How Can Parents Help in Shared Decision Making?

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

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

Your Turn

  • 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? Has the experience been beneficial?

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