My work consists of three intertwining threads guided by my interest in patient engagement in real world contexts. The first is situated in the community and examines the situated practices of individuals diagnosed with neurological and psychiatric disorders to provide a grounded perspective on (in)competence. The second is situated in clinic contexts. I rely on video-based analyses to identify (in)effective communication practices in clinic contexts and provides an ecologically sensitive lens on applications of patient-centeredness, shared decision-making, and the use of decision support strategies in the clinic.The third thread highlights patient engagement in the collective sense by exploring practices, perceptions, and ethics of community-based participatory research (CBPR).