Shared decision making between community therapists and Latinx caregivers during evidence-based practice delivery in publicly-funded children's mental health services

Blanche Wright; Lauren Brookman-Frazee; Margarita Alegría; David Langer; Anna S Lau

doi:10.1016/j.pec.2023.107867

Shared decision making between community therapists and Latinx caregivers during evidence-based practice delivery in publicly-funded children's mental health services

Patient Educ Couns. 2023 Oct:115:107867. doi: 10.1016/j.pec.2023.107867. Epub 2023 Jun 22.

Authors

Blanche Wright¹, Lauren Brookman-Frazee², Margarita Alegría³, David Langer⁴, Anna S Lau⁵

Affiliations

¹ Department of Health Policy and Management, University of California, Los Angeles, USA. Electronic address: bmwright2020@ucla.edu.
² Department of Psychiatry, University of California, San Diego; Child and Adolescent Services Research Center, San Diego, USA.
³ Department of Psychiatry, Harvard Medical School; Disparities Research Unit, Massachusetts General Hospital, Boston, USA.
⁴ Department of Psychology, Suffolk University, Boston, USA.
⁵ Department of Psychology, University of California, Los Angeles, USA.

PMID: 37406470
DOI: 10.1016/j.pec.2023.107867

Abstract

Objectives: This observational study examined shared decision-making (SDM) with caregivers of Latinx youth within the delivery of multiple evidence-based practices (EBPs) in community mental health services. Study aims were to (1) Characterize therapist use of SDM strategies and (2) Describe the types of treatment decisions that were the focus of therapist use of SDM.

Methods: The OPTION instrument was used to measure SDM in 210 audio-recorded therapy sessions with 62 community therapists and 109 Latinx caregivers; frequency and mean ratings of OPTION items were examined. Qualitative analysis on the descriptions of treatment decisions being deliberated was also conducted.

Results: Results revealed that therapists used at least one SDM step in most sessions (N = 192; 91.43%) with a mean composite score of 32.78 (SD=17.79; range: 6.25-81.25). Four superordinate categories of decisions were: (1) Treatment planning, (2) Evidence-based Parenting Strategies, (3) Addressing Youth Functioning, and (4) Addressing Family Psychosocial Needs.

Conclusions: Findings suggest that community therapists serving Latinx families are naturalistically engaging in SDM steps about a variety of decisions during most EBP sessions, but only at modest levels.

Keywords: Evidence-based practice; Latinx populations; Minorities; Parents; Shared decision-making.

Publication types

Observational Study

MeSH terms

Adolescent
Caregivers*
Child
Decision Making
Decision Making, Shared
Evidence-Based Practice
Hispanic or Latino
Humans
Mental Health Services*
Patient Participation

Grants and funding

T32 HS000046/HS/AHRQ HHS/United States