Product #2 Supporting Choice Workbook

Product #2 Supporting Choice Workbook.pdf

Voluntary Customer Satisfaction Surveys to Implement Executive Order 12862 in the Substance Abuse and Mental Health Services Administration (SAMHSA)

Product #2 Supporting Choice Workbook

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Supporting Choice
Helping Others Make Important Decisions
T

Think about
problems, pressures,
people, and priorities

T

Think about
problems, pressures,
people, and priorities

R

Research facts and
possible solutions

R

Research facts and
possible solutions

I

Identify options

I

Identify options

P
M

Weigh the Pluses and

A
P

Action planning

Minuses for each option

Ponder the results
of the decision

Use a TRIP MAP for decision making

P
M

Weigh the Pluses and

A
P

Action planning

Minuses for each option

Ponder the results
of the decision

Use a TRIP MAP for decision making

T

Think about
problems, pressures,
people, and priorities

T

Think about
problems, pressures,
people, and priorities

R

Research facts and
possible solutions

R

Research facts and
possible solutions

I

Identify options

I

Identify options

P
M

Weigh the Pluses and

A
P

Action planning

Minuses for each option

Ponder the results
of the decision

Use a TRIP MAP for decision making

27305.0410.84840104

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A Step-by-Step Approach

P
M

Weigh the Pluses and

A
P

Action planning

Minuses for each option

Ponder the results
of the decision

Use a TRIP MAP for decision making

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Center for Mental Health Services

4/6/10 10:16 AM

Acknowledgements

Notes

Disclaimer
The views, opinions, and content of this publication are those of the authors and do not necessarily reflect the views, opinions,
or policies of SAMHSA or HHS.

Public Domain Notice
All material appearing in this workbook is in the public domain and may be reproduced or copied without permission from SAMHSA.
Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific
written authorization of the Office of Communications, SAMHSA, HHS.

Electronic Access and Copies of Publication
This publication can be accessed electronically through the following Internet World Wide Web connection: http://www.mentalhealth.
samhsa.gov. For additional free copies of this document, please contact SAMHSA’s National Mental Health Information Center at
1-800-789-2647.

Recommended Citation
Substance Abuse and Mental Health Services Administration. What is Right for Me? How to Make Important Decisions in Everyday Life.
HHS Pub. No. SMA-XX-XXXX, Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services
Administration, 2009.

Originating Office
Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, Office of the Associate
Director for Consumer Affairs, 1 Choke Cherry Road, Room 2-1007, Rockville, MD 20850. Phone: 1-800-789-2647.
Webpage: http://www.mentalhealth.samhsa.gov.

This workbook is part of a set of materials designed to promote and support shared decision making in mental health. These materials
include printed descriptive and informational materials, step-by-step decision making workbooks, videos and user guides, worksheets
and tools, tip sheets, podcasts and archived webinars, and an interactive decision aid on using antipsychotic medications as part of a
recovery plan.
All of these materials are available to download at no cost from http://mentalhealth.samhsa.gov/consumersurvivor. Print copies,
DVDs and CD-ROMs of the material are available from SAMHSA National Mental Health Information Center at 1-800-789-2647.

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Resources

About This Workbook

The material in the workbook is derived from many sources. We especially wish to acknowledge the
inspiration provided by the Personal Decision Support Guides created by Ottawa Health Research
Institute and available at http://decisionaid.ohri.ca.

This workbook is part of the Federal Substance Abuse and Mental Health Services Administration
(SAMHSA) project on Shared Decision Making in Mental Health. This project provides tools to help
people who use mental health services and people who provide services to have more collaborative
and productive conversations about all aspects of a person’s mental health recovery plan.

Explore more about decision making skills and different ways to approach decisions through the
links below. The views, policies, and opinions expressed on the featured Web sites are those of the
organizations maintaining the Web site and/or the Web site authors and do not necessarily reflect
those of SAMHSA.

Robert Harris, Introduction to Decision Making
http://www.virtualsalt.com/crebook5.htm

eHow Careers & Work Editor, How to Make Decisions

Often, people want or need support to make a difficult decision. This workbook
is designed to help you support someone in making a decision they find difficult,
not just decisions about treatment or services.

