Westermann G M A, Maurer J M G
Tijdschr Psychiatr. 2015;57(5):352-60.
In the communication and interaction between doctor and patient in Western health care there has been a paradigm shift from the paternalistic approach to shared decision-making.
To summarise the background situation, recent developments and the current level of shared decision-making in (youth) mental health care.
We conducted a critical review of the literature relating to the methodology development, research and the use of counselling and decision-making in mental health care.
The majority of patients, professionals and other stakeholders consider shared decision-making to be desirable and important for improving the quality and efficiency of care. Up till recently most research and studies have concentrated on helping patients to develop decision-making skills and on showing patients how and where to access information. At the moment more attention is being given to the development of skills and circumstances that will increase patients' interaction with care professionals and patients' emotional involvement in shared decision-making. In mental health for children and adolescents, more often than in adult mental health care, it has been customary to give more attention to these aspects of shared decision-making, particularly during counselling sessions that mark the transition from diagnosis to treatment. This emphasis has been apparent for a long time in textbooks, daily practice, methodology development and research in youth mental health care. Currently, a number of similar developments are taking place in adult mental health care.
Although most health professionals support the policy of shared decision-making, the implementation of the policy in mental health care is still at an early stage. In practice, a number of obstacles still have to be surmounted. However, the experience gained with counselling and decision-making in (youth) mental health care may serve as an example to other sections of mental health care and play an important role in the further development of shared decision-making.
在西方医疗保健中医生与患者的沟通和互动方面，已经出现了从家长式方法向共同决策的范式转变。
总结（青少年）精神卫生保健中共同决策的背景情况、近期发展及当前水平。
我们对与精神卫生保健中方法开发、研究以及咨询和决策使用相关的文献进行了批判性综述。
大多数患者、专业人员和其他利益相关者认为共同决策对于提高护理质量和效率是可取且重要的。直到最近，大多数研究都集中在帮助患者发展决策技能以及向患者展示如何获取信息和从何处获取信息。目前，更多的注意力正放在技能和环境的发展上，这些技能和环境将增加患者与护理专业人员的互动以及患者在共同决策中的情感投入。在儿童和青少年的精神卫生领域，相较于成人精神卫生保健，人们更经常地习惯对共同决策的这些方面给予更多关注，尤其是在标志着从诊断到治疗过渡的咨询过程中。这种强调在青少年精神卫生保健的教科书、日常实践、方法开发和研究中已经存在很长时间了。目前，成人精神卫生保健中也正在发生一些类似的发展情况。
尽管大多数卫生专业人员支持共同决策政策，但该政策在精神卫生保健中的实施仍处于早期阶段。在实践中，仍有一些障碍需要克服。然而，在（青少年）精神卫生保健中咨询和决策方面获得的经验可能为精神卫生保健的其他领域提供范例，并在共同决策的进一步发展中发挥重要作用。
