental health workers to using an electronic psychosocial assessment tool (e-tool) within face-to-face service delivery with adolescents and young adults. An exploratory design was used to identify and qualitatively describe the views of 46 mental health workers from services across the ACT and Victoria, Australia. Data were coded using an inductive thematic approach. Comments indicated that mental health workers held both positive and negative views about the e-tool. Some participants believed that it would allow disclosure to occur in a stepped process, normalize questions, give youth greater input, and be time efficient. However, the majority believed that the e-tool would infringe on their work because they needed to respond to their clients immediately, it would not provide an accurate representation of the client, young people did not have the necessary capabilities to engage in the process, they would miss non-verbal cues from the young person, and they were more likely to gain information from organic conversations. The results suggest that many mental health professionals may be fearful of incorporating new technologies in current practice. Specific training and supportive implementation guidelines must be developed to support use of these new technologies and change practice.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Health Professionals’ Attitudes towards Electronic Psychosocial Assessments in Youth Mental Healthcare

Bradford

Rickwood²,

Boer³

2014

Health

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“…We suggest that future research focus on enhanced patientclinician decision-making processes since they can potentially improve medical decisions (27) and are applicable to psychiatric disorders (28,29). These models involve a mutual process whereby the clinician elicits patient experiences and preferences, clarifies patient values about different aspects of treatment, provides balanced information on all treatment options, and collaborates with the patient in formulating a treatment decision.…”

Section: Discussionmentioning

confidence: 99%

Patients' Depression Treatment Preferences and Initiation, Adherence, and Outcome: A Randomized Primary Care Study

Raue¹,

Schulberg²,

Heo³

et al. 2009

Psychiatric Services

131

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Objective-We examined the association of treatment preferences with treatment initiation, adherence, and clinical outcome among depressed mid-life and elderly primary care patients.Methods-60 primary care participants meeting DSM-IV criteria for major depression were randomized to receive treatment congruent or incongruent with their primary stated preference. Participants received either 20 weeks of escitalopram as monitored by a care manager, or 12 weekly sessions of interpersonal psychotherapy followed by 2 monthly booster sessions. Adherence to treatment and depression severity were reassessed at weeks 4, 8, 12, and 24.Results-Participants expressed stronger preferences for psychotherapy than antidepressant medication. Preference strength was a more sensitive measure of outcomes than congruence versus incongruence of preference with the assigned treatment. Across age groups, preference strength was significantly associated with treatment initiation and 12-week adherence rate, but not with depression severity or remission.Conclusions-A continuous measure of preference strength may be a more useful measure in clinical practice than preferences per se. Future research should focus on whether and how greater facilitation of the patient-clinician treatment decision-making process influences clinical outcome.Treatments of depression in primary care settings are effective yet most depressed adults (1), particularly older ones (2), do not receive appropriate care. Even when guideline-based treatments are provided, patients often do not fully participate in them. Not surprisingly, therefore, randomized clinical trials have reported substantially poorer outcomes for "intent to treat" than "treatment completer" cohorts (3), indicating a need for strategies that maximize treatment participation.A patient's decision not to initiate or complete treatment may stem from disappointment or dissatisfaction with the treatment offered by the clinician. While medications are the predominant intervention offered depressed primary care patients, 50%-86% of them prefer a psychosocial intervention (4-7). Thus, many patients conceivably refuse treatment offered in primary care because psychotherapy is not an available option.In psychiatric outpatient settings, treatment preferences have been addressed through "negotiated treatment plans" whereby clinicians elicit patient requests and encourage their participation in treatment planning. Patient reports of greater participation in such negotiations have been associated with greater levels of satisfaction, sense of feeling helped, and adherence to treatment plans (8,9). Studies of mid-life patients in the primary care sector have endorsed the value of a negotiated treatment plan and the importance of patients playing active rather than passive roles in formulating it. Such participation enhances the patient's likelihood of initiating treatment and his/her satisfaction with it (10-12).Despite these benefits, the few studies examining treatment negotiation and clinical outcome have...

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“…Unlike the traditional model, in which practitioners prescribe and make all treatment decisions, SDM is based on a relationship-centered approach (Elwyn, Edwards, Kinnersley, & Grol, 2000;Epstein, Alper, & Quill, 2004). As such, it depends on good communication and the development of a trusting relationship between the client and practitioner (Adams & Drake, 2006;Elwyn et al, 2000;Schauer, Everett, del Vecchio, & Anderson, 2007).…”

Section: What Is Shared Decision Making With Youth?mentioning

confidence: 99%

“…only in the past few years has SDM received attention and acceptance as a necessary component of adult behavioral health care (Adams & Drake, 2006;Deegan & Drake, 2006;Deegan, rapp, holter, & riefer, 2008). Acceptance of SDM as an approach for youth consumers of mental health services and their families has been relatively slow to follow suit (dosreis & Myers, 2008) despite acceptance for use with decisions about physical ailments similar to that documented with adults.…”

mentioning

confidence: 99%

Critical Issues for Psychiatric Medication Shared Decision Making with Youth and Families

O’Brien

Crickard

Rapp

et al. 2011

Families in Society

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the primary aims of this article are to describe the current context for youth shared decision making (sDm) within the U.s. children's mental health system and to identify important considerations for the development of this approach as a research and service domain. the notion is substantiated in the literature that participation in treatment decisions can prepare youth for making their own decisions as adults, can be therapeutic, and can have positive effects on their self-confidence and self-esteem. still, the complex youth-family-provider dynamic raises important issues that need to be addressed before sDm can be successfully implemented.imPliCations FoR PRaCtiCe •Developing a youth sDm model will involve practitioner training, training for youth and parents, defining roles for youth and parents, consent, confidentiality, service delivery factors, and identifying outcomes.

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Shared Decision-Making and Evidence-Based Practice

Cited by 261 publications

References 114 publications

Health Professionals’ Attitudes towards Electronic Psychosocial Assessments in Youth Mental Healthcare

Health Professionals’ Attitudes towards Electronic Psychosocial Assessments in Youth Mental Healthcare

Patients' Depression Treatment Preferences and Initiation, Adherence, and Outcome: A Randomized Primary Care Study

Critical Issues for Psychiatric Medication Shared Decision Making with Youth and Families

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