| 释义 |
- Overview
- History and Development Early Foundations of Medical Family Therapy Emergence of Medical Family Therapy: Convergence of Family Therapy and Family Medicine
- Applications Domains and Competencies of Medical Family Therapists Domain 1: Systems[18] Domain 2: Biopsychosocial-spiritual[18] Domain 3: Collaboration[18] Domain 4: Leadership[18] Domain 5: Ethics[18] Domain 6: Diversity[18]
- Training PROGRAMS
- Further Reading
- References
- External links
{{AFC submission|d|reason|There is a heck of a lot of puffery in here but as the nom here said, there are a lot of references but they don't hold up to scrutiny. |u=Medical Family Therapy|ns=118|decliner=Chrissymad|declinets=20180718193401|ts=20180713202721}} Medical Family Therapy (MedFT) is a subfield of Family Therapy that applies the biopsychosocial-spiritual (BPS-S) model[1] [1]and systems theory[3] in healthcare settings and with individuals, couples and families living with illness. Medical Family Therapy (MedFT) developed out of the intersection between Family Therapy and Family Medicine in the 1970s and 1980s.[2][3] [6]Medical Family Therapy like traditional Marriage and Family Therapy view an individual or family within their larger relational system and seeks to not only address issues within the individual but between the individual or family and their larger social context. However, Medical Family Therapy narrows this focus through its emphasis of these issues in relation to health, illness, and the healthcare environment. Overview Medical Family Therapy (MedFT) is a subfield of Family Therapy that applies the biopsychosocial-spiritual (BPS-S) model[4] and systems theory[5] in healthcare environments and with individuals, couples and families living with illness. A basic premise of MedFT is that there are no psychosocial problems without biological features, and there are no biomedical problems without psychosocial features[6] . According to McDaniel, Hepworth, and Doherty[7] , MedFT is also a response to five eco-systemic splits that lead to “fragmented, ineffective, and less humane care.” They summarized the five splits as: - Mind body dualism: This split separates physical health from mental health and treats both systems as separate rather than a continuum.
- Individual vs. the family: some aspects of healthcare training (medicine and allied health professions) who inherently believe in the unity of mind and body often downplay the role family. The authors see family as a “powerful interpersonal force field within which the patient lives and functions.” Separating the individual from this force field leads to fragmentation of care.
- Individual, family vs. institutional settings: Families with long health complications not only have the relationships that define their internal experiences but also a certain dynamic of trust, mistrust, and confidence with the healthcare institution and healthcare team. MedFTs serve as liaisons between the members of the family and the healthcare team, which is an important aspect of treatment.
- Clinical, operational, and financial: Too often, these worlds are separated in clinical practice and the operational and financial wings of the healthcare system holds answers to long term sustainability of integrating different providers into the healthcare team.
- Separation of community from clinical health care: Most students of healthcare disciplines and social sciences know that neighborhoods, culture, and larger institutions directly impact the quality of our lives. A MedFT not only appreciates these rich frames but also facilitates their involvement in the flow of clinical care.
Two goals of medical family therapy are to promote agency and communion [6][12]. Agency refers to empowering patients and families in making decisions regarding their healthcare. Communion refers to the importance of having family and community support. The hope is to help patients and families act as a team and feel supported rather than experiencing isolation while coping with illness. MedFT punctuates the layers of relationships that are necessary to address issues of health, illness, and recovery. The systemic principles are equally applicable to the family in concern, as well as the members of the healthcare team. MedFTs are grounded in systems theory, but extend beyond traditional marriage and family therapy training. In addition to addressing relational concerns and mental health, MedFTs’ also seek to understand and treat the psychosocial impact of biomedical illness, trauma, and health[8] . MedFTs help promote and facilitate communication and collaboration among staff in healthcare systems, between staff and patients and families, and between mental health and physical health professionals[8][9] [10]. MedFTs value relationships, culture, community, and health as clinicians, researchers, educators, healthcare administrators, and policy makers [11]. As clinicians, researchers, and policy-makers, MedFTs promote health equity and aim to reduce health disparities based on age, race, class, gender, and sexual and gender identity. History and Development The term Medical Family Therapy first appeared in the literature through the work of Susan McDaniel, Jeri Hepworth, and William Doherty (1992) in a text titled Medical Family Therapy: A Biopsychosocial Approach to Families with Health Problems.[6] MedFT addressed the need for systemic and family-oriented approaches across all facets of healthcare. Although the term Medical Family Therapy did not appear in the literature until the early 1990's, the practice of Medical Family Therapy had been well documented as early as the late 1970s/early 1980s.[12] Early Family Therapy pioneers applied general systems theory, cybernetics and the idea that relationships are central to human health and well-being to better understand and treat families living with illness as well as address the gap in the healthcare system between biological and psychosocial health.[13] Initially, Medical Family Therapy was viewed as a clinical orientation and/or framework used by behavioral health clinicians working in health care settings. However, over the past 30 years Medical Family Therapy has evolved into an independent subfield of family therapy, with trained MedFTs practicing in primary, secondary, and tertiary healthcare settings and being trained in degreed MedFT academic programs. (Integrating Behavioral Health Into The Medical Home [Secondary Source]) However, some critics continue to contend that MedFT, while a useful clinical orientation, is not a unique approach or distinct field.[12] For example, critics cite the fact that, in the United Kingdom, a biopsychosocial approach to care had been practiced for years prior to the development of Medical Family Therapy.