You can use this workbook in several ways:

• To prepare yourself to hold a decision making conversation

Contents
2

Introduction

3

Your Role as a Helper

5

Think about
a Decision

9

Research
Information

with someone;

http://www.ehow.com/how_3838_make-decisions.html

• As a guide to help someone work through the steps of decision
University of Florida, Making-Up Your Mind—Improving Your Decision Making Skills
http://http://edis.ifas.ufl.edu/HE691

WebMD, Making Wise Health Decisions
http://www.webmd.com/a-to-z-guides

making on paper or using the worksheet included at the back
of the workbook;

• As an aid for making a shared decision together with someone;
• As a way to help someone prepare for a planning or decision
making meeting about their physical or mental health treatment
and services.

The workbook parallels, and can be used as a companion to, the SAMHSA
workbook for people who use mental health services called “What Is Right
for Me? How to Make Important Decisions in Everyday Life.”

10

Identify
Options

12

Pluses and
Minuses

17

Action Planning

18

Ponder

20

Tips for Talking
About the Decision

24

Resources

Additional copies of these workbooks, worksheets, and other materials in SAMHSA’s
Shared Decision Making in Mental Health series can be downloaded from:
http://www.mentalhealth.samsha.gov/consumersurvivor.

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Introduction
People make decisions every day about their lives, relationships, health care, and services. Some decisions
are easy to make, but others may feel difficult and stressful. These feelings are natural, but no one makes
good decisions if the feelings become overwhelming. You can help people reduce stress and make better
choices by supporting their use of steps to think through their situation and options.
This workbook is designed to assist you in helping someone make a decision that they find difficult.
It presents a way of simultaneously providing support and helping people learn how to make decisions
independently. It uses a simple tool called TRIP MAP to walk through the steps of making a decision.

I have decided to

Action Plan to:
Step

What

Who

When

Completed

1.

❒

2.

❒

3.

❒

4.

❒

5.

❒

The steps are:

T
R
I
P

Think about the problems, pressures, people, and priorities

M
A
P

Minuses for each option

Research facts and possible solutions
Identify options
Weigh the Pluses and

Action planning
Ponder the results of the decision

Like a road map, the TRIP MAP tool helps at each turn, for example, by identifying the most
important priorities or weighing the pluses and minuses of each option.
In each section, you will find both suggestions for the person who is facing the decision and for you in
your role as helper. For example, you will find ideas for starting conversations about these steps, as well
as tips on how to support a person to think carefully about each step.

Resources:

At the end is a blank 2-page worksheet—also found in the companion workbook—that follows the
TRIP MAP process. You can photocopy this worksheet to use any time you help someone make a
difficult decision.

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Plus-Minus Chart: Weigh Your Options
Pluses
(good things)

How
Important?

Your Role as a Helper
Minuses
(bad things)

How
Important?

Making decisions independently is an important part of mental health recovery. People have the
right to make and take responsibility for personal decisions in their lives. But people make their
best decisions when they have good information, consider the input of others, and take time to
think through what is most important to them.

Option 1

Do nothing/
Make no
change

As a peer, family member, friend, or mental health provider, there are many ways you can help
others make informed and thoughtful decisions.

Here are some examples:

• Support emotions. Recognize that decision making is not always logical and rational,
but can be messy, complicated, and emotional. Provide support for emotions, not just
the process. Affirm that it is natural to feel stressed, uncertain, or confused when faced
with a difficult decision. Sometimes people are afraid to even begin the process of decision
making. Ask people about their concerns about making a decision and offer ways to
address them. Suggest that people talk with others who have faced similar decisions.

Option 2

•

Match your support to the person’s preferences. Recognize that people might not want your

help. Offer help with the recognition that your offer might not be accepted. Ask people
what type of help would be useful, such as emotional support or practical information.

• Help only when needed. Not everyone needs help with the whole decision making process.
Option 3

A person may be stuck on only one or two steps. Help with the troubling steps only. They
may want your ideas about options, not help with a full TRIP MAP.

• Be flexible with pace. Respect the pace at which people want to make decisions, while helping them focus on deadlines. TRIP MAP is a step process. It is okay to stop and restart as
needed. Some steps, like ”Research” (page 9), may require considerable time.

