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Shared decision-making for youth psychotherapy: A preliminary randomized clinical trial on facilitating personalized treatment.
Journal of Consulting and Clinical Psychology ( IF 4.5 ) Pub Date : 2021-12-23 , DOI: 10.1037/ccp0000702
David A Langer 1 , Lindsay E Holly 1 , Celia E Wills 2 , Martha C Tompson 3 , Bruce F Chorpita 1
Affiliation  

OBJECTIVE Engaging youth and caregivers as active collaborators in the treatment planning process is a patient-centered approach with the potential to facilitate the personalization of established evidence-based treatments. This study is the first randomized clinical trial to evaluate shared decision-making (SDM) to plan youth psychotherapy. METHOD Forty youth (7-15 years; 33% ethnic minority) were randomly assigned to psychosocial treatment planned using SDM (n = 20) or planned primarily by the clinician (n = 20). In the SDM condition, clinicians guided youth and caregivers through a collaborative treatment planning process that relies on research findings to inform three primary decisions: (a) treatment target problem(s), (b) treatment participants, and (c) treatment techniques. Assessments occurred at baseline, following treatment planning, midtreatment, and post-treatment. RESULTS Youth and caregivers in the SDM condition reported significantly greater involvement in the treatment planning process compared to their counterparts in the clinician-guided condition (U = 123.00, p = .037; U = 84.50, p = .014, respectively) and SDM caregivers reported significantly lower decisional conflict (U = 72.00, p = .004) and decisional regret (U = 73.50, p = .020). Supporting the feasibility of successful SDM implementation, there were no significant differences between conditions on treatment length, satisfaction with decisions, or engagement. There were no significant diagnostic or symptom differences between conditions. CONCLUSIONS Planning psychosocial treatments in collaboration with youth and caregivers is a promising way to support youth and caregiver autonomy and plan evidence-based treatments that are responsive to patient preferences, culture, and values. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

中文翻译:

青年心理治疗的共同决策:促进个性化治疗的初步随机临床试验。

目标 让青年人和护理人员作为积极的合作者参与治疗计划过程是一种以患者为中心的方法,有可能促进已建立的循证治疗的个性化。这项研究是第一个评估共享决策 (SDM) 以规划青少年心理治疗的随机临床试验。方法 四十名青年(7-15 岁;33% 的少数民族)被随机分配到使用 SDM 计划的社会心理治疗 (n = 20) 或主要由临床医生计划 (n = 20)。在 SDM 条件下,临床医生通过协作治疗计划流程指导青少年和护理人员,该流程依赖于研究结果以告知三个主要决策:(a) 治疗目标问题,(b) 治疗参与者,以及 (c) 治疗技术。评估发生在基线,遵循治疗计划,中期治疗和后期治疗。结果 与临床医生指导条件(U = 123.00,p = .037;分别为 U = 84.50,p = .014)和 SDM照顾者报告的决策冲突 (U = 72.00, p = .004) 和决策后悔 (U = 73.50, p = .020) 显着降低。支持成功实施 SDM 的可行性,治疗时间、决策满意度或参与度等条件之间没有显着差异。条件之间没有显着的诊断或症状差异。结论 与青年和看护者合作规划社会心理治疗是支持青年和看护者自主并规划响应患者偏好、文化和价值观的循证治疗的有前途的方法。(PsycInfo 数据库记录 (c) 2022 APA,保留所有权利)。
更新日期:2021-12-23
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