Within your own practice, it is likely that many  of the situations of shared decision making that you have experienced will probably reflect the “involved” end of the spectrum, but we encourage you to think about ways of maximising opportunity for autonomy and involvement, within the constraints we are sometimes challenged by.

We realise that for service users, being “influential” within the decision making process is the gold standard and is often harder to achieve.  However, when applied to some decisions it should be possible. Being influential may entail feeling like you have had an influence over the outcome of the decision or actually being able to change the outcome of the decision.

Some would argue to be truly influential ultimate power needs to be with the service user to accept or reject the decision.  However, an important foundation for enhancing service users influence in decision making is through the framework within which you make the decision which is based on that patient’s values and views and you are guided and bound by that in decision making.