• Simplify. Present TRIP MAP or any structured decision making approach as helpful tools
rather than as a process that must be followed to the letter. Break complicated decisions
into smaller decisions. The goal is to make informed decisions that fit.
Option 4

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• Avoid taking over. Focus on the person’s thoughts and feelings and do not impose your own.
This can be challenging, especially if you have a strong opinion or feel you have a stake in
the decision the person makes. Avoid leading questions such as “Wouldn’t you prefer to…”

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By helping the person examine options objectively, you show your respect for them. You
also help them develop their decision making skills. It is important to keep the dialogue open,
because, in the end, people make their own decisions, either actively or passively (by avoiding
or not following through on a decision).

TRIP MAP Decision Making Worksheet

Talking
about a Decision
Conversation Starters

Think
Problems you want to address

• Do you have time to
Pressures such as deadlines

or people who want you to do
something

People generally make choices that they believe are right for them at the time. You may not
necessarily agree with their choice. Sometimes people make a decision and then find that it did
not work out the way they expected. Part of the TRIP MAP process is to revisit a decision and
see how it is working.

talk? I have some news
I would like to share
with you.

• I have been thinking
about something for a
long time. I would like
to talk to you about it.

• You know I have been

TIP
To Avoid Taking Over
Use open-ended questions about
a person’s priorities.

What do you think is the best way to…

Reflect what the person says.

So what is important to you is…

Ask for permission before
presenting your opinions.

Do you want to know what I think?

Present your opinions as opinions,
not as facts or advice.

Acknowledge any conflict of interest.

Stay open to any idea the
person suggests.

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People who can help and who will

Priorities for what is important

be affected by the decision

to YOU in the decision

struggling with a difficult
decision for some time.
I would like to tell you
what I decided .

Talking
about a Decision
RESEARCH: What facts and information do you need? Where can you get it?

Dealing with Disagreement

• I know you hoped I
In my opinion, your best option is…

Of course, I would be better off if you….

That is an interesting idea! Add it to
your brainstorm list.

IDENTIFY YOUR OPTIONS by brainstorming. Include “make no change” as an option.
Narrow your brainstorm list to what is practical and doable. Circle your three or four
best options and then write them on the Plus and Minus Chart on the next page.

• Make no change/ do nothing
•
•
•
•
•

would decide [mention
their choice here].
Instead, I chose [insert
your choice here]. I would
like to tell you why.

• Your support is important
to me. I would like to
share with you a difficult
decision I just made. It is
important for me to tell
you about it, even if you
disagree with me.

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TIPS

For Talking About the Decision

Often, a person will need to tell others about the decision they made, particularly people who
are affected by the decision. For example, if a person decides to move to a new living arrangement,
they will need to talk to the people they live with now.

Below are a few tips you can share to help a person
talk about their decision with others.

TIP

T

TRIP MAP

Think About a Decision
Good decision making involves more than choosing an option. The first step
is to stop and think about the situation. There are many things that will affect
the decision: people, pressures, the person’s priorities, as well as the pluses and
minuses of the options.

• Think about how people will react and address concerns you
think they will have.

Cut out a wallet card
from the back cover and
give it to the person to
help them remember the
TRIP MAP steps.

• Pick a good time. Avoid talking about a big decision when you
or others are busy, tired, hungry, or angry.

Some people become overwhelmed by the stress of a situation and need help to
see their circumstances in terms of decisions they can make. Framing problems
as decisions can be empowering.

• Remember that people sometimes need time to accept news,
and their initial reaction might change over time.

• Stress your priorities in positive terms. For example, “It’s really
important to me that I have more privacy, so I have decided to look
for my own apartment.”

The text boxes on the next page offer some ways to start conversations about a decision. Sometimes,
role playing or rehearsing these conversations with the person can be helpful. You can help the person
anticipate others’ reactions and practice a response.
You or others may not like the person’s decision or agree with it. It can be especially stressful if the
decision goes against what is important to the person’s family or community. The person does not
necessarily need to defend their decision, but do encourage them to explain to others how they arrived
at it. What is important is that the person weighed options and made a thoughtful, informed choice
that is best for them.

If you disagree with the decision:

• Explain your concerns using “I” not “you.” For example,

say, “I am concerned about….”

not “You should….”

Other people see situations and their options narrowly or jump to a quick solution.
For example, Dori sees quitting as the only solution to her problem. Helpers can
encourage people to think more broadly about their problems and options.

