Time, Trust, and Telling: Narrative Pathways to Shared Decision-Making

This article explores how mental health professionals narrate successful experiences of implementing shared decision-making (SDM) within coordinated individual care planning (CIP) for adults with severe mental illness in Sweden. Drawing on narrative theory and the concepts of master and counter-narratives, the study analyzes two in-depth interviews with professionals who adopted a new SDM-oriented CIP model. While previous research has highlighted barriers to implementation, this study focuses on stories of localized success. The findings show that professionals engage in narrative identity work to navigate and, at times, resist dominant institutional discourses centered on time scarcity, user passivity, and bureaucratic rigidity. Through reflective practice, relational engagement, and adaptive use of tools such as pre-meetings and informational media, the professionals reframe SDM as both feasible and desirable. These counter-narratives reveal the importance of time, trust, and storytelling as enabling conditions for change. The study highlights the role of narrative as a tool of professional agency, offering insight into how small-scale innovations can challenge organizational inertia and foster more participatory models of care.