‘Power’ Approach Gives Patients Stronger Voice in Their Treatment

Psychiatric providers often struggle to blend person-centered care with shared decision making in community clinic settings. “Power statements” is a new approach that may help patients communicate specific goals and participate in their treatment by writing simple, concise sentences, according to new research.

An exploratory study, “Enhancing Clients’ Communication Regarding Goals for Using Psychiatric Medication,” published April 3 in Psychiatric Services in Advance, describes the power statement method and analyses the statements to pinpoint patients’ goals for using psychiatric medications. The lead author is psychologist Patricia E. Deegan, Ph.D., of Pat Deegan & Associates, Byfield, Mass.

More than 17,000 adults with serious mental illness at 69 public mental health clinics were given the option of developing their own power statements. Nearly 14,000 (79 percent) chose to comply. A total of 277 statements were used for content analysis. The majority (51) percent wrote that their personal goal of taking psychiatric medications was to enhance relationships, well-being (32 percent), self-sufficiency (23 percent), employment (19 percent), hobbies (15 percent), and self-improvement (10 percent).

Power statements are part of CommonGround, a Web application that enables people with serious mental illness to participate in treatment decision making and supports their recovery. Power statements also help psychiatric providers understand clients’ goals from the beginning of treatment. These goals can help define treatment success, according to Deegan and colleagues. Patients created power statements in the clinics by using a worksheet that guides users in filling out a two-part template: “I want you to help me find a medication that will help me … so that I can … .”

When patients are empowered to communicate this way, they can express diverse and very personal goals for using medication that extend beyond symptom management, according to the researchers. For most patients, using medication to control symptoms is not an end but a means to an end that includes improved relationships, work prospects, and other parts of a meaningful life, they wrote.

CommonGround was developed by Deegan and contributed financial assistance for this study.

A related AJP in Advance study on the impact of shared decision making with patients is “Effects of Patient Preferences on Outcomes in the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) Study.”

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