[14] Although this is true, advocates for the field highlight that while the biopsychosocial approach is an underlying framework for Medical Family Therapy, its origin, evolution and current applications move it beyond simply a clinical orientation.[12] (Secondary Source Needed) Early Foundations of Medical Family Therapy In the 1950's and 1960's, even before the formal development of Medical Family Therapy, many of the orientations and frameworks in the family therapy field developed from family physicians, psychiatrists, and psychologists working in medical settings. Individuals such as Nathan Ackerman, Murray Bowen, Milton Erickson, Salvador Minuchin, Lyman Wynne, Donald Jackson, Paul Watzlawick and many others believed that there were clear links between the family system, the system of care, physical disease, and mental illness. Many of these theorists were housed in pediatrics and psychiatry formulating systems-based concepts as a result of working with family members around the patient’s illness.[15] For example, the work of Lyman Wynne helped to establish the idea that an individual's symptoms were connected to their systemic context and believed that the family should be a part of treatment for individuals with schizophrenia. This whole family approach was innovative because traditionally only the individual diagnosed with schizophrenia would be hospitalized. Murray Bowen also believed that wellness for one member included the entire family system as a part of treatment and that both physical and mental health were linked to how a family was functioning.[16] Salvador Minuchin found in his work with individuals who had diabetes, that physical manifestations related to the illness could be and often were caused by psychosocial and familial stressors.[17] These ideas and observations helped to link the psychosocial element of family therapy with the biological illnesses that people experienced.Other early Family Therapy pioneers such as, Gregory Bateson, an anthropologist and social scientist, helped to develop concepts such as homeostasis. His concepts suggested that illnesses, health, and recovery patterns might be associated with the communication styles within families. These along with many other research findings, clinical observations, and theoretical conceptualizations provided the foundation for the formal development of Medical Family Therapy in the 1980's and 1990's. Emergence of Medical Family Therapy: Convergence of Family Therapy and Family Medicine The notion of including the family system and focusing on the interconnectedness of individuals within the system was a significant shift in the world of mental health practice in the 1950s. Around the same time, medicine was also experiencing a similar evolution moving from an individual approach, common in the general practitioner model, to a comprehensive family focused approach. John Geyman (1977), a pioneer in the field of family medicine, wrote the following: "It is axiomatic that the specialty of family practices is involved in the comprehensive, ongoing care of individual patients and their families, and that the knowledge and skills required by the family physician include a broad range of clinical competencies. It is likewise axiomatic that the family is the basic unit of care in family practice, but involved herein is a profound conceptual shift extending well beyond the care of the 'whole patient' to the care of the family, not just the individual as the patient. Although this point is part of everyday language of developing discipline of family medicine, a gap usually exists between this conceptual goal and actual practice, including teaching practices with intended commitment to this goal."Three years after this statement, the initial building blocks for Medical Family Therapy emerged at the 1980 American Association of Marriage and Family Therapy annual conference. William J. Doherty a family therapist and Macaran Baird a family medicine doctor gave a presentation on the role of Family therapy in Family medicine. Their continued collaboration resulted in a book titled “Family Therapy and Family Medicine”, published in 1983. The 1980s witnessed an increased number of clinicians practicing and researching family therapy in medical settings, culminating in the 1992 seminal work by Susan McDaniel, Jeri Hepworth, and William Doherty “Medical family therapy: A Biopsychosocial approach to families with health problems.” where the term Medical Family Therapy was coined and established as a clinical framework. In 1994, John Rolland, a psychiatrist trained in family systems authored “Families, Illness & Disability: An Integrative Approach”, which further enhanced the importance of family in addressing issues of illness, recovery, and health. Since 1992, there has been increased interest and commitment to developing MedFT as a clinical and academic discipline supported through expanded clinical practice, academic training programs and ongoing research.[13] Applications In 1992, McDaniel and colleagues developed seven core techniques that helped operationalize the Medical Family Therapy model. These techniques were designed to extend the skill set of family therapist who wished to practice in healthcare settings. The techniques integrated the focus of the patient's health and illness into a systemic framework, representing specific biopsychosocial aspects of illness that were expanded by therapists with differing theoretical backgrounds. These core techniques included: (1) Recognize the biological dimension, (2) Solicit the illness story, (3) Respect defenses, remove blame and accept unacceptable feelings, (4) Maintain communication, (5) Attend to developmental issues, (6) Increase a sense of agency in the patient and the family, and (7) Leave the door open for future contact.[6] Since these initial efforts, the practice of Medical Family Therapy has continued to evolve and has been integrated into primary, secondary and tertiary health care environments. In 2013, a team of field leaders in Medical Family Therapy came together to develop competencies for family therapists working in healthcare settings. In these competencies, the training, role and scope of MedFTs in healthcare environments are described along with the skill competencies for MedFTs as a professional body at large, particularly in the areas of policy and research. Core competencies for family therapists working in healthcare settings are situated in four principal areas: (a) clinical skills; (b) training and supervision; (c) healthcare management and policy; and (d) scholarship. Each of these areas are further anchored in six domains: 1. Systems: integrating and implementing systems theory concepts and ideas. 