Dori’s Story
Dori just started
working at a restaurant
where her friend works,
about a mile and a half
from her home. She
likes the job but has to
work late some nights.
There is no night bus
service, so she worries
about her safety walking at night and dealing
with bad weather.

Some situations are complicated and involve more than one decision.
You can help people see these multiple decisions, prioritize them, and tackle them
one at a time.
You can help a person get off to a good start by encouraging them to think about
the problems, pressures, people, and priorities discussed on the next two pages.
Encourage the person to write down their ideas on a sheet of paper or use the
decision making worksheet found on page 21 and in the companion workbook.

To help illustrate how the TRIP MAP process works, read Dori’s Story in the white box
on the right. The blue box suggests ways a helper could support Dori in her decision
making. As you go through the workbook, you will see more white boxes showing how
Dori uses the TRIP MAP steps and blue boxes with ideas for ways you can for support
her along the way.

Supporting Dori
Dori tells you she has
to quit her job because
she is scared to walk
at night. She likes the
job and is very sad to
leave it. You suggest
that before she makes
a decision to quit, she
should spend some
time seeing if she has
other options.

• Separate your concerns for yourself and what is important to you from your concerns for the person.
• Recognize that the person may have different values and goals than you do.
• Encourage the person to create a “back-up” plan.

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TRIP MAP

Problems

Supporting Dori

The first step in effective decision making is defining the decision that needs to be
made. Most difficult decisions relate to some form of problem or challenge.

You and Dori and talk
together about her
perspective on her
situation and the
pressures she is feeling.

CONGR ATU L ATIO N S!

With winter coming,
she is concerned about
walking to and from
work–not just at night,
but in cold, icy weather.

QUESTIONS | PROBLEMS

You have helped the person to complete the TRIP MAP steps.

To help a person identify and explore the problems and decisions
to be made:

They have:

• What do you see as the problem or situation?
• What do you want to change?
• What do you want to stay the same? To change?
• What decision do you feel you have to make?
• What will this decision help you achieve?
• What decisions come before this one? After this one?
• What decision would you like to work on first?
• Are you leaning toward an option now?

She feels pressured by
her family to get a job
closer to home.
She is leaning toward
quitting the job but
is willing to explore
other ideas.

Pressures
TIP
Common pressures
include time, money,
health, relationships,
community or cultural
expectations, and feeling forced to choose
among limited or undesirable options.

6

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It is important for both the helper and the person making the decision to recognize
the pressures the person is facing. Time may be a factor. For example, sometimes a
quick decision is needed so the person does not miss out on an opportunity.

• Thought about the decision,
• Researched and identified options,
• Weighed the pluses and minuses of the options,
• Selected the best option for him or her, and
• Made an action plan.

The next section of this workbook contains resources you can copy and use as often as needed.

These are:

• Tips for Talking about the Decision
• Decision Making Worksheet
• Plus-Minus Chart
• Action Plan

Other times, there are deadlines such as a class enrollment date or an eviction notice.
In some cases, pressure comes from the realization that if the person does not make a
decision, someone else will make the decision for them.

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P

T

TRIP MAP

QUESTIONS | PRESSURES
To help a person identify the pressures they face in this decision:

Ponder: Is It Working?

Dori’s Decision
If her friend decides to
quit her job, Dori would
no longer have a ride to
work. She would need
to revisit her options for
getting to work and make
another decision: walk,
find another person to ride
with, or buy a used car.
Or maybe Dori gets a raise
at work, so buying a used
car will not be so hard on
her budget.

TIP
People often learn
something by looking
at how their past decisions
turned out—good and bad.
When a person does not
like how a decision turned
out, it provides an opportunity to talk about what does
not work. This information is
helpful for future decisions.

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People make decisions with the information they have available at the time.
But decision making is often an ongoing process, and circumstances can change.
Sometimes decisions do not work out as hoped. In most cases, the person can
make another decision to try something else.
If the decision did not turn out as expected, it does not mean that the person
failed or necessarily made a bad choice. This is often part of the process.
People may revisit decisions many times as they learn new information,
better understand what is important to them, or as the situation changes.
Sometimes people make the same choice each time they face the decision,
but other times they choose a different option.

• When do you need to make this decision?
• Why are you making this decision now?
• What would happen if you did not make a decision?
• Is anyone pressuring you to make this decision? If so, who?
• What do they want you to do? What concerns do you have about this?

