How Can Parents Help in Shared Decision Making?

Mother and daughter with doctor

Families for Depression Awareness for Care for Your Mind

Your teenager has
been diagnosed with a mood disorder and the clinician is talking with
her or him about treatment. What is your role as a parent in the
shared decision making model? How can you participate?

At Families
for Depression Awareness
, we believe that parents can
play an essential role in recognizing and addressing mood disorders
in their children. When
you’re worried about a teen in your life
, you might
need to take crucial actions in a crisis situation, convince a
reluctant teen to go to a mental health provider, or be supportive in
finding and accessing mental health care.

Of course, a
parent’s first step will likely be to find
reliable educational material about mood disorders
that they can be comfortable talking about the mental health
condition, have an idea of what are the relevant symptoms, and become
familiar with the different treatments.

Although teens can
usually speak for themselves, they may be disinclined or unable to do
so while at the provider’s office. Thus, it’s extremely helpful
to have had a discussion before the appointment about what is their
vision of wellness: what do they want to be able to do (e.g., feel
like participating in soccer, be able to concentrate in school), and
what do they want to avoid (e.g., excessive need for sleep, feeling
like their brain is foggy, etc.). What are their values? What do they
want the outcome of treatment to be?

The initial stage of
shared decision making involves information sharing. Often, people
with untreated or undertreated depression lack perspective and have
difficulty recalling details. Parents can provide valuable
information and insights by reporting relevant family history,
treatment history, types and persistence of symptoms, notable
behaviors, trends in mood, side effects, and so on.

Part of shared
decision making is recognizing and respecting the autonomy of the
person living with a mood disorder, so the more that she or he can
participate productively, the better. When the discussion is going
well, the parent need not play such an active role, but can help to
make sure that their teen is providing accurate and complete
information, as needed. If the teen is unwilling or unable to
participate, the parent would naturally take a more active role,
while still involving the teen as much as possible. It is, after all,
her or his treatment, health, and wellbeing at issue.

In shared decision
making, the clinician should also be a source of information. First,
the clinician should explain the diagnosis and the basis for the
diagnosis, and answer any questions. Ideally, the clinician will
provide assurance that there is more than one suitable way to
approach treatment for mood disorders and set the stage for the
dialogue through which the clinician, your teen, and you will select
the most desirable option for moving forward.

For each of the
options, it’s fair to expect that the clinician will discuss risks
and benefits, and she or he should help with evaluating the options
taking your teen’s desires and values into account. It’s a
dialogue, not a presentation, so your teen should participate, and
you should support that process as is reasonable and possible. If
your teen sees the decision as being made for – and not with –
them, they are less likely to adhere to the treatment plan and have
satisfactory outcomes.

What if the provider
is not offering alternatives or asking for your teen’s or your
input? Ask questions! Ask them to explain

  • what are the
    options and the benefits and downsides of each treatment approach
  • how the
    different approaches support your teen’s values and preferences
  • whether the
    timeline for treatment effectiveness varies among the different
  • what is the
    evidence base for the different treatments
  • what aren’t
    they telling you and your teen that will help to make the best
    decision at this juncture.

Finally, at the end
of the appointment, ask them why haven’t they adopted a shared
decision making model!

What Do You

  • How have you
    been involved with the shared decision making around treatment for a
    loved one?
  • What has been
    your family’s role in shared decision making around your
    treatment? In what ways has the experience been beneficial?

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Editor’s Note:
This is a slightly modified version of a post that appeared on Care
for Your Mind on August 9, 2016.

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