Structured shared decision-making using dialogue and visualization: A randomized controlled trial

ObjectiveThe aim of this study is to evaluate a method, “Counseling in Dialogue” (CD), developed to increase the quality of counseling in youth mental health. Decisional conflict was used as indicator of the quality of counseling and shared decision-making.Methods94 children aged 2–12 years were randomized into a CD group and a care as usual (CU) group. In a before-and-after design decisional conflict was measured using the decisional conflict scale (DCS) for parents (N = 133) and the Provider Decision Process Assessment Instrument for therapists (PDPAI, N = 20). 81 children had follow-up data.ResultsCompared with parents of the CU group, parents of the CD group reported significantly less decisional conflict after counseling (difference mothers: −0.38 (95%CI −0.56; −0.19), p < .001; fathers: −0.22 (95%CI −0.44; −0.01), p = .045). 98% of the mothers and 96% of the fathers in the CD group accepted the recommended treatment, compared to 71% (fathers) and 77% (mothers) in the CU group, p < 0.05. Decisional conflict of the therapists was low in both groups after counseling (difference: −0.03 (95%CI −0.19; 0.14), p = .741).ConclusionThe counseling procedure significantly lowered decisional conflict of the parents and promoted the acceptance of the recommended treatment.