Department of Psychology, Harvard University.
Department of Psychology, Suffolk University.
J Clin Child Adolesc Psychol. 2023 Jan-Feb;52(1):95-107. doi: 10.1080/15374416.2022.2127105. Epub 2022 Oct 3.
Discrepancies among the key stakeholders in youth psychotherapy (e.g., caregivers, youths) commonly present an obstacle to treatment planning, forcing clinicians to align with one perspective over another and increasing the likelihood of a treatment plan that is not fully responsive to divergent opinions. At the same time, multi-stakeholder discrepancies can also offer opportunities to build an inclusive, effective treatment plan, guided by the integration of numerous sources of domain-specific knowledge related to the concerns for which families seek clinical care.
We aim to: 1) investigate the degree to which multi-stakeholder discrepancies are observed when youths and caregivers are invited to report their treatment priorities, rather than the presence and severity of youth symptoms, 2) describe the rationale for, as well as the promise and challenges of, shared decision-making (SDM)-an approach designed to facilitate multi-stakeholder collaboration during treatment planning, 3) provide a case example illustrating how a clinician, youth, and caregiver could use SDM to navigate discrepancies and identify therapy targets, and 4) propose future directions for exploring the potential value of SDM in youth psychotherapy.
Different levels of multi-stakeholder agreement were observed when caregivers and youths were asked to identify their treatment priorities, compared to youth symptom presence and severity, revealing nuances in multi-stakeholder agreement in youth psychotherapy.
Multi-stakeholder discrepancies can inform treatment planning processes, and SDM may be an effective approach for navigating them and building a treatment plan that integrates the perspective of all stakeholders in youth psychotherapy.
青年心理治疗中的主要利益相关者（如照顾者、青少年）之间的差异通常会成为治疗计划的障碍，迫使临床医生选择站在某一方，从而增加了治疗计划不能完全响应不同意见的可能性。与此同时，多利益相关者的差异也为制定一个包容和有效的治疗计划提供了机会，该计划以整合与家庭寻求临床护理相关的多个特定领域知识来源为指导。
我们旨在：1）调查当邀请青少年和照顾者报告他们的治疗重点，而不是青少年症状的存在和严重程度时，多利益相关者差异的程度；2）描述共享决策（SDM）的原理、承诺和挑战，这是一种旨在促进治疗计划中多利益相关者合作的方法；3）提供一个案例示例，说明临床医生、青少年和照顾者如何使用 SDM 来解决差异并确定治疗目标；4）提出未来探索 SDM 在青少年心理治疗中的潜在价值的方向。
与青少年症状的存在和严重程度相比，当要求照顾者和青少年确定他们的治疗重点时，观察到了不同程度的多利益相关者一致性，这揭示了青少年心理治疗中多利益相关者一致性的细微差别。
多利益相关者的差异可以为治疗计划提供信息，而 SDM 可能是一种有效的方法，可以帮助处理这些差异，并制定一个整合青少年心理治疗中所有利益相关者观点的治疗计划。
