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Guided Self-Determination - What does "guided" mean in connection with self-determination?

Vibeke Zoffmann1, Jeanette Finderup2, Rikke Jørgensen3

  • 1Juliane Marie Center, Rigshospitalet, Blegdamsvej 9, Copenhagen DK-2100, Denmark; Section for Health Services Research, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen DK-2200, Denmark; School of Nursing and Midwifery, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia; Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, 1 Gheringhap St, Geelong, VIC 3220, Australia.

Patient Education and Counseling
|August 21, 2025
PubMed
Summary

Guided Self-Determination (GSD) empowers healthcare users by fostering autonomy. This method resolves the apparent paradox of "guided" self-determination, showing guidance and autonomy are compatible for better decision-making.

Keywords:
EmpowermentGuided Self-DeterminationPotential for changeSelf-determinationShared decision-makingValues-clarification

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Area of Science:

  • Healthcare decision-making
  • Patient empowerment
  • Translational research

Background:

  • Persistent challenges exist in empowering healthcare users.
  • Guided Self-Determination (GSD) is an empowerment-based method for decision-making and problem-solving.
  • GSD's effectiveness is established across various long-term conditions.

Purpose of the Study:

  • To clarify the "guided" and "self-determination" components of the GSD method.
  • To address potential misunderstandings regarding the GSD method's name.
  • To provide a scientific discussion on the GSD method's principles.

Main Methods:

  • Expert discussion involving translational empowerment, self-determination theory, and GSD.
  • Analysis of Self-Determination Theory (SDT) strengths and practical limitations.
  • Description of GSD's use of reflection sheets for user preparation and active involvement.

Main Results:

  • Self-Determination Theory (SDT) has strong conceptualization but lacks practical clinical application support.
  • GSD utilizes reflection sheets to prepare users for active participation with healthcare professionals (HCPs).
  • GSD facilitates user self-insight via values clarification, enabling discovery of personal change potential and constructive decision-making.

Conclusions:

  • Guidance that respects and fosters autonomy leads to genuine self-determination.
  • Guidance and self-determination are complementary, not contradictory.
  • Empowerment-based methods like GSD enhance user self-determination in clinical decision-making and problem-solving.