Supporting Shared Decision Making with Option Grid™ in Child Mental Health

The Health Foundation, Innovating Improvement project

This project is part of the Health Foundation’s Innovating for Improvement programme. The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK.

health foundation


Shared decision making is a key feature of the THRIVE conceptual framework and was highlighted as a priority for child and adolescent mental health in the Department of Health/NHS England Taskforce report Future in Mind. However, implementation of shared decision making within a CAMHS setting remains problematic with barriers including training, medical culture, concern about time required and fear of loss of practitioner autonomy. While many clinicians believe they are already participating in shared decision making with clients, a rapid internal audit of CYP IAPT CAMHS service users in 2015 indicated that only 30% of young people felt that they were given enough information at assessment to make a choice about the treatment they received.

Camden have implemented shared decision making as part of their assessment clinics and this work fed into the development of the THRIVE conceptual framework. However, there is still variability in patient experience of shared decision making in Camden. Evidence shows that tools supporting the shared decision making process can improve its quality.

In this project, the Tavistock and Portman NHS Foundation Trust, the Anna Freud National Centre for Children and Families and the Dartmouth Institute for Health Policy and Clinical Practice are developing and translating Option Grids™ into a shared decision making tool to support children and young people at key decision points within their CAMHS journey.

Option Grid decision aids are a trademarked shared decision making tool that helps patients and health providers compare alternative treatment options. For more information please see

As part of the project, five Option Grids have been created and are being piloted in Camden From February 2017. Three grids will address Quadrant 2 (getting help) of the THRIVE framework, focusing on depression, ADHD and deliberate self-harm. The remaining two grids will address Quadrant 1 (Getting Advice) of the THRIVE framework, focusing on low mood/low level anxiety and behavioural difficulties. It is anticipated that as a result of this quality improvement project, experience of care and patient involvement will be improved, more patients will be signposted to a wider range of providers and intervention types, and more children and young people will engage in self-help.

Contact the project team

To find out more about the Option Grids project please contact Daniel Hayes, i-THRIVE Option Grids Project Manager at or Rosa Town, i-THRIVE Option Grids Research Assistant at


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