Emphasis in Medical Family Therapy
1. Training Sites
2. Faculty Publications
3. Collaborative Care: Additional Resources
According to McDaniel, Hepworth, and Doherty (1992), “the fundamental tenet of medical family therapy is that all human problems are biopsychosocial systems problems: there are no psychosocial problems without biological features and no biomedical problems with psychosocial features” (p. 26). Medical family therapy is part of a growing movement in health care that has as its goal the collaboration of medical and mental health professionals in assessing, planning, and providing care to families in order to repair both the fragmentation in health care services and the conceptual split between mind and body.
The USD MFT faculty have been actively involved in the collaborative care movement and are building an emphasis within the MFT program that is focused on preparing family therapy students to work in primary care medical settings. Below is a list of medical family therapy clinical training sites affiliated with USD, USD faculty publications in the area of medical family therapy, and additional resources on medical family therapy and collaborative care.
I. USD’s Medical Family Therapy Training Sites
Pediatrics & Adolescent Medicine, University of California, San Diego Medical Center7910 Frost Street, Suite 350 San Diego, 92123 * (858) 496 - 4800
Site Description: UCSD Pediatrics is a Collaborative Care Program between the University of San Diego’s MFT Program, and UCSD’s Residency Training in Primary Care Pediatrics, providing MFT students with the opportunity to assess and treat children, adolescents, and their families. The program, which is continuing in its development, seeks to create a partnership between UCSD pediatric residents and USD family therapy trainees and interns with the shared goal of improving access and quality of care for mental health needs that present in primary care.
Patients range from about 4-18 years of age, and are involved in individual and family therapy, provided in both English and Spanish, for a variety of mental health issues. Common presenting problems include relational problems within the family, lifestyle transitions, anxiety, depression, Attention Deficit Hyperactivity Disorder, and bereavement. Patients may also present with comorbid physical and mental illnesses, such as chronic illness and depression, and benefit from coordinated treatment services between their physicians and therapists. MFT trainees and interns conduct routine assessments, utilizing screening instruments such as the SANDAP, Family Assessment Device, Stressor Scale, and Current Problems Checklist, providing for effective treatment planning and further research. Currently, there is one MFT trainee, who works approximately 25 hours per week for a one-year, unpaid traineeship, and one part-time MFT intern. Due to ongoing grant writing for funding and support services, interns are able to receive a stipend for their services. Hours spent at the clinic are divided between client contact, group and individual supervision, and consultation with medical staff regarding patient care.
Important Contacts:
- Leita Koontz, M.A., AAMFT Approved Supervisor (Lkoontz3@cox.net)
- Dean Sidelinger, MD, Pediatrics Site Director (dsidelinger@ucsd.edu)
Pediatrics Website:
UCSD Pediatrics and Adolescent Medicine: http://health.ucsd.edu/specialties/Peds/
Division of Family Medicine, University of California, San Diego Medical Center
9500 Gilman Drive La Jolla, CA 92093-0807 * (619) 543-5490
Site Description: UCSD Division of Family Medicine is a Collaborative Care Program between the University of San Diego’s MFT Program, and UCSD Family Medicine, providing MFT interns and trainees with the opportunity to assess and treat a diverse patient population, while collaborating with UCSD physicians and doctoral students in a medical setting. Patients, who are referred for mental health services by their primary care physicians, receive improved healthcare services, due to mental and medical health professionals working together on the organization and delivery of treatment. Patients may be involved in individual, couples, and family therapy, in both English and Spanish, and range in age, socioeconomic status, and cultural and ethnic backgrounds. MFT trainees and interns have the opportunity to clinically address issues including, but not limited to, anxiety, depression, substance abuse, sexual disorders, phase of life concerns, issues related to aging, grief, and parent training. Also, patients may present with comorbid mental and physical illnesses, such as pain and depression, and benefit from coordinated treatment services. During the assessment process, clinical staff uses a wide range of screening instruments, such as the Beck Depression Inventory (BDI) and the Brown ADHD scale, which contributes to thorough treatment planning and future research. Currently, there are two UCSD Family Medicine sites, located in Hillcrest and Scripps Ranch, each staffed with two MFT trainees, one or two MFT interns, and collaborating medical professionals. MFT trainees at Family Medicine typically see 10-15 patients on a weekly basis, in addition to paperwork, case consultation, and bimonthly Behavioral Science Clinics, for a one-year, unpaid traineeship. MFT interns are part-time, and due to ongoing grant writing for funding and support, receive a stipend for their services. Additionally, Family Medicine is involved in a clinical research project related to treating anxiety disorders with the collaborative care model (CALM), continuing to foster greater understanding for the benefits of collaborative health care.