2. Biological, Psychological, Social, and Spiritual: recognizing that health is comprised of all four areas of mutual influence. 3. Collaboration: working alongside and cooperatively with others with the intention to promote and provide a cooperative and organized approach to health care. 4. Leadership: guiding systems toward a more collaborative and integrated approach to health care, as well as championing for resources so that healthcare systems function at their highest capacity. 5. Ethics: promoting the highest standard of work in accordance with the American Association for Marriage and Family Therapy (AAMFT) Code of Ethics, in recognition of other healthcare team members’ codes of ethics, and in accord with rules and laws governing one’s profession and professional setting. 6. Diversity: recognizing various groups, communities, and cultural influences that impact the delivery, response, policies, and study of integrated behavioral health care. Below is a full description of the competencies with their knowledge/abilities/personal characteristics and target indicators. Domains and Competencies of Medical Family Therapists Domain 1: Systems[18] | COMPETENCIES | KNOWLEDGE/ABILITIES/ PERSONAL CHARACTERISTICS | TARGET INDICATORS | | 1.1 Clinical | 1.1a Discerns within and between each of the BPSS dimensions relevant to health and wellness across levels of clinical care using a relational and systemic lens. | Explains and operationalizes appropriate literature to conceptualize systemic practice (e.g., Family Therapy, Medicine, Medical Family Therapy, Nursing, Psychology, Public Health, Social Work). Uses clinical models that promote relational and BPSS health and well-being in the care for patients, families, communities, physicians and/or physician extenders, and the healthcare team. Articulates and applies within and between each of the dimensions of the BPSS framework in their healthcare settings using a relational and systemic lens: (a) in the presence and absence of illness; (b) in traditional and integrated behavioral health sessions; (c) in clinical debriefing with the healthcare team on behalf of patient/family care; (d) across developmental stages and the lifespan. Describes the reciprocal interactions of BPSS dimensions amongst individuals, family, social support, and larger systems (e.g., healthcare team member self-care, healthcare team member self- reflections, healthcare team member-patient/family relationships, and supervisor-healthcare team member relationships). | | 1.1b Recognizes the multi- directional influences between family/ support systems and healthcare systems. | Facilitates communication between and among patients/clients, families, healthcare team members, community partners, and payers from a systemic/relational perspective. Encourages healthcare team members and patients to balance conversations about illness/well-being, health/wellness, and deficits/resilience while considering relational health. Identifies and appropriately intervenes in issues that involve violence (e.g., domestic violence, adverse relational issues) and trauma (e.g., abuse, neglect, sexual violence, war). Considers family/support systems and healthcare team members in each treatment plan and involves them as appropriate in practice (e.g., organize family meetings to clarify agenda and increase support). | | 1.1c Considers systemic/ relational challenges and resources when promoting health behavior change. | Applies and adapts family/support systems theories and BPSS interventions to specific diagnoses (e.g., solution focused brief therapy for depression, emotionally focused therapy for couples facing trauma, structural family therapy for psychosomatic concerns, asthma and diabetes management). Develops standards of care protocols that reflect family/support systems involvement in treatment based on identified needs of the healthcare team and population trends (e.g., end of life discussions; advanced directives; large levels of prescriptions for ADHD; eating disorders; multiple family members with multiple chronic conditions / disease states). | | 1.2 Training and Supervision | 1.2a Utilizes a systemic / relational and BPSS framework when mentoring, supervising, or teaching learners, behavioral health providers, healthcare providers, researchers, and administrators. | Ensures that BPSS and relational practice, research, and teaching activities are informed by evidence-based practices/research. Promotes proficiency in supervisees and learners’ usage of family- oriented care tools and measures (e.g., genograms, five family- oriented questions). Links impacts of family systems and family behaviors to disease management and recovery process in discussions with medical/ healthcare team. Uses family systems concepts such as boundaries (rigid, open, enmeshed), structure (executive sub-system, parental sub-system, intergenerational coalitions), and relational processes (triangles, differentiation, family projection processes) to shape roles, learnings, and interactions with the healthcare team. | | 1.2b Teaches about healthcare culture from a systemic/relational lens. | Develops and utilizes tools to orient and advance understanding regarding the healthcare culture (e.g., medical vocabulary tests, medical vs. behavioral health team member stereotypes, structural map of healthcare team and organization) and collaborative practices (e.g., guidelines for entering medical contexts, Peek’s Three-World View). Aids learner in identification of key stakeholders and develops strategies to manage these relationships. Teaches reciprocal interactions and influences of the biopsychosocial-spiritual dimensions through self-reflexivity, individual and team level resilience training, self-of-the provider work, and team dynamics work. | | 1.2c Facilitates opportunities for inter-professional collaboration and supervision for learners and supervisees. | Promotes and leads interdisciplinary learning opportunities (e.g., group supervision that includes MedFTs with Balint groups, didactics, precepting, morning rounds/huddles, palliative care team, pharmacy, and psychiatry residents). Develops and maintains relationships with community partners to provide training experiences. Identifies opportunities to develop services with other healthcare team members such as medical assistants, nurse practitioners, pharmacists, and case management staff. Develops and facilitates necessary support group services for learning with a special focus on healthcare team member-patient- system