People
Most important decisions affect not just the person making the decision,
but also friends, family members, and others.

Pondering is different than second-guessing. It means helping a person think
about what they learned from the process of making and acting on a decision.
It is an opportunity to celebrate what worked out, as well as to consider new
information or any problems that popped up.

Sometimes others need or want to be involved in making this decision.
The person may welcome involvement by others–or not. Help the person
think about how much and in what way they want others involved–for example,
not at all, as a source of information, as an advisor or supporter, or as a partner
in making a shared decision.

QUESTIONS | PONDER: IS IT WORKING

QUESTIONS | PEOPLE

To help a person ponder how the decision worked out:

To help a person think about how others are–or could be–
involved in this decision:

• How did your decision turn out?
• In what ways did it help you achieve what was most important
to you?

• What happened when you tried your action plan?
• How do you think things could have been different?
• What could you do differently the next time you have to make
this decision?

• Is the decision completely up to you or are others involved?
• Who is affected by your decision? Do they need to be involved

Supporting Dori
Dori says the decision is
hers to make – although
her choice would affect
her boss, her friend, and
maybe her family. Her
brother knows about
cars and could talk to her
about them. She thinks
her personal safety and
protection from the
weather are more important than getting to and
from work quickly. She
does not want to spend
a lot of money on transportation because she
wants to save for her
own apartment.
Looking at her list,
Dori feels that safety
is the most important.

in making this decision?

• How do you want to make use of others’ opinions?
• Who can you talk to about your decision?
• How do you want to involve others in your decision making?

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T
Priorities

A

TRIP MAP

People are more likely to be satisfied with and follow through on a decision that addresses what matters to them. People may never have all the information they need or want about their options. There
may not be one clear “best” choice among the options. Therefore, feelings and personal values play
an important role in the decision.

Action Planning

Encourage the person to make a list of things that are important to them in this decision. It is useful
to rate which priorities are the most important to the person in case they have to make tradeoffs.

Making a decision involves more than just choosing the best option. People must
act on a decision to make a specific change in their lives.

QUESTIONS | PRIORITIES
To help a person think about what is most important to them:

• If there were a “perfect” answer, what would it look like?
• What are the two most important things on your list?
• What are the two least important things on your list?
• If you cannot have all the things you want, what would you give up and what

Supporting Dori
You help Dori figure out
the steps for putting her
decision into action. You
ask if she needs a backup
plan for times when her
friend cannot drive. She
thinks it was a good idea.
She writes an action plan
and then checks off items
as she does them.

Creating an action plan helps people follow through, especially if it identifies
what needs to be done, who does it, when it needs to be done, and what resources
are needed to do it. Steps may include informing others, gathering more facts, or
doing activities.
Encourage the person to keep the action plan simple and doable. Action steps are
most helpful when listed in the order they need to be done.
Below is Dori’s Action Plan as an example. There is a blank action plan on the
worksheets at the end of this workbook and in the companion workbook.

would you keep?

Dori’s Action Plan to: Ride to work with a friend
Step

TIP
One way to help a person rate priorities is to directly compare two important
things. For example: “If you could have an apartment near a grocery store or
one that allows pets, which would you prefer?”

What

Who

When

Completed

1.

Talk to friend about the
decision. Make sure it is still OK
with friend.

Dori & friend

As soon as possible

❒

2.

Agree on Dori’s share of gas.

Dori & friend

As soon as possible

❒

3.

Agree on a schedule and a start
date.

Dori & friend

As soon as possible

❒

4.

Make a backup plan for times
when friend cannot drive.

Dori

After agreements are
made

❒

5.

Meet at agreed place and time.

Dori & friend

After agreements are
made

❒

Resources: Home phone number or e-mail for friend; money to pay for gas; convenient place to

meet; another way to get to work if friend is not available

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P
M
QUESTIONS | CHOOSE THE BEST OPTION

R

TRIP MAP

To help a person choose the option they feel is best for them:

• Which option best addresses why you are making this decision?
• Which option best matches what is most important to you?
• What are you willing to trade to get what you really want?
• What might happen if you make this choice? How likely is that to happen?
How would you feel about that?

Research Information
Does the person know the facts of the situation and what the options are? Do they
understand the pros and cons of each of these options? If not, you can help them
get more information.