Important Contacts:
- Michele Smith, PhD., AAMFT Approved Supervisor (mssmith@ucsd.edu)
- Gene Kallenberg, MD, Family Medicine Division Chief (gkallenberg@ucsd.edu)
Additional Links:
- UCSD Division of Family Medicine: http://famprevmed.ucsd.edu/
Reproductive Medicine, University of California San Diego
4168 Front Street #8663, San Diego 92103-8663
Site Description: Dedicated to the treatment of women’s health issues, Reproductive Medicine is a UCSD Medical site that has recently begun to utilize the collaborative care model by including mental health professionals in its delivery of services. As a developing practicum site, Reproductive Medicine provides MFT trainees and interns with the opportunity to work with a variety of medical staff, namely physicians, nurses, medical residents, attendings, midwives, and child birth educators. Patients range in age from their early 20’s to late 30’s, and are primarily seeking individual therapy for a variety of mental health concerns related to pregnancy, highlighting the importance of coordinated mental and physical treatment for patients at Reproductive Medicine. Common mental health concerns include maternal depression, grief and loss during pregnancy, postpartum depression, anxiety disorders related to pregnancy and parenting, transition to parenthood, and occasionally issues related to infertility. Several screening instruments are used, namely the Primary Care Evaluation of Mental Disorders (PRIME-MD), the Family Assessment Device (FAD), and the Edinburgh Postnatal Depression Scale, all of which provide for effective treatment planning and future research. Individual mental health therapy services are provided in both English and Spanish, and tend to follow a brief model of treatment, due to the nature of women entering therapy at different times in their reproductive struggles. Additionally, English-speaking support groups are available for postpartum depression and transition to parenthood, focused on the preservation of marital intimacy for new parents. Currently, there is one part-time, unpaid MFT trainee, and one part-time MFT intern, who receives a grant-funded stipend. As this program continues to develop, MFT trainees will work for approximately 25 hours per week, for a one-year traineeship. Hours are divided between direct client contact, documentation, supervision, and case consultation.
Important Contacts:
- Jo Ellen Patterson, Ph.D., AAMFT Approved Supervisor (Joellenpatterson@aol.com)
- Jessica Kingston, MD, Reproductive Medicine, UCSD (jkingston@ucsd.edu)
Additional Internet Resources
- UCSD Reproductive Medicine: http://repromed.ucsd.edu/
2. USD Faculty Publications in Medical Family Therapy and Collaborative Care
Books:
- Patterson, J., Albala, A., McCahill, M.E., & Edwards, T.M. (2006). The therapist’s guide to psychopharmacology: Working with patients, families, and physicians to optimize care. New York: The Guilford Press.
- Patterson, J., Bischoff, R., Peek, C.J., Heinrich, R., & Scherger, J. (2002). Mental health professionals in medical settings: A primer for the general practice of mental health care. New York: W.W. Norton.
- Patterson, J., Williams, L., Grauf-Grounds, C., & Chamow, L. (1998). Essential skills in family therapy: From the first interview to termination. New York: The Guilford Press.
Journal Articles:
- Edwards, T.M., & Patterson, J. (2006). Supervising family therapy trainees in primary care medical settings: Context matters. Journal of Marital and Family Therapy, 32, 33-43.
- Edwards, T. M., & Turnage, J. (2003). “Cheating almost killed me”: Collaborative care for a man who believed he had AIDS. Families, Systems & Health, 21, 233-240.
- Edwards, T.M., & Patterson, J., (2003). A ‘golden girl’ tarnished: Amplifying one patient’s (& family’s) voice through collaborative care in a family medicine setting. Journal of Feminist Family Therapy, 15, 75-88.
- Sieber, W.J., Kallenberg, G., McColley, N., McQuaid, J., Patterson, J., Wu, J., & Edwards, T. (2003). Informing the implementation of a collaborative care model in a culturally diverse primary care clinic system. Annals of Behavioral Medicine, 25(suppl.), 49.
