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Shared Risk Taking: Shared Decision Making in Serious Mental Illness.
Yaara Zisman-Ilani1, Paul H Lysaker1, Ilanit Hasson-Ohayon1
1Department of Social and Behavioral Science, College of Public Health, Temple University, Philadelphia (Zisman-Ilani); Veterans Affairs Medical Center, and Department of Psychiatry, Indiana University School of Medicine, Indianapolis (Lysaker); Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel (Hasson-Ohayon).
Psychiatric Services (Washington, D.C.)
|February 9, 2021
Summary
Shared decision making (SDM) is underutilized in serious mental illness care. This study reconceptualizes SDM as shared risk-taking, offering insights into clinical interventions for managing illness and recovery.
Area of Science:
- Health communication
- Mental health research
- Clinical psychology
Background:
- Shared decision making (SDM) is an interpersonal health communication model.
- SDM is underutilized among individuals with serious mental illness.
- Existing research highlights patient capacity, clinician, and system barriers to SDM.
Purpose of the Study:
- To present a reconceptualization of SDM.
- To explore the role of risk-taking in SDM for individuals with serious mental illness.
- To inform clinical interventions addressing risk in SDM.
Main Methods:
- Conceptual analysis and reconceptualization of SDM.
- Integration of concepts such as intersubjectivity, meaning making, and metacognition.
- Discussion of risk-taking within illness management and recovery phases.
Main Results:
- SDM is reframed as a process of shared risk-taking.
- Risk-taking in SDM occurs across various illness management and recovery stages.
- Intersubjectivity, meaning making, and metacognition are key to addressing risk in SDM.
Conclusions:
- Reconceptualizing SDM as shared risk-taking offers a new perspective for serious mental illness care.
- Understanding and addressing risk is crucial for effective SDM in this population.
- Clinical interventions can be informed by intersubjectivity, meaning making, and metacognition to support shared risk-taking in SDM.
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