--- title: "Collaborative deliberation: a model for patient care. | Sutter Health" description: "Collaborative deliberation proposes interpersonal engagement, recognition of alternative actions, comparative learning, preference construction and integration." url: "https://www.sutterhealth.org/research/publications/collaborative-deliberation-pt-care-model-1055312489" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Collaborative deliberation: a model for patient care. # Collaborative deliberation: a model for patient care. Elwyn G, Lloyd A, May C, van der Weijden T, Stiggelbout A, Edwards A, Frosch DL, Rapley T, Barr P, Walsh T, Grande SW, Montori V, & Epstein R. _Patient Educ Couns. 97(2):158-64. doi: 10.1016/j.pec.2014.07.027. Epub 2014 Aug 13._ 2014-11-01 ## Abstract OBJECTIVE: Existing theoretical work in decision making and behavior change has focused on how individuals arrive at decisions or form intentions. Less attention has been given to theorizing the requirements that might be necessary for individuals to work collaboratively to address difficult decisions, consider new alternatives, or change behaviors. The goal of this work was to develop, as a forerunner to a middle range theory, a conceptual model that considers the process of supporting patients to consider alternative health care options, in collaboration with clinicians, and others. METHODS: Theory building among researchers with experience and expertise in clinician-patient communication, using an iterative cycle of discussions. RESULTS: We developed a model composed of five inter-related propositions that serve as a foundation for clinical communication processes that honor the ethical principles of respecting individual agency, autonomy, and an empathic approach to practice. We named the model 'collaborative deliberation.' The propositions describe: (1) constructive interpersonal engagement, (2) recognition of alternative actions, (3) comparative learning, (4) preference construction and elicitation, and (5) preference integration. CONCLUSIONS: We believe the model underpins multiple suggested approaches to clinical practice that take the form of patient centered care, motivational interviewing, goal setting, action planning, and shared decision making. [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/25175366) ## Research topics - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Decision or no decision: how do patient-physician interactions end and what matters?](https://www.sutterhealth.org/research/publications/pt-md-endings-decision-or-no-1055312572) Tai-Seale M, Bramson R, Bao X. J Gen Intern Med. 22(3):297-302. 2007 Mar 01 - Publication ### [Implementing shared decision-making: consider all the consequences.](https://www.sutterhealth.org/research/publications/shared-decision-making-allconsequences-1055312516) Elwyn G, Frosch DL, Kobrin S. Implement Sci. 11:114. doi: 10.1186/s13012-016-0480-9. 2016 Aug 08 - Publication ### [Shared decision making and motivational interviewing: achieving patient-centered care across the spectrum of health care problems.](https://www.sutterhealth.org/research/publications/shared-decision-making-motivational-interviewing-1055312537) Elwyn G, Dehlendorf C, Epstein RM, Marrin K, White J, Frosch DL. Ann Fam Med. 12(3):270-5. doi: 10.1370/afm.1615. 2014 May 01 - Publication ### [Implementation of patient decision support interventions in primary care: the role of relational coordination.](https://www.sutterhealth.org/research/publications/pt-decision-spt-primary-care-relational-coord-1055312888) Tietbohl CK, Rendle KA, Halley MC, May SG, Lin GA, Frosch DL. Med Decis Making. 35(8):987-98. doi: 10.1177/0272989X15602886. Epub 2015 Aug 27. 2015 Nov 01 - Publication ### [Enhancing shared decision making through carefully designed interventions that target patient and provider behavior.](https://www.sutterhealth.org/research/publications/enhance-sdm-target-pt-and-provider-behavior-1055312395) Tai-Seale M, Elwyn G, Wilson CJ, Stults C, Dillon EC, Li M, Chuang J, Meehan A, Frosch DL. Send to: Health Aff (Millwood). 35(4):605-12. doi: 10.1377/hlthaff.2015.1398. 2016 Apr 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/collaborative-deliberation-pt-care-model-1055312489#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Collaborative deliberation: a model for patient care."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/collaborative-deliberation-pt-care-model-1055312489#medicalscholarlyarticle","name":"Collaborative deliberation: a model for patient care.","headline":"Collaborative deliberation: a model for patient care.","abstract":"OBJECTIVE: Existing theoretical work in decision making and behavior change has focused on how individuals arrive at decisions or form intentions. Less attention has been given to theorizing the requirements that might be necessary for individuals to work collaboratively to address difficult decisions, consider new alternatives, or change behaviors. The goal of this work was to develop, as a forerunner to a middle range theory, a conceptual model that considers the process of supporting patients to consider alternative health care options, in collaboration with clinicians, and others. METHODS: Theory building among researchers with experience and expertise in clinician-patient communication, using an iterative cycle of discussions. RESULTS: We developed a model composed of five inter-related propositions that serve as a foundation for clinical communication processes that honor the ethical principles of respecting individual agency, autonomy, and an empathic approach to practice. We named the model 'collaborative deliberation.' The propositions describe: (1) constructive interpersonal engagement, (2) recognition of alternative actions, (3) comparative learning, (4) preference construction and elicitation, and (5) preference integration. CONCLUSIONS: We believe the model underpins multiple suggested approaches to clinical practice that take the form of patient centered care, motivational interviewing, goal setting, action planning, and shared decision making.","description":"Collaborative deliberation proposes interpersonal engagement, recognition of alternative actions, comparative learning, preference construction and integration.","keywords":["Disease Management","Health Services"],"datePublished":"2014-11-01","url":"https://www.sutterhealth.org/research/publications/collaborative-deliberation-pt-care-model-1055312489","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"25175366"},{"@type":"PropertyValue","propertyID":"DOI","value":"10.1016/j.pec.2014.07.027"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/25175366/","https://doi.org/10.1016/j.pec.2014.07.027"],"isPartOf":{"@type":"Periodical","name":"Patient Educ Couns"},"author":[{"@type":"Person","name":"Elwyn G"},{"@type":"Person","name":"Lloyd A"},{"@type":"Person","name":"May C"},{"@type":"Person","name":"van der Weijden T"},{"@type":"Person","name":"Stiggelbout A"},{"@type":"Person","name":"Edwards A"},{"@type":"Person","name":"Frosch DL"},{"@type":"Person","name":"Rapley T"},{"@type":"Person","name":"Barr P"},{"@type":"Person","name":"Walsh T"},{"@type":"Person","name":"Grande SW"},{"@type":"Person","name":"Montori V"},{"@type":"Person","name":"Epstein R"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Disease Management","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Disease+Management%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Services","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Services%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/collaborative-deliberation-pt-care-model-1055312489","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/collaborative-deliberation-pt-care-model-1055312489#breadcrumblist"}}} ```