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. 2016 Jan;21(1):19-31.
doi: 10.1177/1359104514547596. Epub 2014 Sep 1.

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

Neus Abrines-Jaume  1 , Nick Midgley  2 , Katy Hopkins  3 , Jasmine Hoffman  3 , Kate Martin  4 , Duncan Law  5 , Miranda Wolpert  6
Affiliations

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

Neus Abrines-Jaume et al. Clin Child Psychol Psychiatry. 2016 Jan.

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.

Keywords: Child and Adolescent Mental Health Services; Shared decision making; child mental health; implementation; plan-do-study-act.

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