A few months ago I went out for a meal with a friend. I wasn’t
anticipating a jolly evening. She is a social worker and had a
difficult child care decision to make that would affect four
children, with five possible solutions each with their pros and
cons. She had not slept properly for five nights trying to work it
out, was exhausted and fractious and generally promised to be bad
Three-quarters of an hour later it was sorted – at least on
Making difficult decisions is one of the most stressful parts of
professionals’ working lives. Psychological research into the
complex process of decision-making reveals that we are not as
clever at making decisions as we would like to
It shows that however good our intentions, we actually are unable
to process more than about three variables with any degree of
reliability, and are rarely aware of the weight we are giving to
many extraneous or irrational elements. This is why people find
themselves unable to sleep or obsessed with a particular problem
-Êthey really are trying to do the impossible. Our denial of
this fact not only causes us enormous stress, but can leave us
vulnerable to criticism and even endanger those we are trying to
The good news is that these findings have prompted the development
of a stunningly simple, but powerful tool for solving part of the
problem. It is called decision analysis.
The idea is that one itemises all the possibilities with all their
pros and cons. Allocate each “pro” or “con” a numerical score on
any consistent scale. Then add up each list and see which has the
highest score. The process can involve as many people as are
relevant, the scores can be personal or professional depending on
the situation, and are entirely in the individual’s control.
If you do not like the result you can change any scores that seem
not to be right, or think again about what has been left out. If
one feels mathematically confident, probabilities can also be added
in. In any case, it can be useful to record estimates of
probabilities regarding various options, either as subjective
numbers or where they are available from research.
Using this tool does not absolve us from the work of elucidating
our own and our clients’ issues. Often counselling, discussion and
skill will be needed to reveal these issues. The tool can also,
however, reduce the need for this as many items can be illuminated
and show where attention is required.
If this is beginning to sound too complicated, you might pause to
consider the task of trying to do this all in your head, let alone
with numerous other people. You might also consider the frustration
of the people whose lives are affected by our agonising, insomnia
inducing, but ultimately largely opaque, decisions.
The advantages of this process include:
- It is simple to understand and use, making it accessible (I
have used it with people with learning difficulties, for example,
with wonderful results), and easily adaptable to different
- No one can avoid responsibility for their opinion because it is
quantified as well as visible. Hidden agendas are almost
- Anyone can change their opinion at any time and that can be
- It provides a clear, quick and concise way of recording not
only the decision but how and why it was made, exactly what
information was available, used or ignored.
- It is relatively quick and simple to translate into other
- It lends itself well to communication through secure electronic
- Training to use it is straightforward.
- It could also be invaluable for inclusion in court reports and
perhaps, in these days of retrospective scrutiny of social workers’
decisions, defending them in public and particularly before the
In short, this is a tool for illumination, recording,
time-saving and stress reduction. It is also a tool for
demystification, communication, negotiation, transparency and
accountability. Use it.
Rachel Celia is a London-based psychotherapist and trainer. For
more e-mail email@example.com
1 P Ayton, “On the competence and
incompetence of experts”, in G Wright, F Bolgar, Expertise and
Decision Support, Plenum Press, 1982; J Baron, Thinking
and Deciding, Cambridge University Press, 1988; and A
D Kahneman, “The framing of decisions and the psychology
of choice”, Science, 211, 1981
1 RM Dawes, Rational Choice In An Uncertain
World, Harcourt Brace College Publishers, 1988.