title: Structured shared decision-making using dialogue and visualization: a randomized controlled trial.
abstract: OBJECTIVE
  The aim of this study is to evaluate a method, "Counseling in Dialogue" (CD), developed to increase the quality of counseling in youth mental health. Decisional conflict was used as indicator of the quality of counseling and shared decision-making.
  
  
  METHODS
  94 children aged 2-12 years were randomized into a CD group and a care as usual (CU) group. In a before-and-after design decisional conflict was measured using the decisional conflict scale (DCS) for parents (N=133) and the Provider Decision Process Assessment Instrument for therapists (PDPAI, N=20). 81 children had follow-up data.
  
  
  RESULTS
  Compared with parents of the CU group, parents of the CD group reported significantly less decisional conflict after counseling (difference mothers: -0.38 (95%CI -0.56; -0.19), p<.001; fathers: -0.22 (95%CI -0.44; -0.01), p=.045). 98% of the mothers and 96% of the fathers in the CD group accepted the recommended treatment, compared to 71% (fathers) and 77% (mothers) in the CU group, p<0.05. Decisional conflict of the therapists was low in both groups after counseling (difference: -0.03 (95%CI -0.19; 0.14), p=.741).
  
  
  CONCLUSIONS
  The counseling procedure significantly lowered decisional conflict of the parents and promoted the acceptance of the recommended treatment.
authors.affiliation: Department Child and Adolescent Psychiatry, Orbis Medical Centre, The Netherlands. g.westermann@orbisconcern.nl
authors.forename: George M A
authors.initials: GM
authors.lastname: Westermann
authors.forename: Fop
authors.initials: F
authors.lastname: Verheij
authors.forename: Bjorn
authors.initials: B
authors.lastname: Winkens
authors.forename: Frank C
authors.initials: FC
authors.lastname: Verhulst
authors.forename: Floor V A
authors.initials: FV
authors.lastname: Van Oort
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D003220:Conflict, Psychological; D003376:Counseling; D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008875:Middle Aged; D009426:Netherlands; D010290:Parents / Q000523:psychology; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation; D017060:Patient Satisfaction; D011368:Professional-Family Relations