relationships. | | 1.2d Exhibits responsiveness to intersecting needs of learners, patients, family members, and overall healthcare system. | Maintains an inviting and allied presence for all team members and attends to relationships that affect learners (e.g., frequently visits the practice floor and engages with patients, healthcare team members, allied professionals, and management). Identifies opportunities for relationship enhancement activities such as team building, community outreach, and community engagement to promote morale and relationship health. | | 1.3 Healthcare Management and Policy | 1.3a Understands the management of systems integral to the provision of BPSS and relationally- oriented health care. | Identifies and convenes teams of systems facilitators to promote and circulate BPSS and relationally-oriented health care (e.g., advisory boards, implementation teams). Articulates historical and current collaborative relationships between care sites (e.g., community collaborations) in order to align the respective mission and vision statements of care contexts. Applies critical research and updates regarding practice-related changes that influence BPSS and relationally oriented policies. | | 1.3b Educates healthcare team members, alongside policy- and decision- makers, about the benefits of systemic interventions and research. | Articulates and promotes BPSS and relationally-oriented research (evidence-based) to construct healthcare policy (e.g., leadership presentations, policy briefs). Influences practice patterns within the clinic by aligning to national and other standards as appropriate. | | 1.3c Advocates for the inclusion and sustainability of family therapists in health care. | Creates a business model for sustaining family therapists in a healthcare setting (e.g., billing structure, overhead costs, productivity, salary). Designs, tests, and stabilizes multiple income generation methods (e.g., classes, group visits, special trainings, trainings for professionals). Advocates for accurate information in job-postings and training opportunities for family therapists in healthcare settings. | | 1.4 Scholarship Competency | 1.4a Designs, evaluates, and disseminates systemic and relational programs of research with inter- professional colleagues. | Designs studies that highlight the systemic nature of health to further advance relational and dyadic research (e.g., BPSS dependent variables). Surveys and critiques existing literature to identify gaps and limitations in the implementation of team-based models. Develops and regularly communicates evidence-based findings to stakeholders who can advance systems’ relational health. Identifies key performance indicators as evidence of outcome achievement (e.g., five consults per half day; two family meetings in a week). | | 1.4b Understands the integration of research and practice through systematic applications of research to clinical work. | Articulates and justifies the importance of systemic and relational research in the practice system. Understands principles of dissemination and implementation science prior to selecting population specific intervention for targeted clinical research. Works with healthcare information technology to develop appropriate methods of capturing systemic data for clinical research and investigation. |
Domain 2: Biopsychosocial-spiritual[18] | COMPETENCIES | KNOWLEDGE/ABILITIES/ PERSONAL CHARACTERISTICS | TARGET INDICATORS | | 2.1 Clinical Skills | 2.1a Understands and applies ways to integrate the BPSS framework with health and family therapy theories and models. | Applies a broad range of evidence-based family therapy and health behavior theories and interventions in tandem with the BPSS framework with individuals, couples, families, and groups in healthcare systems. | | 2.1b Identifies and applies BPSS framework in relation to diseases and conditions common to the setting. | Demonstrates integration of BPSS framework into: (a) direct care (i.e., assessment, diagnoses, treatment/intervention, monitoring/ follow-up); (b) treatment team collaboration; (c) development/ coordination of a comprehensive treatment plan; (d) clinical documentation and provision of resources with awareness of research and culturally informed practice for common diseases and conditions. Demonstrates knowledge of epidemiology, human anatomy, behavioral health, pathophysiology, physiology, and relational diagnoses in the context of cultural and spiritual beliefs and practices. | | 2.1c Possesses a basic knowledge of psychopharmacology and pharmacology relevant to the target clinical population and any BPSS effects of these drugs. | Outlines the basic classes of psychotropic drugs, common uses, and potential BPSS side effects across the lifespan. Outlines the common medications prescribed in one’s clinical practice setting, common uses, and potential BPSS side effects. | | 2.1d Understands common biological and mental/ behavioral comorbidities of various health conditions (e.g., chronic pain, depression) with consideration of cultural and spiritual beliefs and practices. | Describes major health conditions treated in one’s clinical context and potential BPSS comorbidities in relation to patients’ social locations, health histories, and social networks. | | 2.1e Recognizes BPSS terminology and abbreviations in discussions, consultations, and documentation. | Communicates with consideration for the recipient’s healthcare literacy, appropriate terminology and abbreviations in oral and written communication within biological, mental, relational and spiritual health (e.g., ADHD, BID, enmeshment, HEENT, hematoma, HNT, parentified child, triangulation). | | 2.1f Distinguishes time, need, and content for consult using a BPSS framework with a variety of patients, families, healthcare team members, and community partners. | Inquires about multiple BPSS dimensions when consulting with patients, families, healthcare team members, community partners, and others relevant to care. Articulates how the BPSS dimensions interact with each other and/ or influence care. Conducts a BPSS assessment with patients and families in preventing or dealing with health conditions. Refers to specialists with expertise in each of the BPSS dimensions when content or need for further evaluation/treatment falls outside the family therapist’s scope of practice. Identifies the intersection of BPSS framework with diverse social locations and social determinants of health. Identifies patient/family centered care and population health factors through a BPSS framework. | | 2.2 Training and Supervision | 2.2a Uses BPSS framework during administrative