(PS5-A17) Why Might I Change My Approach?: Moderators of Clinicians’ Perceived Roles in Treatment Planning

Collaboration with patients in making decisions about their mental health treatment can improve patient satisfaction, treatment adherence, and health outcomes (Fiks & Jimenez, 2010), as well as empower patients in their own care (Langer & Jensen-Doss, 2018). Despite positive outcomes, collaboration does not always occur. Recent qualitative research shows that clinicians appear to identify with a primary role in treatment planning. For example, clinicians may identify themselves as “collaborators” (i.e., jointly making decisions with patients), “communicators” (i.e., sharing information/listening), “unilateral decision-makers” (i.e., the clinician makes the decisions), or “generally engaged” (i.e., involved in some way) in treatment planning (Schild et al., 2021). Identification of occurrences when clinicians adjust their role is needed to understand possible facilitators and barriers of collaborating with patients. This study aims to address the following question: What moderates clinicians’ perceived roles in treatment planning? In this mixed methods study, 30 community-based mental health clinicians who treat youth and families completed a 50-minute semi-structured interview evaluating their perspectives on treatment planning practices. Interviews were coded using grounded theory (Glaser & Strauss, 1967) embedded in the guidelines from Willm’s et al. (1990) for identifying concordance among codes and using constant comparisons to generate themes. Reliability was found to be satisfactory at 0.68. Analyses reveal several clinician-reported moderators of their roles in treatment planning, including: child developmental stage and capabilities (reported by 22 clinicians, 73.3%); child clinical severity/complexity (19 clinicians, 63.3%); disagreement about treatment decisions (e.g., between the youth and parent, between the clinician and youth and/or parent; 10 clinicians, 33.3%); youth and/or parent motivation to engage in treatment (5 clinicians, 16.7%); and treatment decision being made (2 clinicians, 6.7%). The relevance and context of these moderators, in addition to their implications, will be discussed in more depth on the poster. Importantly, this research informs how clinicians can adapt collaborative strategies to overcome moderators perceived as barriers to the collaborative process to center patient preferences and values in treatment planning. This research also supports the dissemination and implementation of collaborative treatment planning strategies (e.g., shared decision making) and raises awareness in clinical training settings of situations in which additional supervision and consultation on how to maintain collaborative practices might be beneficial to personalize treatments that are responsive to each patient and family’s identities and needs.