Shared Decision-Making in Mental Health Care - SAMHSA Store ...

9Section 2The Practice of SharedDecision-MakingThe process of SDM, as identified by Simon et al. (2006), includes several steps:• Recognition that a decision needs to be made;• Identification of partners in the process as equals;• Statement of the options as equal;• Exploration of understanding and expectations;• Identifying preferences;• Negotiating options/concordance;• Sharing the decision; and• Arranging followup to evaluate decision-making outcomes.These steps do not all have to be taken at one time, and may not all be conductedin the presence of both parties. Decision aids (DAs), for example, can be utilized byconsumers on their own or with the assistance of peers. These tools can help a consumeridentify the treatment options and explore their preferences prior to meetingwith their provider.Decision AidsDAs are tools used to help consumers understand and clarify their choices and preferencesin regard to a discrete decision within SDM. DAs are offered in a variety offorms, from printed brochures to interactive electronic tools. Some are designed tobe completed by a health care consumer in advance of a professional consultation;others are designed for completion during the clinical encounter. DAs are often utilizedin the context of SDM.“When people have the opportunity to carefully consider their care, theytend to have less decisional conflict.” —Patricia Deegan, Ph.D.DAs have been shown to improve consumer knowledge of treatment options, supportmore realistic expectations of treatment outcomes, increase consumer comfortwith choices, decrease the number of consumers with decisional uncertainty, increaseconsumer participation in decision-making without increasing consumer anxiety,Shared Decision-Making in Mental Health Care:Practice, Research, and Future Directions