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

Abstract

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.

Goal formulation and tracking in child mental health settings: when is it more likely and is it associated with satisfaction with care?

“…This finding may suggest that goal formulation and tracking may be associated with higher levels of parental satisfaction, potentially through higher levels of parental involvement and collaborative working, as suggested by prior research [2, 42], and may highlight the association between therapeutic relationships and the importance of goal formulation and tracking [12, 16, 20, 27, 55, 61, 65]. It may of course also be possible that this association is more to do with another common factor such as greater therapeutic alliance to which both higher levels of goals and satisfaction relate, but given the existing literature on how goal setting might help support this it is not unreasonable to at least consider goal setting as enhancing satisfaction and collaborative working.…”

“…Because naturalistic research is a measure of everyday life, participants may not have the commitment they might have had to providing data in a randomised control trial. Moreover, the practice of goal formulation can feel strange to practitioners and has, as part of collaborative practice, been described as feeling ‘clunky’ [2] perhaps especially when the approach has not been implemented in a well-considered manner, such as having open discussions and training [67]. Parents who are less satisfied may be more likely to disengage and not provide outcome or feedback information [5].…”

“…There are a number of barriers to formulating and tracking goals in child mental health practice, including the child’s capacity to do so [29, 64]; involvement of parents who may have different experiences and perceptions to the child or their own emotional and behavioural difficulties [75]; lack of resources to record goals formally (or the pressure to do so) and training on setting and tracking meaningful goals [34, 61]; and safeguarding concerns around balancing the involvement of the child with their vulnerability [2, 71]. Some models of therapy (e.g.…”

Facilitators and Barriers to Person‐centred Care in Child and Young People Mental Health Services: A Systematic Review

“…The rest of the studies were carried out in Australia ( n = 2), Hong Kong ( n = 1) and Canada ( n = 1). In terms of the aims of included studies, eight studies primarily focused on exploring experiences and beliefs related to PCC ( n = 2; Abrines‐Jaume et al, ; Grealish, Tai, Hunter, & Morrison, ), whereas other studies looked into various aspects of service users' general experience of mental health services.…”

“…Finally, all studies but one (Molesworth & Crome, ) presented findings in a comprehensive manner providing quotes illustrating the main themes obtained by the analysis. Nonetheless, several studies did not provide sufficient detail on issues such as justification of the research design ( n = 3; Iachini, Hock, Thomas, & Clone, ; Molesworth & Crome, ; Street, ), recruitment strategy ( n = 6; Lee et al, ; LeFrançois, ; Ma & Lai, ; Molesworth & Crome, ; Offord, Turner, & Cooper, ; Street, ), data collection ( n = 3; LeFrançois, ; Molesworth & Crome, ; Street, ), the relationship between researcher and participants ( n = 14; Buckley et al, ; Harper, Dickson, & Bramwell, ; Hart, Saunders, & Thomas, ; Iachini et al, ; Kovshoff et al, ; Lee et al, ; LeFrançois, ; Molesworth & Crome, ; Offord et al, ; Oruche, Downs, Holloway, Draucker, & Aalsma, ; Pelto‐Piri, Engstrom, K., & Engstrom, ; Street, ; Tam‐Seto & Versnel, ; Wisdom, Clarke, & Green, ), ethical issues ( n = 4; Abrines‐Jaume et al, ; LeFrançois, ; Molesworth & Crome, ; Wisdom et al, ) and rigour of data analysis ( n = 4; Hart et al, ; LeFrançois, ; Molesworth & Crome, ; Street, ). Finally, contribution to research, knowledge or policy was not discussed in two studies (Molesworth & Crome, ; Street, ), new areas of research were not identified in six studies (Buckley et al, ; Hart et al, ; Lee et al, ; Molesworth & Crome, ; Pycroft, Wallis, Bigg, & Webster, ; Street, ) and generalizability of findings was not taken into account in nine studies (Buckley et al, ; Bury, Raval, & Lyon, ; Coyne et al, ; Kovshoff et al, ; LeFrançois, ; Molesworth & Crome, ; Offord et al, ; Pelto‐Piri et al, ; Street, …”