tasks, consultation, supervision, and training in a healthcare context (e.g., primary, secondary, and tertiary care systems) or other settings that incorporate the BPSS framework into traditional and integrated care models. | Evaluates supervisees’ and learners’ knowledge and application of the BPSS framework through a relational and systemic lens. Provides instruction, consultation, and mentorship on BPSS dimensions as they relate to ethical clinical care, research, policy, leadership, and collaboration with interdisciplinary professionals/ teams in health care or other settings. | | 2.2b Illustrates the historical foundation of the BPSS framework and current trends of its use. | Delivers training regarding the historical foundation of the BPSS framework and theoretical implications for BPSS practice, education, and research. Describes current trends regarding the BPSS framework and its influence on individual, relational, and domestic/global health. | | 2.3 Healthcare Management and Policy | 2.3a Applies the BPSS framework through a relational lens to healthcare management and policy. | Creates and articulates healthcare protocols and policies that (a) integrate the BPSS framework; (b) are relationally oriented; (c) promote workflow organizational patterns that are efficient and sustainable; (d) honor the patient and healthcare teams’ social locations. Contributes to the development of local, state/regional, national, and/or global healthcare policies that advance research, training, and treatment of BPSS concerns, evidence-based approaches, and practice-based evidence. | | 2.3b Understands healthcare policies that advance BPSS and relational care. | Identifies BPSS polices and protocols that are indicated for clinical, research, and/or training healthcare contexts or populations. Articulates the benefits of BPSS and relational healthcare policies (when available) and constraints (when absent) to a wide range of audiences, from direct consumers to administrators, legislators, and/or researchers. | | 2.3c Leads healthcare teams in adopting and maintaining BPSS informed protocols and policies. | Trains healthcare team members on how to execute BPSS informed protocol and policies. Implements processes that assist a team in reaching consensus regarding the utilization of the BPSS framework in the healthcare context. Evaluates protocols and quality improvement strategies for the inclusion of BPSS in practice, research, and/or training. | | 2.4 Scholarship | 2.4a Utilizes contemporary literature and evidence-based models that integrate the BPSS framework into health care and health services research, practice, program development, and evaluation and/or policies. | Identifies seminal and current resources and empirical support for implementing and sustaining BPSS care and policies in the family therapist’s professional setting. Applies qualitative, quantitative, and mixed-methods BPSS research and program evaluation into practice. | | 2.4b Conducts BPSS research, program evaluation, and/or grant writing in healthcare settings with interdisciplinary teams. | Designs and participates in BPSS research, program evaluation, and/or grant writing (e.g., big data, clinical trials, dissemination and implementation studies, practice-based networks, qualitative inquiry). Maximizes use of statistical analyses, health informatics, content analyses, and health engineering to analyze BPSS patient/family centered data and population health data from Electronic Health Record (EHR). Complies with IRB and/or each setting’s research approval processes, HIPAA, ethical and professional standards associated with data collection and research implementation/dissemination. Collaborates and consults with interdisciplinary teams, recognizing the needs from, and of, the community in relation to implementation and dissemination of BPSS research. Designs and conducts evaluations or research studies that include or recognize the involvement and integration of all BPSS dimensions into interventions and protocols in a healthcare setting. |
Domain 3: Collaboration[18] | COMPETENCIES | KNOWLEDGE/ABILITIES/ PERSONAL CHARACTERISTICS | TARGET INDICATORS | | 3.1 Clinical Skills | 3.1a Employs evidence-based models that promote inter- professional collaboration and relational care across clinical settings. | Articulates strengths, limitations, and potential biases of evidence- based integrated behavioral healthcare models. Incorporates evidence-based approaches while providing individual patient, couple, and/or family assessments, diagnoses, and treatment planning. | | 3.1b Works effectively and efficiently across levels of integrated behavioral health care utilized by the system. | Identifies the level of integration appropriate to a healthcare context or healthcare team members (e.g., strengths/limitations of level of integration). Elicits and integrates feedback from patients, families, healthcare teams, support staff, and community partners to improve service delivery. Identifies and utilizes resources (e.g., clinic champions, community services) while providing integrated behavioral health services. Resolves workflow challenges to remove obstacles to care and maximize service to the population. Communicates openly with team members around power differentials and other aspects of diversity (e.g., race, gender, class) that may be present. | | 3.1c Communicates individual and relational BPSS information collaboratively with the healthcare team. | Provides timely verbal and/or written communication directly to the healthcare team regarding each patient’s assessment, diagnosis, care, and plan for treatment. Documents BPSS and relational healthcare information important to the patient’s treatment plan in the EHR. Adopts medical terminology and communication to improve collaboration (e.g., Situation-Background-Assessment- Recommendation [SBAR]). | | 3.1d Exhibits approachability and flexibility when collaborating with healthcare team members. | Maintains visibility and accessibility to increase opportunities for collaboration. Exhibits flexibility in integrated behavioral healthcare environment (e.g., open to interruptions by, and interrupting, healthcare team members). | | 3.1e Develops a respectful working alliance to achieve shared treatment goals with other healthcare team members, the patient, and their family. | Builds working relationships with all members of the healthcare team, including clinical support and administrative staff through formal and informal work-related activities (e.g., team huddles, staff meetings, after-work activities). Introduces self to new and existing healthcare team members and gains and understanding of basic information