- Patterson, J. (2002). Learning from the pioneers of collaborative care. Family Systems & Health, 20(4), 375-378.
- Edwards, T. M., Patterson, J., Grauf-Grounds, C., & Groban, S. (2001). Psychiatry, MFT, & family medicine collaboration: The Sharp behavioral health clinic. Families, Systems and Health, 19, 25-36.
- Patterson, J. (2001). Training: The missing link in creating collaborative care. Family Systems & Health, 19(1), 53-58.
- Gawinski, B. A., Edwards, T. M., & Speice, J. (1999). A family therapy internship in a multidisciplinary health care setting: Trainees’ and supervisor’s reflections. Journal of Marital and Family Therapy, 25, 469-484.
- Patterson, J., McIntosh-Koontz, L., Baron, M., & Bischoff, R. (1997). Curriculum changes to meet challenges: Preparing MFT students for managed care settings. Journal of Marital and Family Therapy, 23(4), 445-459.
- Patterson, J., Bischoff, R., Scherger, J., & Grounds, C. (1996). University family therapy training and a family medicine residency in a managed care setting. Family Systems and Health, 14, 5-16.
- Patterson, J. & Scherger, J. (1995). A critique of health care reform in the United States: Implications for training and practice in marriage and family therapy. Journal of Marital and Family Therapy, 21, 127-135.
- Patterson, J. & Magulac, M. (1994). Pharmacology for family therapists. Journal of Marital and Family Therapy, 20, 151-171.
Book Chapters:
- Patterson, J., D’Urso, S., Kallenberg, G.A., & Edwards, T. (in press). Collaborative care for an immigrant couple. In R. Kessler (Ed.), Collaborative medicine case studies: Evidence in practice. NY: Springer.
- Sieber, W. J., Edwards, T. M., Kallenberg, G. A., & Patterson, J. (2005). Maximizing patients’ health through engagement with families. In R. Crane & E. S. Marshall (Eds.), Families & health: Interdisciplinary perspectives (pp. 438-450). Sage Publications.
- Edwards, T. M., & Patterson, J. A. (2004). A ‘golden girl’ tarnished: Amplifying one patient’s (& family’s) voice through collaborative care in a family medicine setting. In A. Prouty (Ed.), Feminist perspectives on medical family therapy (pp. 75-88). New York: Haworth Press.
- Patterson, J., Bischoff, R., & McIntosh-Koontz, L. (1998). Training therapists to work in primary care. In Blount, A. (Ed.), Integrated primary care: The future of medical and mental health collaboration. New York: W.W. Norton.
3. Collaborative Care: Additional Resources
Ongoing Research and Treatment in Collaborative Care Related Links:
- IMPACT: Treatment for Late-life Depression : www.impact-uw.org
- Hogg Foundation for Mental Health, University of Texas www.hogg.utexas.edu
- Primarycareshrink.com web.mac.com/nefserrano/iWeb/PrimaryCarePsychology/Welcome.html
- Integrated Primary Care www.integratedprimarycare.com
Important Collaborative Care Journals:
- Annals of Behavioral Medicine. Published by the Society of Behavioral Medicine.
- Families, Systems and Health. Published by the Educational Publishing Foundation, part of American Psychological Association Publications.
- Journal of Clinical Psychology in Medical Settings. Published by Kluwer Academic/Plenum Publishers.
- Health Psychology. Published by American Psychological Association.
- The International Journal of Integrated Care. Published by Utrecht Publishing.
- Journal of Medical Psychotherapy. Published by the American Board of Medical Psychotherapists and Psychodiagnosticians.
Nationwide and International Agency Support for Collaborative Health Care:
American Psychological Association Health Psychology (Division 38) |
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Collaborative Family Healthcare Association |
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Counselors & Psychotherapists in Primary Care |
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Integrated Primary Care |
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International Society for Behavioral Medicine |
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Society for Behavioral Medicine |
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Society of Teachers of Family Medicine |
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The Cummings Foundation |
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Wales Mental Health in Primary Care |
References
McDaniel, S. H., Hepworth, J., & Doherty, W. J. (1992). Medical family therapy: biopsychosocial approach to families with health problems. New York: Basic Books.
