SHARE Approach to train professional healthcare providers to assist clients in making the best decision about their plan of care. This client-centered approach is designed to engage clients in decisions based on their preferences, needs, and values (AHQR, 2020). The SHARE Approach has five steps to follow with tips for implementation including strategies to use with clients. The following is a brief overview of the model: Essential Steps of Shared Decision-making Step 1: Seek the client’s participation. ● Communicate that a choice exists and invite the client to participate in the process. 1. Summarize the health problem. 2. Ask the client to participate. 3. Include family and caregivers in decisions. 4. Remind the client that his or her participation is important. Step 2: Help the client explore and compare treatment options. ● Discussing options with the client can help build a trusting relationship. ● Assess what the client already knows about his or her options. ● Write down a list of the options and describe them in plain language. 1. Explain each option clearly. 2. Avoid using technical or medical jargon 3. Point out when there are clear differences between specific options 4. Talk about important unasked questions. ● Clearly communicate the risks and benefits of each option in a way that the client can understand. ● Offer positive and negative outcomes. ● Offer evidence-based decision tools whenever possible. ● Use and explain appropriate visual aids (graphs, charts, pictographs) to help patients understand explanations. ● Use the teach-back technique to check for understanding. 1. Ask the client to explain in his or her own words what the options are. 2. Being able to use different approaches, such as Web-based decision aids, printed handouts, or handwritten drawings, will help adapt to the different ways in which people learn and process information. 1. Verbalize uncertainty about the choice or concern about undesired outcomes. Discussion There will be many decisions the counselor and client will have to make in planning and delivering counseling services. The best practice is a client-centered approach for shared decision making that places the focus on engaging the client in the process based on their needs, preferences, values, and desired outcomes. The counselor takes a supportive role to assist the client in reaching a decision by providing evidence-based information on the options being considered, including risks and benefits of each. Counselors may need to assist the client in determining shortand long-term goals, identifying barriers to those goals, developing a plan of action, and taking steps to move forward. ● Look for signs of decisional conflict. The client may:
2. Waver between choices. 3. Delay the decision. 4. Question personal values or what is important to them. 5. Be preoccupied with the decision. 6. Show signs of distress or tension. Step 3: Assess the client’s values and preferences. ● Encourage clients to talk about what matters most to him or her. ● Listen actively to the client. ● Show empathy and interest in the effect that a problem is having on the client’s life. ● Acknowledge the values and preferences that matter to the client. ● Agree on what is important to the client. ● Assessing preferences matters, especially when clients defer decisions to clinicians. The counselor should ensure that the dialogue reflects important information about the options (e.g., specific procedures, risks, and benefits) and that a client’s preferences are acknowledged. Step 4: Reach a decision with the client. ● Help the client move to a decision. Ask if he or she is ready to decide or if they have any additional questions. ● Ask the client if he or she would like additional information tools such as educational materials or decision aids to help decide. ● Check to see if the client needs more time to consider the options or discuss them with others. Schedule another session if the client requests more time to consider the options. ● Confirm the decision with the client when he or she is ready to decide. Ask the client to describe the treatment options and which one he or she chose. ● Verify the next steps to be taken and timing of these actions with the client. ● Schedule follow-up appointments. Step 5: Evaluate the client’s decision. ● Make plans to review the decision in the future. Remind the client that decisions may be reviewed and can be changed if they are not working well. ● Monitor the extent to which the decision is implemented. ● Assist the client to manage barriers to implement the decision. ● Revisit the decision with the client to determine if other decisions need to be made. The client may enter the counseling process believing that the counselor will provide the answers as the authority and that they will assume a passive role. The shared decision- making process may require time to educate the client on the five steps, and additional time for practice, based on the client’s ability to contribute and advance through the process. The counselor will need to continually assess the client’s responses to determine the next course of action as the client learns to apply the decision-making steps. The goal is to build skills for independent decision making that lead to self-reliance or autonomy rather than dependency on others.
TECHNOLOGY ASSISTED COUNSELING
There are many terms to describe distance therapy using electronic methods, which include audio and video communication, including the addition of social media with all the inherent confidentiality and privacy issues. The term
“distance” refers to the fact that the counseling is not face- to face with the client and counselor in the same location.
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Book Code: PCTX1325
EliteLearning.com/Counselor
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