about each member of the healthcare team. Engages in the mutual exchange of professional opinions about clinical, operational, and financial decisions. Participates as an active and valued member of the healthcare team (e.g., approaches healthcare team members to discuss patient’s BPSS and relational care). Collaborates with healthcare team members before, during, and/or after the patient encounter. | | 3.2 Training and Supervision | 3.2a Assesses each supervisee’s/learner’s knowledge and skills in inter- professional collaboration. | Measures competencies in inter-professional collaboration and engages the learner/supervisee in identifying areas of strength and potential for growth through use of case consultation and/or supervision with raw data (e.g., video, audio-recording). Assists learners in establishing developmentally appropriate goals related to participating in integrated behavioral healthcare teams. Elicits feedback from the learner’s patients, patients’ partners/ spouses and family members, and healthcare team members regarding collaboration skills. | | 3.2b Develops the supervisee’s/learner’s collaborative skills with the inter-professional team. | Provides oral and written feedback regarding functioning collaboratively as a member of an inter-professional team. Assists the learner in receiving and assimilating feedback regarding inter-professional training and/or supervisory opportunities. Trains others in designing collaborative research projects. | | 3.2c Teaches and models collaborative skills appropriate for the healthcare setting. | Teaches effective, brief communication methods appropriate for clinical setting (e.g., SBAR). Teaches how to articulate assessment outcomes and family therapy interventions with collaborative team. Instructs learners on how to construct and implement a collaborative treatment plan. Seeks opportunities to enhance collaborative skills (e.g., attending a noon conference lecture about medical issues and other healthcare professional conferences). | | 3.3 Healthcare Management and Policy | 3.3a Develops policies and procedures to enhance collaboration. | Advocates for and/or writes policies that promote integration of family therapists into the relevant healthcare context (e.g., submits and/or presents white papers). Participates in continuing education related to management and advocacy of integrated care. Identifies healthcare policies that facilitate collaboration among inter-professional integrated behavioral healthcare teams and advocate for parity among them (e.g., office space, reimbursement). Consults with healthcare team to evaluate clinical, operational, and financial needs to enhance collaborative partnerships. | | 3.4 Scholarship | 3.4a Demonstrates ability to engage in scholarly projects within an interdisciplinary team. | Involves and/or joins other healthcare team members in research initiatives (e.g., clinic quality improvement projects, research articles, presentations, and trainings). Reviews and submits grant opportunities/proposals pertaining to integrated care. | | 3.4b Implements, evaluates, and disseminates research that demonstrates interdisciplinary collaboration. | Analyzes empirical research literature published about interdisciplinary collaboration. Studies impact of interdisciplinary collaboration on clinical, operational, and financial outcomes (e.g., Plan-Do-Study-Act [PDSA] cycles). Disseminates the outcomes of program evaluation studies and/or research that reflect collaborative designs, analyses, and implications. |
Domain 4: Leadership[18] | COMPETENCIES | KNOWLEDGE/ABILITIES/ PERSONAL CHARACTERISTICS | TARGET INDICATORS | | 4.1 Clinical Skills | 4.1a Promotes and creates current evidence-based knowledge and skills regarding inter-professional collaboration and integrated behavioral healthcare models. | Demonstrates command of evidence-based literature regarding inter-professional collaboration and integrated behavioral healthcare models. Promotes and expands upon models of family-centered and integrated behavioral health care in collaboration with patients, families, community partners, healthcare teams, administrators, researchers, policy makers, legislators, learners, and/or supervisees. Constructs and advances innovative models of integrated care in a variety of contexts (e.g., medical settings, schools, churches, behavioral health agencies, employee assistance programs) following recommended implementation and dissemination guidelines. | | 4.1b Conveys clinical/research expertise with a variety of psychological, behavioral, and relational health diagnoses and interventions to patients, families, learners/ supervisees, healthcare teams, administrators, community partners, and/ or researchers. | Advocates for psychological, behavioral, and relational health diagnoses and interventions for patients and families. Educates on use of ICD and DSM (i.e., procedural and diagnostic codes) in clinical and research applications. Models a variety of psychological, behavioral, and relational health interventions in collaboration with members of the patient’s family/support system and healthcare team to: (a) maximize patient care; (b) promote system efficiency; (c) train or mentor developing professionals. Achieves recognition for local/community, state/regional, national, and/or global contributions in clinical practice/research of psychological, behavioral, and relational health within one’s area of specialty (e.g., identified as a content expert, receiving an award). | | 4.1c Identifies own and other’s role(s) within the hierarchy of leadership in the healthcare context. | Constructs a philosophy of leadership, including but not limited to: one’s role as an advocate, clinical researcher, clinical supervisor, community liaison, health educator, team leader, and/or trainer. Disseminates integrated behavioral healthcare knowledge and skills at clinical, organizational, and staff team meetings (e.g., with patients, families, healthcare team members, staff, administration). Acquires advanced credentialing or certification in leadership, training, and/or supervision. | | 4.2 Training and Supervision | 4.2a Understands and exemplifies the role and responsibilities of an effective, mentor, administrator, primary investigator, supervisor, and/ or trainer. | Models professionalism for learners through timely and culturally appropriate (inclusive of full range of social location elements) feedback, ethical decision-making, responsiveness to questions/ concerns, and attention to self-of the trainer matters that may impact the training and supervision process. Completes professional development training in leadership. Advocates