NANCY BREEN RUDDY, PhD
Hunterdon Family Practice Residency Program
SUSAN H.MCDANIEL, PhD
University of Rochester School of Medicine and Dentistry
Illness creates loss, necessitates role changes, and siphons financial and emotional resources. Experiencing illness is a major stressor, in and of itself. Therefore, it is not difficult to imagine how illness sets the stage for psychological and interpersonal difficulties.
Most physicians now recognize the importance of the interplay between biological, psychological, and social factors in illness. The “biopsychosocial model” (Engel, 1977) has become increasingly integrated into modern medicine. However, many medical providers feel overwhelmed by the tasks of monitoring and treating their patients at all levels. Frequently, medical providers find they need assistance in helping patients who have serious mental health or relational difficulties, whose medical and psychosocial issues are intertwined, or who are struggling to cope with their own or a family member's illness.
The field of medical family therapy has developed in order to meet the needs of these patients (McDaniel, Hepworth & Doherty, 1992). Although medical family therapy utilizes many theories and techniques from other types of family therapy, it is a metaframework that draws attention to the biopsychosocial nature of human experience. Medical family therapists must be familiar with illness and its effects on individuals and families; they must understand the medical system and how to work collaboratively with medical providers; and they must be familiar with techniques that assist families in coping with the unique stress illness places on them. This chapter will review these areas, beginning with the various settings in which medical family therapy is likely to be practiced. We will then discuss the approaches and techniques used in medical family therapy, and the literature regarding the utility of these approaches and techniques.