NEW USER REGISTRATION AND LOGIN - Iowa Healthcare Collaborative
Collaborative Family Healthcare Association 13 th Annual Conference
description
Transcript of Collaborative Family Healthcare Association 13 th Annual Conference
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Session #ML-1October 29, 2011
2011 Collaborative Family Healthcare Association Annual Meeting
MAINSTREAMING MEDICAL FAMILY THERAPY:The Importance of a Systemic Approach to Integrated Healthcare
Susan H McDaniel PhD, University of Rochester William J Doherty PhD, University of MinnesotaJeri Hepworth PhD, University of Connecticut
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Faculty Disclosure
Please add the commercial interest disclosures that you reported on your signed Disclosure form:
I/We have not had any relevant financial relationships during the past 12 months.
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Need/Practice Gap & Supporting Resources
• Need for a biopsychosocial approach to psychotherapy and behavioral health
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
*Participants can identify the original vision and concepts of Medical Family Therapy, including its use as a metaframework for other approaches such as CBT, DBT, and psychoeducation.*Participants can describe this family systems-based approach to behavioral health in primary care as well as specialty settings.*Participants can discuss the compelling need for Medical Family Therapy as it relates to ethical, interpersonal, and socioeconomic issues in healthcare.*Participants can discuss future opportunities and challenges for family- oriented behavioral health in the emerging healthcare system. *Participants will identify how medical family therapy principles can be helpful in team development and role clarification in the Patient-centered Medical Home.
Objectives
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Expected Outcome
What do you plan for this talk to change in the participant’s practice?
• Incorporate an overall systematic framework for behavioral health in healthcare.
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
MEDICAL FAMILY THERAPYHistory and New Contexts
William J. Doherty, PhDProfessor of Family Social Science & Family and Community Medicine
University of Minnesota
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
• The Origin Story• The biopsychosocial systems approach• Family focus• Medical Family Therapy as metaframework
*Can be used by many disciplines*Can be used with many problems and populations
• Agency and communion still overarching goals • Member of collaborative team: from triangle to team• Health care reform as larger context
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Roles and Strategies for Medical Family Therapists
Jeri Hepworth, PhDProfessor and Vice-Chair of Family Medicine
University of Connecticut
President, Society of Teachers of Family Medicine
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Roles and Strategies for Medical Family Therapists
1) Behavioral Health Consultant2) Clinical Team Member and Consultant
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Medical Family Therapist as Systemic Behavioral Health Consultant
• Tracking medical and mental health outcomes• Tracking medication and treatment adherence• Supporting the patient’s relationship with the referring provider • Providing psychoeducation about the diagnoses and treatment• Encouraging patient and family activation • Clarifying motivation for change and treatment• Negotiating a mutually-agreeable treatment plan• Facilitating family support• Encouraging psychiatric consultation when needed • Engaging in targeted brief therapy
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Clinical Strategies• Recognize the Biological Dimension
Patients have bodies and disease• Elicit the family illness history and meaning
Health Beliefs and History• Respect defenses, remove blame, and accept
unacceptable feelings
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Clinical Strategies (continued)
• Provide Psychoeducation and Support Describe Common Patterns of Interaction
• Reinforce the family’s non-illness identity Put the Illness in It’s Place
• Facilitate Communication Within the Family and the Clinical Team
• Attend To Developmental issues
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
• Increase the Family’s Sense of Agency Patient Activation and Empowerment
• Enhance the Family’s Sense of Communion Allow Others to Help
• Maintain an Empathic Presence with the FamilyMindfulness of the Therapist
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Enhancing Team Functioning• Multi-Level Participation• Respect defenses, remove blame, and accept
unacceptable feelings• Facilitate Communication• Attend to Developmental Issues• Increase Agency and Communion of Team• Mindful Team Practice
Susan H. McDaniel, Ph.D.Dr. Laurie Sands Distinguished Professor of Families and Health
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Session #October __, 20110:00 AM
Director, Institute for the FamilyAssociate Chair, Department of Family Medicine
University of Rochester Medical Center
MEDICAL FAMILY THERAPY IN ACTION:GENETIC CONDITIONS
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Most patients, across conditions, are not significantly distressed after testing positive
for a genetic illness
(Lerman, Vroyle, Tercyak & Hemann, 2002, JCCP Review)
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Dealing with familial illness risk is not a rational process
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Coping with Health Information Monitoring Behavior
-Scan and amplify threatening cues-Seek Information
Blunting Behavior-Distract from or avoid threatening
cues-Minimize Information
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Medical Family Therapy
Monitoring Behavior
-Benefit from targeted information -Family members provide support & record information
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Medical Family Therapy Blunting Behavior
-Emphasize future outcome of current behavior
-Family members increase concerns, confront denial, and provide support
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
The Psychology of Genetic Testing• Huntington Disease
10-20% Sought Testing
• Breast Cancer35-43% Sought Testing
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
The Psychology of Genetic Conditions
Perceived rather than scientific risk influences: • Behavior• Decision-Making• Emotional Outcome
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Wanting to know for one’s children is the single biggest reason
that adults choose to get tested for genetic conditions
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Clinical Strategies for Medical Family Therapy
1 - Recognize the Biological Dimension 2 - Elicit the family illness history and meaning 3 - Respect defenses, remove blame, and accept unacceptable feelings. 4 - Facilitate communication. 5 - Attend to developmental issues 6 - Reinforce the family’s non-illness identity 7 - Provide psychoeducation and support. 8 - Increase the family's sense of agency 9 - Enhance the family’s sense of communion10 - Maintain an empathic presence with the family
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Behind every health and mental health professional is a person and a family with a history of medical and mental
health issues
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Medical Family Therapy in the 21st Century
Must be• Conceptually creative• Clinically innovative• Seek truth through research