Decisional Balance Models in Mental Health Explained

decisional balance models mental health decision-making
Dr. Neeshu Rathore
Dr. Neeshu Rathore
 
May 6, 2025 3 min read

Types of Decisional Balance Models in Mental Health

Mental health is a complex field, and understanding how we make decisions regarding our well-being can be quite enlightening. One of the useful frameworks in this area is the decisional balance model. This model helps us weigh the pros and cons of our choices, especially when it comes to behaviors that affect our mental health. Let’s break down the different types of decisional balance models and how they apply to mental health.

What is a Decisional Balance Model?

At its core, a decisional balance model is a tool that helps you evaluate the positives and negatives of a particular decision. It gives you a clearer view of what choices you have and what impacts those choices may have on your mental health.

Key Types of Decisional Balance Models

1. Prochaska and DiClemente’s Stages of Change Model

This model is primarily used in the context of behavioral change. It outlines five stages:

  • Precontemplation: Not considering change.
  • Contemplation: Acknowledging the need for change but not ready to take action.
  • Preparation: Planning for change and gathering resources.
  • Action: Actively making changes.
  • Maintenance: Sustaining the changes made.

Example: If someone is contemplating therapy, they might be in the contemplation stage, recognizing their need for help but feeling uncertain about taking that step.

2. Decisional Balance Sheet

This model involves creating a visual chart where you list:

  • Pros of the decision
  • Cons of the decision

Example: If you are considering starting antidepressants, you might list pros like improved mood and cons like potential side effects. This visual aid can help clarify your thoughts.

3. The Fishbein Model

This model focuses on attitudes toward different choices. It includes:

  • Beliefs: What you think will happen if you make a choice.
  • Evaluations: How you feel about those beliefs.

Example: A person might believe that joining a support group will help them feel less isolated, which positively influences their decision to attend.

4. Behavior Change Wheel

This model emphasizes the importance of capability, opportunity, and motivation in making decisions:

  • Capability: Do you have the skills or knowledge?
  • Opportunity: Are there external factors helping or hindering you?
  • Motivation: What drives you to make this choice?

Example: Someone might want to practice mindfulness but feel they lack the time (opportunity) or knowledge (capability) to do so effectively.

Steps to Use Decisional Balance Models

  1. Identify the Decision: Clearly define what choice you are considering.
  2. List Pros and Cons: Use one of the models to weigh your options.
  3. Reflect on Your Feelings: Consider your emotions regarding each option.
  4. Seek Support: Discuss your thoughts with a therapist or trusted friend.
  5. Make a Decision: Choose the best option based on your evaluation.
  6. Review and Adjust: After some time, reflect on your decision and adjust if necessary.

Real-Life Applications of Decisional Balance Models

  • Therapy Choices: A patient weighing the decision to enter therapy can use a decisional balance model to consider both the fear of vulnerability and the potential for healing.
  • Medication Decisions: When deciding on taking medication for anxiety, patients can list the benefits of reduced symptoms against possible side effects.
  • Lifestyle Changes: Individuals contemplating lifestyle changes, like exercise, can evaluate how it might support their mental health versus their current habits.

Using decisional balance models can empower individuals to make informed choices about their mental health. By breaking down complex decisions into manageable parts, you can clarify your thoughts and move forward with confidence.

Dr. Neeshu Rathore
Dr. Neeshu Rathore
 

Clinical Psychologist, Associate Professor in Psychiatric Nursing, and PhD Guide with extensive experience in advancing mental health awareness and well-being. Combining academic rigor with practical expertise, Dr. Rathore provides evidence-based insights to support personal growth and resilience. As the founder of Psywellpath (Psychological Well Being Path), Dr. Rathore is committed to making mental health resources accessible and empowering individuals on their journey toward psychological wellness.

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