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Development and pilot testing of a skills training modality intended to improve shared decision making in treatment for serious mental illness

Emily Treichler, University of Nebraska - Lincoln


Shared decision-making (SDM) has become a goal of mental health services nationally and internationally. Mental health practitioners, consumers, and researchers alike recognize that greater consumer involvement in clinical decision making is key to positive treatment related outcomes. This approach to treatment is of particular importance to the serious mental illness (SMI) population because the recovery movement focuses on empowerment and autonomy throughout a person’s life, including treatment related issues. This dissertation reviews and analyzes the evolution of the SDM concept, and describes development of a new modality to promote use of SDM in mental health service systems. The new modality applies skill training principles to help people with SMI gain skills to initiate and engage in SDM with their treatment teams and other stakeholders involved in the services they receive. Modality development also included structured participatory dialogues with mental health consumers and practitioners. Participants gave feedback on early versions of the modality and guided development of content and format. A group leader manual was a core component and a focus of the dialogue process. The resulting CDST protocol was pilot tested for feasibility with 21 adults with SMI in an adult day program. Results were favorable. Therapists were able to maintain strong fidelity, and fidelity improved over time; attendance and attrition were both in line with comparable studies; participants reported high levels of satisfaction; and preliminary data indicated that participants gained skills and knowledge over the course of the skills training. Participants did not complete homework as often as expected, an issue to be adjusted in later studies. Larger trials of CDST are merited given the outcome of this study.

Subject Area

Mental health|Clinical psychology

Recommended Citation

Treichler, Emily, "Development and pilot testing of a skills training modality intended to improve shared decision making in treatment for serious mental illness" (2016). ETD collection for University of Nebraska-Lincoln. AAI10139044.