Academic journal article Journal of Marital and Family Therapy

A National Survey of Family Physicians: Perspectives on Collaboration with Marriage and Family Therapists

Academic journal article Journal of Marital and Family Therapy

A National Survey of Family Physicians: Perspectives on Collaboration with Marriage and Family Therapists

Article excerpt

Recognizing the fit between family medicine and marriage and family therapy (MFT), members of both fields have made significant advances in collaborative health research and practice. To add to this work, we surveyed a nationwide random sample of 240 family physicians (FPs) and asked about their perspectives and experiences of collaboration with MFTs. We found that FPs frequently perceive a need for their patients to receive MFT-related care, but their referral to and collaboration with MFTs were limited. Through responses to an open-ended question, we gained valuable information as to how MFTs could more effectively initiate collaboration with FPs.

Despite the success of medical family therapists in providing integrative, collaborative healthcare, we know little about how commonly family physicians (FPs) and marriage and family therapists (MFTs) coUaborate in routine patient care. To our knowledge, there have been no studies published from the perspective of the FP that describe the extent to which FPs seek the collaboration of MFTs, the degree to which they are aware of MFT as a field, their perceived need for their patients to receive MFT, or their attitude toward MFT as a potential resource for patient treatment.

Leaders in family medicine and MFT recognize the common occurrence of mental health concerns arising in a medical visit. In fact, it has been estimated that more than 60% of patient visits to primary care physicians (PCPs) include mental health concerns (Moon, 1997), and many of these concerns may not be the presenting complaint (Jackson & Tisher, 1996; Schurman, Kramer, & Mitchell, 1985). Several MFT/FP teams have developed models for collaboration (Doherty & Baird, 1983; Dym & Berman, 1986; Hepworth & Jackson, 1985; Seaburn, Lorenz, Gunn, Gawinski, & Mauksch, 1996). Other researchers and practitioners have written books that serve as a guide to other mental health practitioners for how to be effective collaborators with other healthcare practitioners (e.g., Seaburn et al., 1996).

The specialty of family medicine, which arose in the 1960s, embraces a systemic, biopsychosocial perspective to illness that stresses the importance of caring for the whole person within his or her family, social context, and Ufe cycle stage (Chung, 1996; Fischetti & McCutchan, 2002). It is not surprising that FPs regularly treat their patients' mental health problems. By definition of their specialty, FPs are trained to integrate behavioral science concepts with their biomedical training (AAFP, 2000; Seaburn et al., 1996) as well as to manage psychotropic medication. The American Academy of Family Physicians (AAFP, 2000) recommended curriculum guidelines delineate how family medicine residents must understand the individual in the context of his or her family, as well as the emotional impact of illness, and be able to evaluate and diagnose mental health disorders from a biopsychosocial perspective. For decades, authors in family medicine and collaborative healthcare journals have published literature regarding the use of MFT techniques such as family systems thinking, the use of genograms, meeting with the entire family, brief therapy techniques, and when to refer patients for family therapy (Bader, 1990; Bloom & Smith, 2001; Bullock & Thompson, 1979; Christie-Seely, 1981; Davis, 1988; Frank, 1985; Lang et al., 2002; Mayer et al., 1996; Tomson & Asen, 1987). Additionally, organizations such as the Collaborative Family Healthcare Association (CFHA; see http://www.cfha.net) and the Society for Teachers of Family Medicine (STFM; see http:// www.stfm.org) continue to promote research, education, and practice in collaborative healthcare. Given family medicine's emphasis on family systems, the family as the unit of care, and biopsychosocial perspective, it seems that MFTs would be a logical, and even sought-after, complement to FPs in providing comprehensive patient care.

As a specialty of MFT, medical family therapy (MedFT) has already made significant advances in this area. …

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