Shared decision making is a collaborative process in which a clinician and a patient choose a treatment together, using clinical evidence and the patient’s values, preferences and life context. We use this approach in our psychiatry practice on the Upper West Side so patients understand options and leave with a clear, personalized plan.
What shared decision making is
Shared decision making is more than informed consent. It is a structured conversation about options, likely benefits, possible harms, and how each choice fits the patient’s goals and daily life. Rather than the clinician telling the patient what to do, we present evidence, clarify preferences and reach a decision together.
Core elements
- Options. We identify reasonable treatment choices, such as psychotherapy, medication, or combined care.
- Evidence. We explain what research and clinical guidelines say about benefits and risks.
- Preferences. We ask about your goals, routines, and tolerance for side effects.
- Deliberation. We weigh tradeoffs and answer questions so you can decide with confidence.
- Follow up. We plan how to track results and adjust the plan as needed.
Why shared decision making matters in New York
Shared decision making improves alignment between care and the realities of city life. Many patients in New York balance work, school and family responsibilities. Choices about medication schedules, therapy timing, and side effect tradeoffs are practical decisions as much as clinical ones.
We see adults with anxiety, depression and mood disorders who benefit when clinical recommendations fit their schedules, commute patterns and support networks. For college students and young professionals, a treatment that minimizes next day sedation can be essential. For parents and older adults, coordination with therapists and family can shape the plan. That is why we pair shared decision making with careful coordination when appropriate.
When medication is being considered, shared decision making complements medication management by clarifying goals and expected outcomes before starting or changing a prescription. Learn more about our approach to medication management in the Medication Management topic.
Key concepts to understand
- Decisional capacity. We check that a person can understand information and make informed choices. When capacity is limited, we involve caregivers or use supported decision making.
- Risk tolerance. Different people accept different levels of side effects or uncertainty.
- Probabilities use plain language. We translate clinical data into what is likely to happen day to day.
- Values clarification. We ask what matters most to you, such as symptom relief, cognitive clarity at work, or minimizing medication changes.
- Iterative process. Decisions are revisited based on outcomes and new information.
How we apply shared decision making in clinical care
Our process follows clear stages. We use this structure whether the issue is starting antidepressant medication, choosing between cognitive behavioral therapy and exposure therapy for OCD, or deciding about stimulant treatment for ADHD.
- Assessment. We begin with a one on one diagnostic assessment to clarify symptoms, history and current life demands. This helps identify appropriate options and any safety concerns.
- Information exchange. We review evidence, expected timelines and typical side effects in plain language. We link choices to how they will affect daily functioning.
- Explore preferences. We ask about goals, prior treatment experiences and practical constraints, such as work schedules or child care.
- Deliberation and decision. We weigh tradeoffs together and agree on a plan. The plan may include a single option, a staged approach, or additional time to decide.
- Follow up and adjustment. We track outcomes, side effects and adherence, and we adjust the plan when needed.
We coordinate with therapists and other providers when collaborative care will improve outcomes. See our Care Coordination topic for how we work with colleagues.
Common questions patients ask
Patients often express the same concerns when facing decisions. We address these openly so you can make a thoughtful choice.
- Will I be forced to take medication? No. Shared decision making means we discuss whether medication is one of the reasonable options and you decide with our guidance.
- How much time does the process take? Initial decisions are made over one or more visits. Some choices need time for reflection and follow up.
- What if I change my mind? Decisions are revisited. We expect to adjust treatment based on your experience and goals.
- How do we handle urgent risks? If there is an immediate safety concern, we prioritize assessment and a clear safety plan before a broader deliberation.
Decision checklist
Use this checklist to prepare for a shared decision making conversation
- Describe your main symptom and how it affects daily life.
- Note any previous treatments and how they worked.
- Identify what matters most to you, for example energy, sleep or concentration.
- List practical constraints, such as work hours or childcare responsibilities.
- Bring questions about benefits, side effects and monitoring.
Comparison: shared decision making versus clinician directed decisions
| Feature | Shared decision making | Clinician directed decisions |
|---|---|---|
| Who leads | The clinician and patient share responsibility | The clinician recommends and the patient follows |
| Role of patient | Active, shares preferences and goals | More passive, accepts clinician recommendations |
| Evidence use | Evidence is translated into options and tradeoffs | Evidence guides the clinician’s single recommendation |
| Typical benefit | Better alignment with patient values and clearer expectations | Faster decision making in routine or emergency situations |
When shared decision making is most helpful
Shared decision making is especially useful when options have different tradeoffs or when patient preferences strongly influence what counts as a good outcome. Common situations include:
- Choosing between starting medication and trying psychotherapy first for depression.
- Selecting a medication when several effective options exist but side effect profiles differ.
- Deciding whether to add psychotherapy to an existing medication regimen for anxiety.
- Planning treatment for ADHD when work or school demands affect medication timing.
Related services we provide
We integrate shared decision making into a range of services so care matches your goals. Learn more through these pages.
- Psychiatry for one on one assessment and long term care.
- Anxiety Therapy that pairs clinical strategies with patient preferences.
- Medication Management that tracks outcomes and adjusts plans collaboratively.
- Depression Therapy where goals and treatment choices are planned together.
- Care Coordination to align psychiatric care with therapists, primary care and school supports.
Related locations and populations we serve
Our practice is located on the Upper West Side of New York, New York. We commonly work with adults with anxiety, adults with depression, bipolar disorder patients, college students and young professionals. We also provide care for parents seeking support and for older adults who prefer coordinated planning with family and caregivers.
When location or life stage makes certain options harder to use, shared decision making helps identify practical alternatives and supports.
Helpful resources and further reading
We link clinical conversations to reliable sources so you can review evidence at your own pace. For foundational information on treatment choices, see Treatment Options. For practical topics on tracking results and side effects, see Treatment Outcome Tracking and Side Effect Management.
Pro tip: Bring notes about how symptoms affect a typical week. Concrete examples make it easier to match treatment choices to your life.
Key takeaway
Shared decision making puts clinical evidence and your personal goals on equal footing so treatment choices fit your life. We use this approach across psychiatric care to make decisions clear, practical and revisable as your needs change.
Frequently asked questions
How long does a shared decision making conversation take?
Initial discussions happen during the diagnostic assessment. Some decisions are made in a single visit. Others require follow up and time to reflect. We plan next steps and a follow up timetable together.
Can shared decision making reduce medication use?
Sometimes. The process helps you and your clinician choose the option that best matches your goals. That could mean starting medication, trying therapy first, or combining approaches depending on the clinical picture.
Will insurance cover the options we discuss?
Coverage varies by plan and by service type. We outline likely pathways for therapy and medication and coordinate with your other providers when necessary. For specific coverage questions, check your insurer or benefits office.
How do you involve family or support people?
With your permission, we include family members or other supports in discussions when that helps decision making. We balance confidentiality with the practical need for support and coordination.
What if I prefer the clinician to decide?
Shared decision making is flexible. If you prefer a clinician directed recommendation, we will provide a clear, evidence based recommendation and explain why we believe it is appropriate.
Learn more and read reviews
To read patient reviews and get directions, check our Google Business Profile. To explore how we approach treatment choices, visit our Topics hub and service pages linked above.