As mental health providers, we often talk about youth and caregivers as the ultimate experts on their family members, culture, and day-to-day lives. They have insider knowledge that helps providers more accurately assess their current concerns and allows for more successful integration of evidence-based practices into their own unique schedules and preferences. Yet, all too often, families are left out of using their expertise in the treatment planning process. In many cases, providers select an intervention or set of services based on their own training and comfort with specific practice models, assuming that families will be on board because those approaches have worked for others. However, it is critical to involve youth and caregivers in the decision-making process at every step of care to ensure their individual voices are heard and to maximize the likelihood of that care being effective.
Why Partnering With Families Matters
In fact, research on shared decision-making (SDM) in youth mental health care indicates positive effects for including youth and caregivers in the treatment planning process across multiple important domains. Use of SDM models was associated with greater improvement in youth psychosocial difficulties and mental health functioning in several trials (Edbrooke-Childs, Jacob, Argent et al., 2015; Cheng, Hayes, Edbrooke-Childs et al., 2017; Butler, 2014). Another study also found that families felt more involved and less conflicted about their care when using a SDM system as opposed to provider-driven decision-making (Langer, Holly, Wills, Tompson, & Chorpita, 2022). Broader interventions that involve youth and caregivers when exploring treatment options and collaborating on goals have also been linked to increased attendance and engagement in therapy (Simmons, Hetrick, & Jorm, 2011; Jones, Hassett, & Sclare, 2017; Svamo, Haug, DeMarinis, & Hertzberg, 2024). Given these findings, it is important that providers find ways to invite families into the planning process as equal partners, determining the most fitting course of action together.
Practical Strategies for Partnering With Families
Here are some recommendations for how providers can better partner with families in planning for their care, including the PracticeWise tools that help support this partnership:
- Gather information on the most effective treatments for the family based on the youth’s unique characteristics and present these as options in a larger discussion with the youth and their caregivers. The research literature is one valuable source of knowledge that can be a helpful starting point in designing a collaborative care plan. Fortunately for providers, the PWEBS application distills the large volume of research papers on youth mental health treatments (over 1,900!) to a searchable tool that gives quick results on the treatments with the most support based on specific factors like problem type (e.g., anxiety, disruptive behavior, depression, attention), age, gender, or race/ethnicity. PWEBS equips providers with the most up-to-date knowledge so they can confidently discuss the treatments that have worked best across large groups with families and elicit their thoughts on them.
- Apply evidence-based strategies to improve family engagement from the very start of treatment. The MAP Engagement System includes several step-by-step practice guides with specific strategies to identify youth and caregivers’ early expectations and perspectives on treatment and weave them into the planning and goal setting activities. It also uses the CARE process (Consider, Answer, Respond, Evaluate) to help providers test out how families are responding to those strategies so that they can make quick adaptations and consider other strategies that may be more helpful in getting families actively involved in their care planning.
- Provide psychoeducation about the concerns that the youth and caregivers are having to ensure they understand what we know (as well as what we do not know!) about them, factors that contribute to the concern(s), and how treatment strategies help address those factors. Psychoeducation is an important intervention to implement early in treatment to increase awareness, make the youth and family feel less alone in the process, and explain the rationale for the interventions that will be used. It also gives families an opportunity to ask questions and creates space for open conversation about available treatment choices. PracticeWise offers several Psychoeducation Practitioner Guides with separate versions for youth and caregivers that are devoted to specific concerns, such as anxiety, depression, disruptive behavior, inattention and trauma in addition one you can customize to other target areas to guide these discussions.
- Use data to inform ongoing conversations. Measurement-based care (MBC) is an evidence-based practice in which providers track treatment progress over time using both standardized and individualized measures and regularly present this information to families to get their feedback and make collaborative treatment decisions. MBC allows providers, youth, and caregivers to gain more objective insight into how things are going and make early changes to address any worsening or lack of improvement. One of the major barriers to using MBC is the time and effort it takes for providers to compile and synthesize the data into a format that families can easily digest. PracticeWise’s Clinical Dashboard makes that process simple by presenting a helpful visual graph of the data so that families can see how they have responded to different practices over time and celebrate wins as well as navigate more complex challenges.
- Consider the youth and caregivers’ unique needs and whether thoughtful adaptations need to be made to address them. There are several helpful Process Guides that outline a framework for providers to be more deliberate and inclusive in the care planning process. The Treatment Planner prompts providers to identify a focus area for treatment, map out the interventions they plan to use across the different phases of treatment, and consider how other concerns and stressors may impact treatment over time. It is a great tool for ensuring agreement about the initial target of treatment and how to handle other concerns as they arise. The Embracing Diversity Process Guide also helps providers consider how they might adapt both the process and the content of treatment to better fit the family’s unique needs. For example, some youth and caregivers may want a member of their faith community to be involved to guide how interventions are implemented whereas other families may want to only involve immediate family in treatment decisions.
- Collaborate with other providers in a team meeting, if appropriate. When working with a team of providers from allied fields, it can be helpful to have periodic group meetings that also involve the family to ensure that everyone is aligned and aware of all services being offered. The MAP Process Guide can be a useful tool for identifying where providers may be experiencing challenges and how consultation with other members of the treatment team may provide more information that will help move care forward.
Making Service Planning a Shared Process
There are many ways we can better partner with families and invite them to apply their own expertise in making decisions about their care. Ultimately, it is each family’s choice to pursue the kind of care that best fits their needs and goals, and providers serve as guides, helping them navigate options and move forward together. Tools such as the MAP Engagement System can support this shared process by helping providers intentionally invite youth and caregivers into planning conversations and sustain collaboration throughout care. For more information on how PracticeWise tools support collaboration with families, visit welcome.practicewise.com.
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About the Author
Jennifer Regan, Ph.D., serves in multiple roles on the Services and Products Development team for PracticeWise. Learn more about Dr. Regan on the PracticeWise team page.
