Shared Decision-Making—Balancing Between Power and Responsibility as Mental Health-Care Professionals in a Therapeutic Milieu

Abstract

Background: Shared decision-making (SDM) is supposed to position patient and expert knowledge more equal, in which will have an impact on how mental health-care professionals relate to their patients. As SDM has not yet been widely adopted in therapeutic milieus, a deeper understanding of its use and more knowledge of interventions to foster its implementation in clinical practice are required. Aim: To explore how mental health-care professionals describe SDM in a therapeutic milieu as expressed through clinical supervision. The research question was “What are prerequisites for mental health-care professionals to practice SDM in a therapeutic milieu?” Methods: A qualitative content analysis of data from focus groups dialogues in 10 clinical supervision sessions where eight mental health-care professionals participated was performed. Findings: The theme, practicing SDM when balancing between power and responsibility to form safe care, was based on three categories: internalizing the mental health-care professionals’ attributes, facilitating patient participation, and creating a culture of trust. Conclusion: SDM is a complex and arduous process requiring appropriate interventions. Clinical supervision is necessary for reflection on SDM and for improving practice in a therapeutic milieu.