One way to help is to suggest some ways to get needed information.

For example:

TIP

• Visit a library. There may be books and other resources to help. Librarians
can help people find the most useful information.

Not ready to make a decision? Help the person explore the
consequences of not making a decision at this time. Must this
decision be made soon or can it be made later?

• Use the Internet. You can help the person identify trustworthy Web sites.

Choosing to not make a decision is a decision itself. It has pluses
and minus like any other option.

• Talk to others. Peers, family, friends, spiritual advisors, and providers might

Encourage the person to look for Web sites that include reviews from
others who have used a product or service.
have more information about this particular decision. Also, suggest speaking to people who have special knowledge about the topic. For example, a
person who is thinking about buying a used car might want to talk to an
auto mechanic about which ones have the fewest repairs.

QUESTIONS | RESEARCH INFORMATION
To help a person identify information needs:

• Do you have all the facts about this situation?
• Do you know what all of your options are?
• Do you know all the pros and cons of your options?
• What kind of information do you need?
• Where can you go to get the information you need?

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Supporting Dori
You encourage Dori to
make sure she has all the
facts about her situation correct. She double
checks the bus schedule
to verify how late the bus
runs. It stops at 7 p.m.
She jokes that maybe she
should get a car. You suggest that she research the
idea and ask her who she
knows who understands
cars. Pleased that you did
not shoot down the idea,
she agrees to talk to her
brother.
You show her some
Internet sites that have
used car information and
suggest she visit a library
to look at a book that
rates reliability and cost
of specific models.
You ask if her friend could
help with transportation at nights or in bad
weather. Dori says she’ll
talk to her friend about
the idea.

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I

P
M

TRIP MAP
Identify Options

Dori’s Brainstorm

Brainstorm

• Quit the new job
• Do nothing: keep

After gathering facts and information, help the person make a list of options.
Any idea is a good idea at this point. Encourage creativity and do not worry
about how realistic or effective the options might be. During brainstorming,
listing an option does not mean it is practical or doable or that you approve
or condone it. You are helping the person think broadly and generate ideas.

walking

• Ask to work only
when the bus runs

• Ride with friend
• Buy a used car
• Try to find an

The worksheet in the back of this workbook may be helpful for this step.

apartment closer
to work

QUESTIONS | IDENTIFY OPTIONS
To help a person create a list of options:

TIP
Encourage the
person to consider
“No change” as an
option. They may
find that what they
are already doing is
their best choice.

• What could be done to solve the problem?
• What do other people do in situations like this?
• What kinds of things are you considering?
• What have you already tried?
• What do you want to do?
• Those are great ideas. Have you also considered_______?
• Can you stick with this option?

Choose the best option
What does the completed table reveal? Does one option seem to fit the person’s goals and
priorities? Is the person leaning toward one option over others? If so, what else do they need
to make a decision?
When the person is comfortable they have made a good choice, ask them to write it on
the worksheet.

Still not sure?
If the person is still having trouble deciding, here are some things that
might help:
1. Review with the person why they are making this decision. Encourage them to look
again at how they defined the problem in the “Think” (page 5) step and then
review the options. Does one best help them meet their original goal?
2. Revisit priorities. Encourage the person to look again at their list of priorities from the
“Think” step. Help them consider which option is most likely to achieve what they said
was most important to them. Ask the person whether they have discovered priorities
they did not list earlier.
3. Consider tradeoffs. Decisions are especially difficult when a person has to select
one priority at the expense of another, or when none of the options are good. Help
the person consider what they are willing to give up in order to get something they
value more.
4. Get more information. Sometimes talking about a set of options uncovers the need
for more information. Help the person think about what new information is needed
and where to get it.
5. Get more ideas. When a person cannot decide among options, it can be helpful to go
back to the brainstorm list. Is there something on the list that should be considered?
Could ideas be combined to make a fresh idea? Encourage the person to talk with others
–they may have fresh ideas or another way of thinking about the options.
6. Make a “backup” plan. If the person is concerned about a preferred option not working
out, it can be helpful to create in advance a backup plan of what to do instead. This can
help create confidence for making a choice.

