Shared Decision-Making and Self-Directed Care

  • Michelle P. Salyers
  • Yaara Zisman-Ilani


Patient involvement in health care is driven by ethical, theoretical, and practical considerations and has clear implications for mental health policy. The realization that patients and clinicians need to collaborate closely for successful treatment is especially salient for people with chronic health conditions. Indeed, the mental health field is witnessing a proliferation of patient-centered practices. We focus on two general strategies: shared decision-making (SDM) and self-directed care, both of which require patient involvement in mental health service delivery and in promoting mental well-being. These strategies also require a fundamental shift in issues of the working relationship in the production of health outcomes; who controls the work in mental health services? How do we balance preferences and expertise in making key decisions to promote mental health and well-being? This chapter wrestles with these issues and highlights research evidence for practices that promote SDM and self-directed care. We also describe key challenges in implementing these approaches and point to directions for future research.


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Copyright information

© The Author(s) 2020

Authors and Affiliations

  • Michelle P. Salyers
    • 1
  • Yaara Zisman-Ilani
    • 2
  1. 1.Department of Psychology School of ScienceACT Center of Indiana, Indiana University-Purdue University IndianapolisIndianapolisUSA
  2. 2.College of Public HealthTemple UniversityPhiladelphiaUSA

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