ArticleSocial science & medicine (1982)2015
Justifying medication decisions in mental health care: Psychiatrists' accounts for treatment recommendations.
Article in Social science & medicine (1982), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Shifting Perspectives on the Challenges of Shared Decision Making in Mental Health Care.Community mental health journal · 2024Pooled it
- Communication practices that encourage and constrain shared decision making in health-care encounters: Systematic review of conversation analytic research.Health expectations : an international journal of public participation in health care and health policy · 2017Pooled it
- Autoethnographic Reflections on Mental Distress and Medication Management: Conceptualising Biomedical and Recovery Models of Mental Health.Community mental health journal · 2025Article
- Patients' and health professionals' perspectives regarding shared decision making in the psychiatric inpatient setting - A multiple qualitative case study.PEC innovation · 2024Article
- Discussing physical restrictions in care plan meetings between family members of residents with dementia and nursing home staff.Dementia (London, England) · 2023Article
- Treatment decision making in psychiatry: Formulating patients' perspectives in outpatient psychiatric consultations.Frontiers in psychology · 2023Article
- 'I'm Not Going to Tell You Cos You Need to Think About This': a Conversation Analysis Study of Managing Advice Resistance and Supporting Autonomy in Undergraduate Supervision.Postdigital science and education · 2021Article
- Treatment Recommendations in Oncology Visits: Implications for Patient Agency and Physician Authority.Health communication · 2019Article
- Unravelling subjectivity, embodied experience and (taking) psychotropic medication.Social science & medicine (1982) · 2019Article
- How clients solicit medication changes in psychiatry.Sociology of health & illness · 2019Article
- How Psychiatrists Recommend Treatment and Its Relationship with Patient Uptake.Health communication · 2018Article
- Understanding Users in the 'Field' of Medications.Pharmacy (Basel, Switzerland) · 2016Article
- Assessment of shared decision-making in community mental health care: Validation of the CollaboRATE.International journal of clinical and health psychology : IJCHPArticle
Corrections and comments
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Authors and funding
2 authors.
Funding
Abstract
Psychiatric practitioners are currently encouraged to adopt a patient centered approach that emphasizes the sharing of decisions with their clients, yet recent research suggests that fully collaborative decision making is rarely actualized in practice. This paper uses the methodology of Conversation Analysis to examine how psychiatrists justify their psychiatric treatment recommendations to clients. The analysis is based on audio-recordings of interactions between clients with severe mental illnesses (such as, schizophrenia, bipolar disorders, etc.) in a long-term, outpatient intensive community treatment program and their psychiatrist. Our focus is on how practitioners design their accounts (or rationales) for recommending for or against changes in medication type and dosage and the interactional deployment of these accounts. We find that psychiatrists use two different types of accounts: they tailor their recommendations to the clients' concerns and needs (client-attentive accounts) and ground their recommendations in their professional expertise (authority-based accounts). Even though psychiatrists have the institutional mandate to prescribe medications, we show how the use of accounts displays psychiatrists' orientation to building consensus with clients in achieving medical decisions by balancing medical authority with the sensitivity to the treatment relationship.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.