Shared Decision-Making and Positive Psychology
I’ve recently heard a talented researcher speak about the topic of shared decision-making, stating that no one can hope to know exactly how another person feels or what works best for them and their circumstances, that person will be the expert in themselves. This is precisely the stance I felt informed my exploration of flow experiences and positive psychology generally. To hear it now in the early stages of my PhD journey in reference to an approach to decision making within psychotherapy caused one of those wonderful ‘lightbulb’ moments as I’ve attempted to tease out how my previous knowledge ties in with my current research focus. The realisation came hard and swift that: shared decision-making falls firmly under the scope of positive psychology, MY positive psychology.
In an earlier post ‘What positive psychology means to me’ I stated that to me, positive psychology is not simply about the pursuit of happiness, but about the pursuit of excellence, of people working at their best, with that excellence being defined by their own standards, enjoyment, and satisfaction when working towards their greatest potential and excelling themselves. I truly believe that a shared decision-making approach to psychotherapy fulfils this remit.
Optimising for the client, based on the client
As mentioned previously, shared decision-making is at the core of the pluralistic approach to counselling and psychotherapy (Cooper & McLeod, 2011). An approach utilising shared decision-making seeks on the one hand to involve the patient or client in their own care, potentially resulting in a sense of empowerment in tackling their illness or disorder. Yet, it also seeks to discover what works best for that client, their current circumstances, what they like, and what they really want from therapy. It can be viewed as optimising the specific goals, tasks, and methods used within the psychotherapy process to fit the individual in a manner that is best for them, using a set of general principles. In this context it is optimising the process for that person, based on that person – whilst encouraging the practitioner to participate in discussions around this.
As well as utilising shared decision-making for collaborative working, two more key characteristics of the pluralistic approach include enabling the client to make use of the existing strengths including personality attributes, knowledge, and skills, and also seeing the client as the agentic force behind their own change. If accommodated for and promoted, all three of these characteristics are likely to interact with and inform each other.
Shared decision making, flow, and strengths
With this in mind, an integration of renowned positive psychology concepts such as character strengths and flow experiences into the pluralistic approach and the process of shared decision-making is crystal clear. For example, what a client might feel works best for themselves could well play on their strengths – those aspects of their personality or character that the client would be naturally drawn to using and that would energise them when used, yet such a preference would also be informed by their past flow experiences – intensely satisfying, absorbing, challenging and skill utilising experiences that were induced in a context that we, as a result, naturally seek to reproduce, and thus we are more likely to want to recreate this context than select a method or a desired goal that wouldn’t allow for such a context to be recreated.
My positive psychology: the pursuit of excellence, of people working at their best.
Although the language may differ, and the positive psychology concepts not be explicit within it, I see shared decision-making, and indeed the wider pluralistic approach as a model example for an integration of ‘positive’ and ‘negative’ psychology that holds a key focus on the optimising of the individual and approaches to the treatment of individuals in a manner that is informed by the experts, the individuals themselves. It may not strictly be positive psychology, but it is MY positive psychology.
About the author: Adam Gibson