for and encourages learners seeking internships or jobs in preparation for the workforce that advances their skills and practice of integrated behavioral health care and inter- professional collaboration. | | 4.2b Recognizes areas of growth and strength in learners’ clinical, operational, and financial practice and performance. | Identifies and implements evaluation instruments, with written and oral feedback, to learners or supervisees regarding strengths and areas of growth in integrated behavioral health model fidelity and inter-professional collaboration. Gives timely, clear, and respectful feedback about duties, roles, and performance on practice, research, and/or teaching of inter- professional collaboration, relationally-based interventions, and integrated behavioral health care models. Supervises healthcare teams’ execution of individual, couple, and relationally-based psychological, behavioral, and relational health interventions/clinical research. Investigates billing and reimbursement practices to sustain integrated behavioral health care. Recommends work flow improvements to streamline the provision of integrated behavioral health care. | | 4.2c Trains/educates and supervises healthcare team members who may come from a variety of disciplines and educational backgrounds to practice from a BPSS relationally- based integrated behavioral healthcare approach. | Prepares and conducts educational/training opportunities in various formats (e.g., hallway conversations, noon conferences, precepting, and workshops) about topics relevant to inter- professional collaboration and integrated behavioral health care that are BPSS-based, grounded in empirical evidence, and considerate of the laws, ethics, rules, and policies governing different disciplines. | | 4.2d Advances training opportunities to expand relationally-based integrated behavioral health care with and for community partners and communities of interest. | Presents at local, state/regional, national, or global levels on relationally-based care and integrated behavioral health to audiences of community partners, and developing professionals. Receives recognition as a role model and ambassador among mentees and supervisees. | | 4.2e Mentors learners and healthcare team members about their interpersonal communication and team- based processes. | Delivers recommendations to learners and healthcare team members in ways that reduce complex systemic concepts into basic terminology and avoid professional jargon when discussing relational processes. Offers examples to learners and the healthcare team about how to communicate effectively and ethically with patients, families, community partners, colleagues and other healthcare team members. Employs strategies with learners and healthcare team members for sharing and receiving feedback with patients, families, team members, and/or community partners. Identifies areas of improvement and strength with learners and healthcare team members in their delivery of BPSS and relationally- based care (e.g., 360-degree annual performance evaluations). | | 4.3 Healthcare Management and Policy | 4.3a Utilizes management and/or administrator roles in executing inter-professional collaboration and integrated behavioral healthcare models and policies that impact: (a) healthcare teams; (b) clinical, financial, and operational systems of health care; (c) psychological, behavioral, and relational practice and research for patients and families. | Creates and/or expands care models and/or policies based on current trends in integrated behavioral health care that lead to improvements in inter-professional team functioning and sustainable patient/relationally-based care. Articulates current rules, regulations and guidelines for primary care (e.g., value based care, financial incentives, affordable care, and public and private insurance reimbursement, and alternative payment methods). | | 4.3b Fosters engagement of all stakeholders in a healthcare system impacted by policies and procedures. | Conducts meetings and creates oral and written procedures with key stakeholders (e.g., administrators of healthcare delivery, billing specialists, Health Information Technology (HIT) directors, privacy/ compliance officers, community partners, and representatives from external organizations). Surveys the community regularly for other potential stakeholders who share a similar mission/vision and/or should be part of the system’s referral or collaborative network. | | 4.3c Influences legislation and policies around the practice of integrated behavioral health care and family therapy. | Advocates for legislation that promotes parity with reimbursement and relationally-based practice privileges for all licensed behavioral health professionals with training in family therapy and behavioral health integration. Advocates for existing health policies to: (a) remove barriers and language that inhibits/discourages healthcare team members and family member/support system communications; (b) require healthcare systems to have someone trained to provide evidence- based family therapy services on staff; (c) support reimbursement for family-centered care. Demonstrates skill in preparing presentations/webinars, professional papers, policy briefs, and/or white papers on integrated behavioral health care, inter-professional collaboration/ education, and/or family centered-care. | | 4.3d Elicits a wide range of perspectives from members of the healthcare team and data sources. | Gathers perspectives from patients and families, members of the healthcare team/system, and other members of the community, as well as data from the EHR and other potential sources, to advance best practices and/or policies on inter-professional collaboration and/or integrated behavioral health care. Exhibits sensitivity and diplomacy while developing inter- professional collaboration and/or integrated behavioral healthcare programs, protocols, and policies within the context of specific organizational cultures, social determinants of health, and social locations. Collects, analyzes, and interprets patient/family centered information and population health data in relation to patient/ family outcomes and quality improvement. | | 4.4 Scholarship | 4.4a Contributes to knowledge regarding current empirical trends and current policies relevant to interdisciplinary collaboration and integrated behavioral health care. | Contributes to empirical literature, program evaluation, grants, or contracts as it pertains to interdisciplinary collaboration and integrated behavioral healthcare practices, management systems, billing processes, leadership, and advocacy. Recognizes the role of