The relationship between child- and parent-reported shared decision making and child-, parent-, and clinician-reported treatment outcome in routinely collected child mental health services data

Clin Child Psychol Psychiatry. 2016 Apr;21(2):324-38. doi: 10.1177/1359104515591226. Epub 2015 Jun 22.


Objective: Shared decision making (SDM) between service users and providers is increasingly being suggested as a key component of good healthcare. The aim of this research was to explore whether child- and parent-reported experience of SDM was associated with child- and parent-reported improvement in psychosocial difficulties and clinician-reported functioning at the end of treatment in child and adolescent mental health services (CAMHS).

Method: The sample comprised N = 177 children (62% female; 31% aged 6-12 and 69% aged 13-18) with a variety of mental health problems from 17 services where routinely collected data consisted of presenting problems at outset, child- and parent-reported change in symptoms between Time 1 and Time 2 (Strengths and Difficulties Questionnaire; SDQ), clinician-reported change in functioning between Time 1 and Time 2 (Children's Global Assessment Scale; CGAS), and experience of SDM at Time 2 (as measured by responses to the Experience of Service Questionnaire; ESQ).

Results: Analysis revealed that both child- and parent-reported experience of SDM were associated with higher levels of child- and parent-reported improvement in psychosocial difficulties. However, child-reported experience of SDM was only associated with higher levels of child-reported improvement when their parents also reported higher levels of SDM.

Conclusion: In CAMHS, involving both children and parents in decision making may contribute to enhanced treatment outcomes.

Keywords: Shared decision making; child mental health; functioning; longitudinal; multilevel; psychosocial difficulties.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Health Services / standards*
  • Child
  • Child Health Services / standards*
  • Decision Making*
  • Female
  • Humans
  • Male
  • Mental Health Services / standards*
  • Parents / psychology*
  • Patient Outcome Assessment*
  • Patient Participation / psychology*
  • Treatment Outcome*