A qualitative analysis of implementing shared decision making in Child and Adolescent Mental Health Services in the United Kingdom: Stages and facilitators. (January 2016)

• Record Type: Journal Article
• Authors: Abrines-Jaume, Neus; Midgley, Nick; Hopkins, Katy; Hoffman, Jasmine; Martin, Kate; Law, Duncan; Wolpert, Miranda
• Is Part Of: Clinical child psychology and psychiatry. Volume 21:Number 1(2016:Jan.)
• Page Start: 19
• Page End: 31
• Publication Date: 2016-01
• Subjects: Shared decision making -- child mental health -- Child and Adolescent Mental Health Services -- plan-do-study-act -- implementation; Clinical child psychology -- Periodicals; Child psychiatry -- Periodicals; 618.9289
• DOI: 10.1177/1359104514547596
• Languages: English
• ISSNs: 1359-1045

Abstract

Objectives: To explore the implementation of shared decision making (SDM) in Child and Adolescent Mental Health Services (CAMHS), and identify clinician-determined facilitators to SDM.Methods: Professionals from four UK CAMHS tried a range of tools to support SDM. They reflected on their experiences using plan-do-study-act log books. A total of 23 professionals completed 307 logs, which were transcribed and analysed using Framework Analysis in Atlas.Ti.Results: Three states of implementation (apprehension, feeling clunky, and integration) and three aspects of clinician behavior or approach (effort, trust, and flexibility) were identified.Conclusions: Implementation of SDM in CAMHS requires key positive clinician behaviors, including preparedness to put in effort, trust in young people, and use of the approach flexibly.Practice implications: Implementation of SDM in CAMHS is effortful, and while tools may help support SDM, clinicians need to be allowed to use the tools flexibly to allow them to move from a state of apprehension through a sense of feeling "clunky" to integration in practice.