Abstract

Shared decision making (SDM) is an interpersonal health communication model that is underutilized with people with serious mental illness. Although research has emphasized the role of patient capacity-, clinician-, and system-related barriers in SDM underutilization, the risk taking that affects SDM with people with mental illness is less often discussed. This Open Forum presents a reconceptualization of SDM as a process of shared risk taking that often occurs during different phases of illness management and recovery. The concepts of intersubjectivity, meaning making, and metacognition are offered to inform clinical interventions needed to address risk in SDM.

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