What is GSD?
Guided Self-Determination (GSD) is an evidence-based method and a dialogue tool for mutual decision-making (Zoffmann, 2012). Person-centred, it ensures that patient and healthcare professional cooperate from the outset on what the patient experiences as most relevant and challenging.
GSD is the health system involves reflection, cooperation and change, helping patients and healthcare professionals (HPs) to clarify and collaborate constructively about difficult health challenges. One of the main features of GSD is preparatory semi-structured reflection sheets and conversations with an HP certified in GSD and trained in empowering the patient.
Patients complete various reflection sheets at home to prepare for the face-to-face conversations with the HP, helping them to specify what they think is difficult in relation to their current situation and allowing them to gain insight into their own reactions. They become better able to express what is difficult or challenging in daily life living with their paticular health issue. Moreover, the sheets raise awareness of their own values and mobilise new opportunities to implement a desired change.
The reflection sheets that patients fill out in advance provide a foundation for the face-to-face conversations, which are structured to focus attention on what is important for the individual patient, actively involving them in mastering their own health challenges.
See a compendium of the reflection sheets (danish)
When is GSD necessary?
Originally developed to help patients with complex diabetes overcome barriers impeding their empowerment in the patient-healthcare professional relationship, the GSD method has since been adapted to a wide range of chronic or long-term diseases such as kidney failure, schizophrenia, endometriosis and cancer, as well as to other patient groups, e.g. the parents of children born prematurelly.
Shown to have a positive impact on patient reported outcomes, GSD is especially udeful for long-term conditions or complex situations that make moving forward in dealing with the disease difficult.
Read the review “Impact of the person-centred intervention guided self-determination across healthcare settings—An integrated review” on wiley.com
Watch this video to get a taste of what competence development using the GSD method involves
Training programme
The Capital Region of Denmark offers a training programme that allows healthcare professionals from Denmark and abroad to become GSD certified, qualifying participants to apply the GSD method in individual and group-based sessions in their own clinical environment. By taking the programme you will gain a theoretical understanding of the GSD method and undergo training in advanced communication techniques.
Using a blended learning approach that combines e-learning and classroom teaching, the programme focuses on practical training of the method, which involves practicing conversations in your own practice with subsequent supervision.
To become certified in the GSD method, you must complete the assignments in the e-learning modules, take tests, complete two days of participation, two practice sessions (each consisting of 3-4 consultations with patients and users in your own professional context) and do a final exam.
The training programme extends over five months and includes:
- 1-hour online kick-off
- Self-study days (e.g. e-learning modules, a reading list and assignments)
- Face-to-face classes
- Training of the GSD method/conversations with patients in participant’s own clinical environment
- Supervision on practice conversations
Customised GSD training programme
Depending on your needs and situation, the length and content of the GSD training programme can be adapted to fit the specific context in which the GSD method will be applied.
Read more about the traning program (danish)
Publications & News
Evaluation of the training programme in the dialogue method Guided Self-Determination (GSD) – Team North Jutland 2020-21.
Which aspects support and maintain competencies after graduation?
In January 2022, the Competence Development Department at The Centre for HR and Education (The Capital Region of Denmark) conducted a follow-up interview survey, after graduation, with selected informants among participants in the training programme held in three municipalities (Læsø, Brønderslev and Hjørring) of the North Denmark Region.
The interview survey was a follow-up to questionnaires that the participants had answered during education and right after graduation. The purpose of the in-depth individual interviews was to gain further knowledge about what supports and possibly determines the retention of competencies, when informants use the GSD method in their own professional context after completing the training program. It is known that aspects such as informal learning like sparring with colleagues, management support, etc. support the continued learning in practice, but the survey had also the aim to examine whether and how relationships and collaboration between healthcare professionals and citizens are a factor that influences the retention of competencies.
Among other things, the study found that the citizens involvement is essential for them to experience being heard, to feel ownership and for the comfortability of daring to share. From the perspective of the healthcare professional, the method made them go a step deeper, become more present and being able to use their professionalism more and in a better way in practice.
The full evaluation report is currently being finalized and will be published on this page soon.
New article: “About me as a person, not only the disease – piloting Guided Self-Determinaton in an outpatient endometriosis setting”
Scandinavian Journal of Caring Science (2019)
This article, which discusses how the GSD method can be used to support women with the chronic illness endometrioses in their everyday lives, describes how the method was tested in an outpatient setting at the Department of Gynaecology, Rigshospitalet, University Hospital of Copenhagen Denmark. Patients are now offered individual GSD consultations there as part of their post-treatment follow up.
The article was written in collaboration with the department’s clinical team for patients with endometriosis.
Recent article: “Training programme provides the tools to involve patients [Uddannelse giver redskaber til at involvere patienter]”
Journal of the Danish Health Service (2019)
This article describes how the GSD training programme provides the tools necessary for involving patients. The authors are development consultant Izaskun Altemir Garcia and education consultant Susan Munch Simonsen, both of whom work with developing the GSD competencies of healthcare professionals. The article discusses their experiences with the training programme and how it helps them apply a person-centred approach that involves patients and users in their own treatment and decision-making processes.
International conference on person-centred healthcare
The GSD training programme was presented at the International Congress on Person Centered Healthcare (17-18 October 2019 in Porto, Portugal), which focused on how this method can be developed and implemented in practice.
Development consultant Izaskun Altemir Garcia and educational consultant Susan Munch Simonsen attended the conference and held a short oral presentation on the GSD training programme describing how healthcare professionals can use the GSD method to systematically involve patients and users equally and how it can help them effectively communicate with patients about solving the patients’ health challenges.
The Associacäo Para a Seguranca do Doente (APASD) organised the conference with the support of Conselho Regional Norte da Ordem dos Médicos and the European Society for Person Centered Healthcare. Distinguished speakers from across the globe gave talks on a wide range of areas relevant to the implementation and development of the person-centred approach, providing participants with ample opportunities to gain inspiration about how this new way of thinking can be implemented in local practice.