The Choice Appointment

Choice appointments are the first contact the person has with the service. The aims of the Choice appointment are to build the Therapeutic Alliance, Shared Decision Making and uses principles from single session therapy by:

  • Clarifying with the service user their hopes for change
  • Exploring whether this service or another service, or multiple agencies, are best placed to help
  • Identifying what they can do for themselves
  • Considering risk, including safeguarding
  • Considering possible relevant diagnoses
  • Formulating together
  • Allowing the person and family to make an informed choice about what they need and want, including services
  • Developing with them things to try at home to move forward
  • Providing written information about mental health issues and solutions and other sources of help, such as other agencies and websites.

The Choice philosophy is that the service user experience is central. We should use our expertise to facilitate rather than to dominate, to grow a Therapeutic Alliance rather than stifle it. As a part of this we ensure we offer several practical choices:

Before coming to the service they are given:

  • Choice to engage or not in the service
  • Choice as in booking preferences for times and days
  • Choice of venue (if you have several sites)
  • Choice as to which members of their family/network come.

When they are with us they are given:

  • Choice to change or not
  • Choice of formulation e.g. to label / medicalise the problem or not
  • Choice of goals
  • Choice of type of interventions
  • Choice about subsequent appointments, times, venues.

Practice Point: Choices are, of course, constrained! It is our duty as professionals to ensure safety so people cannot choose something that is dangerous or ineffective. Nor can they choose something that is not available – but you may have a conversation about gaps in service and other places they may be able to go.