Neus Abrines-Jaume1, Nick Midgley2, Katy Hopkins3, Jasmine Hoffman3, Kate Martin4, Duncan Law5, Miranda Wolpert6. 1. EBPU, Anna Freud Centre and UCL, London, UK Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine (LSHTM), London, UK. 2. Anna Freud Centre and UCL, London, UK. 3. EBPU, Anna Freud Centre and UCL, London, UK. 4. Common Room Consulting Ltd, London, UK. 5. Child Outcomes Research Consortium, London, UK. 6. EBPU, Anna Freud Centre and UCL, London, UK EBPU@annafreud.org.
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.
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.
Authors: Louise Chapman; Julian Edbrooke-Childs; Kate Martin; Helen Webber; Michael P Craven; Chris Hollis; Jessica Deighton; Roslyn Law; Peter Fonagy; Miranda Wolpert Journal: JMIR Res Protoc Date: 2017-10-30
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