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I
Narrow the List

Dori’s Plus-Minus Chart: Weigh Your Options

Option 1
No change:

Continue to
walk

Option 2

Quit job

Option 3

Buy used car

Option 4

Ride with
friend

14

Final_Helper_Workbook.indd Spread 13 of 14 - Pages(14, 11)

Pluses
(good things)

How
Important?

Minuses
(bad things)

How
Important?

No cost

***

Takes a long time

*

*

Weather gets bad

***

Does not feel safe

***

Get exercise

Opportunity to
find something
better

After brainstorming, help the person consider each brainstorm idea and circle the ideas
that seem most practical and doable. The more options the person has, the more confusing
the decision can be. Three to four options is a manageable number. Be certain to consider the
option of making no change.
Encourage the person to transfer their circled options to the Plus-Minus Chart on the worksheet
in the back of the workbook.

QUESTIONS | NARROW OPTIONS

*

Lose income
and job I like

***

Reliable

**

Expensive to buy

***

Saves time

***

Costs of gas,
insurance

***

Feels safer

***

Could break down

**

Feels safer

***

Do not like
feeling dependent
on friend

**

Inexpensive

***

May not be reliable

**

Saves time

*

Friend’s car is
old and could
break down

*

Friendly
conversation

**

Mother does
not like friend

*

To help a person narrow a list of options:

• Do you have all the information you need about this option?
If not, where can you learn more?

• Do you have the money or resources you need to make this work?
• Does this option depend on someone else?
• Does this option help achieve what is most important to you?
• How would this option affect others who are important to you?

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M

TRIP MAP
Pluses and Minuses: Weigh the Options

TIPS
Do not try to influence
the decision by emphasizing the pluses of options
you like or the minuses
of options you dislike.
Share your perspective
by offering ideas and
suggestions, but present
them fairly and as your
opinion. For example,
“I have some concerns
about….” or “Have you
considered…..”

Now that the person has a set of practical and doable options, it is time to list
and rate the pluses (good points) and minuses (bad points) of each option. The
worksheets at the back of this workbook and in the companion workbook include
a Plus-Minus Chart that can aid in this step. On page 14 is Dori’s example.

List Pluses and Minuses
Encourage the person to identify, from their perspective, the
pluses and minuses of each option. Help them think about any
kinds of pluses and minuses for the option, such as:

• Potential outcomes
• Feelings
• Impact on others

Weigh the Rate Importance
Some of the pluses and minuses will be more important to the person than
others. Reviewing the list of priorities from the “Think” step may help the person
weigh what matters most. In the column labeled “how important?” encourage the
person to use stars to rate how important each plus and minus is to them.

* One star means it matters very little.
** Two stars means it matters somewhat.
*** Three stars means it matters a lot.

QUESTIONS | WEIGH THE RATE IMPORTANCE
To help a person think about what matters most to them:

• How important is this pro to you?
• How important is this con to you?
• How does this pro or con relate to what is most important to you?

• Availability of resources

Supporting Dori
QUESTIONS | LIST PLUSES AND MINUSES
To help a person identify the pluses and minuses of each option:

• What is good about this option?
• What worries you about this option?
• If you did nothing, what would happen? Is that OK with you?
• How might people who care about you (such as friends, family, and
others) be affected by this choice?

12

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You acknowledge all the thinking and research Dori has done so far.
She is doing a great job and sticking with the process.

Dori Weighs
Her Options
Dori realizes she has options other than quitting
her job. She can continue
to walk to work. She can
buy a used car. She can
ride to work with a friend.
She wrote her options on
the Plus-Minus Chart. She
listed what she likes and
does not like about each
option. She used stars to
rate how important these
things are to her.
Option 4, riding with a
friend, has more of what
is important to Dori and
less of what is not important to her. This process
helps Dori conclude that
riding to work with a
friend may be her best
option at this time.

As she uses the Plus-Minus Chart to think about the good and bad
things about each option, you ask questions to help her to think broadly.
For example, how would she feel if she quit her job? Does she have a
place to park a car at home? How might riding with a friend affect
their friendship?
You explain the star rating system and help Dori weigh how important
each plus and minus is to HER. You ask her if she wants to hear your
thoughts on these. She looks at the completed chart to see if one option
seems to fit her priorities better. The one that does–Option 4–is not
what she expected. You talk with her about her surprise.

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File TitleFinal_Helper_Workbook.indd
Authorgruner_b
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