Shared Decision-Making—Balancing Between Power and Responsibility as Mental HealthCare Professionals in a Therapeutic Milieu

Abstract

Abstract Background: Shared decision-making (SDM) is supposed to position patient and expert knowledge more equal, in which will have an impact on how mental healthcare professionals relate to their patients. As SDM has not yet been widely adopted in therapeutic milieus, a deeper understanding of its use and more knowledge of interventions to foster its implementation in clinical practice are required. Aim: To explore how mental healthcare professionals describe SDM in a therapeutic milieu as expressed through clinical supervision. The research question was ‘‘What are prerequisites for mental healthcare professionals to practice SDM in a therapeutic milieu?’’ Methods: A qualitative content analysis of data from focus groups dialogues in 10 clinical supervision sessions where eight mental healthcare professionals participated was performed. Findings: The theme, practicing SDM when balancing between power and responsibility to form safe care, was based on three categories: internalizing the mental healthcare professionals’ attributes, facilitating patient participation, and creating a culture of trust. Conclusion: SDM is a complex and arduous process requiring appropriate interventions. Clinical supervision is necessary for reflection on SDM and for improving practice in a therapeutic milieu.