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Capability
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Knowledge
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An awareness of the philosophy of SDM but not always the term
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A lack of knowledge regarding care and treatment options
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Cognitive and interpersonal skills
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The overlap between core therapeutic skills and skills needed for SDM
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Negotiation and containment as ‘new’ skills needed for SDM
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Memory, attention, and decision making processes
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The availability of options may affect what is presented to the young person and family
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Behavioural regulation
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A lack of clarity around whether there are guidelines and protocols for SDM
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Reviews of treatment and goals, whilst considered important, are conducted sporadically
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Opportunity
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Environmental context and resources
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Facilities not conducive to SDM
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Limited or a lack of psychological interventions for SDM
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Administration and time constraints that inhibit SDM
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Procedural influences stop SDM
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Social influences
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Team members positively and negatively influencing decisions
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Dominating parents
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Motivation
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Professional role and identity
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Shared decision making is something CAMHS clinicians ‘do’
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Overruling a young person’s wishes due to professional standards
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Beliefs about consequences
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Shared decision making empowers young people and families
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Shared decision making takes too much time
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Shared decision making can make psychological problems worse
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Beliefs about capabilities
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Feeling confident engaging in SDM
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Feeling less confident due to a lack of knowledge around options
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Emotion
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Feeling overwhelmed which inhibits SDM
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