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Community Ment Health J. 2018 Jan;54(1):7-16. doi: 10.1007/s10597-017-0136-5. Epub 2017 Apr 11.

Supporting Shared Decision-making for Children's Complex Behavioral Problems: Development and User Testing of an Option Grid™ Decision Aid.

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Department of Psychiatry, Geisel School of Medicine at Dartmouth, Dartmouth Trauma Interventions Research Center, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03756, USA.
Center for Program Design and Evaluation at Dartmouth, 21 Lafayette #373, Lebanon, NH, 03756, USA.
Department of Psychiatry, Dartmouth-Hitchcock Psychiatric Associates, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Lebanon, NH, 03756, USA.
The Dartmouth Institute for Health Policy and Clinical Practice, One Medical Center Drive, Lebanon, NH, 03756, USA.


There is a lack of research to guide collaborative treatment decision-making for children who have complex behavioral problems, despite the extensive use of mental health services in this population. We developed and pilot-tested a one-page Option Grid™ patient decision aid to facilitate shared decision-making for these situations. An editorial team of parents, child psychiatrists, researchers, and other stakeholders developed the scope and structure of the decision aid. Researchers included information about a carefully chosen number of psychosocial and pharmacological treatment options, using descriptions based on the best available evidence. Using semi-structured qualitative interviews (n = 18), we conducted user testing with four parents and four clinical prescribers and field testing with four parents, four clinical prescribers, and two clinic administrators. The researchers coded and synthesized the interview responses using mixed inductive and deductive methods. Parents, clinicians, and administrators felt the Option Grid had significant value, although they reported that additional training and other support would be required in order to successfully implement the Option Grid and achieve shared decision-making in clinical practice.


Behavioral disorders; Child psychiatry; Children; Children’s mental health; Decision aid; Shared decision making

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