(PS3-8) Clinician Perspectives on a Collaborative Treatment Planning Tool for Selective Mutism

Abstract Text: Shared decision-making (SDM) is a patient-centered treatment planning approach that prioritizes patient empowerment and autonomy (Langer et al., 2022). Symptoms of mental health disorders, such as selective mutism (SM), that interfere with communication may present as a barrier to SDM. However, patient decision aids (DAs), which are standardized, evidence-based tools that support informed decision-making consistent with patient values, may have potential to alleviate these barriers. The current study used mixed methodology to develop a DA tailored for SM treatment planning and evaluate clinicians’ interest in and preferences for using the DA. Participants were 10 mental health professionals with experience in treating youth with SM using cognitive behavioral approaches who were recruited nationally via communications from the Selective Mutism Association and via snowball sampling in which clinicians referred others for participation. Clinicians participated in two phases of the study. The first phase consisted of a 45-minute, exploratory, semi-structured qualitative interview and background questionnaire which informed development of the DA by eliciting information related to how clinicians plan treatment for SM. The second phase of data collection consisted of another 45-minute semi-structured interview and a satisfaction questionnaire to obtain feedback on and understand preferences for use of the DA. Interviews were coded using grounded theory (Glaser & Strauss, 1967) embedded in the guidelines from Willm’s et al. (1990) for identifying coding concordance and using constant comparisons to generate themes. Reliability was satisfactory at 0.79. Quantitative and qualitative results corroborated each other indicating that clinicians were satisfied with the DA, including agreement that the DA would allow them to work from the evidence base (M = 4.60; scale 1 (strongly disagree) to 5 (strongly agree)) and actively involve parents (M = 4.90) and the child (M = 4.00) in treatment planning. Qualitative analysis of clinician perspectives revealed three themes: (1) the DA supports family engagement in treatment planning, (2) providing various options to families can present challenges (e.g., patients feeling overwhelmed, patients/families expressing that they are not interested in evidence-based treatment components), and (3) the DA is best used flexibly and frequently throughout treatment for an individualized, patient-centered approach that supports evidence-based practice. The implications of these themes will be discussed in more depth on the poster. Importantly, these findings provide rich qualitative data that indicate preliminary support from clinicians for use of DAs in treatment planning for SM, reflect clinicians’ views that this DA can serve its intended purpose of facilitating SDM within this clinical population, and offer considerations for best practices for use to ensure that the treatment planning process is just as tailored to the individual as the treatment itself. This poster underscores this year’s conference theme by shedding light on treatment planning methodology that is person-centered and affirms individual values, preferences, and culture to support positive treatment outcomes.