system delivery reform in healthcare delivery, research, and administration (i.e., contemporary policies around healthcare delivery and Patient Centered Medical Homes [PCMHs]). Holds leadership or has a contributing role in organizations recognized for advancements in health care and delivery system reform associated with integrated behavioral health care, interdisciplinary collaboration, education, and/or family centered- care (e.g., AAMFT, AHRQ, CFHA, HRSA, SAMHSA, WHO). | | 4.4b Leads research teams studying interdisciplinary collaboration and/or integrated behavioral health care. | Designs and/or collaborates with the development, implementation, and/or dissemination of scholarship (e.g., CBPR, population health studies, program evaluation, quality improvement, RCTs) toward sustainable and efficient family- centered and integrated behavioral healthcare models. | | 4.4c Serves as a leader in writing, submitting, and implementing grants or contracts on BPSS and relational health and health care. | Assembles a team of inter-professional collaborators and community members to develop and submit a BPSS informed grant proposal. Manages a funded grant or contract adhering to research and budget rules and guidelines (e.g., professional standards, HIPAA, IRB, regulatory boards, funders) and the expected processes agreed upon by all parties signing off on the submitted grant application. Serves as a grant reviewer for integrated behavioral health care, family-centered health care, and other BPSS-oriented proposals. | | 4.4d Mentors in research planning, methodology, evidence-based outcomes, program evaluation, and quality improvement in the context of integrated behavioral health care. | Guides interdisciplinary research teams to impact healthcare management and policy and foster greater knowledge about BPSS, family-centered care, and integrated behavioral health care (e.g., patient/family centered research, PDSA cycles, population health studies, program evaluation, and research programs). Ensures that quantitative, qualitative, and mixed method designs are accurately and ethically implemented in integrated behavioral healthcare contexts. | | 4.4e Embodies the role of relationally- oriented researcher and research mentor | Articulates a personal self of the researcher statement that includes an understanding of one’s values and biases as a relational researcher. Serves as a mentor to an early career researcher. |
Domain 5: Ethics[18] | COMPETENCIES | KNOWLEDGE/ABILITIES/ PERSONAL CHARACTERISTICS | TARGET INDICATORS | | 5.1 Clinical | 5.1a Demonstrates adherence to ethical practice when engaged in therapeutic and consulting services with individuals, couples, families/ social supports, secondary supports, healthcare teams, community partners and any others directly involved in helping patients, families, and organizations. | Adheres to the current ethics and values of family therapists (AAMFT Code of Ethics). Acquires and maintains appropriate licensure or certifications and liability coverage. Adheres to supervision requirements for family therapists as outlined by the relevant licensure board(s) and/or clinical setting(s). Abides by scope of practice as defined by the family therapist’s applicable laws and regulations, job description, and AAMFT Code of Ethics. Complies with appropriate institution, state/regional, and federal/ provincial regulations related to ethical and legal issues regarding assessment, diagnosis, treatment, collaboration, consulting, integrated behavioral health care, and case management activities. Demonstrates knowledge about healthcare standards defined by applicable laws or governing authority bodies (e.g., accrediting bodies, CMS, HIPAA, 42CFR Part 2, JCAHO, national boards). Ensures that policies and procedures are in place for ethical, confidential, and secure use of technology including telehealth, social media, and electronic communications between client/ patient, family/support member(s), supervisee, supervisor, community partner, and/or team member. Articulates and adheres to distinct settings’ ethical policies regarding the delivery of integrated care/integrated behavioral healthcare services (e.g., churches, employee assistance programs, medical, behavioral health, school-based health clinics). Adheres to institutional, state, and federal regulations related to billing and reimbursement and seeks counsel from the regulator prior to implementing new models of integrated behavioral healthcare delivery. Stays current on the AAMFT Code of Ethics and other interdisciplinary codes of ethics, policies, and best practice guidelines to promote ethical inter-professional collaboration/shared-decision making and integrated behavioral healthcare services. | | 5.1b Recognizes ethical issues faced by family therapists that are unique to delivering integrated behavioral health care. | Responds in a timely way to ethical challenges and liability issues related to being a family therapist in an integrated behavioral healthcare setting (e.g., confidentiality, documentation, dual/ multiple relationships, and informed consent) and medical ethical decisions (e.g., advance care planning, issues of reproduction, parental rights). Demonstrates knowledge of other healthcare team members’ professional codes of ethics and where differences may exist with the AAMFT Code of Ethics. Identifies specific ethical principles or codes that may be compromised in the delivery of integrated behavioral health care. Upholds the rights and privileges of individuals, couples, and families across the lifespan receiving care in healthcare settings (e.g., churches, employee assistance programs, medical, behavioral health, substance use disorder treatment, school-based health clinics). | | 5.1c Employs appropriate actions to resolve ethical dilemmas unique to integrated behavioral health care. | Follows rules and policies adopted by the clinical setting, as well as each team member’s regulatory body(ies), and professional associations for addressing ethical issues, violations, and grievances. Seeks input and support in a timely manner from colleagues, supervisors, site administrators, and/or legal counsel when resolving ethical dilemmas. | | Demonstrates understanding of professional ethical codes, domestic/international laws, and accreditation standards of each supervisee and learner’s professional discipline and those of the other members of the team. Conducts trainings to help inter-professional and integrated behavioral healthcare teams provide care and carry out research that is respectful and reflective of the ethical codes and domestic/ international laws that govern each member’s discipline(s). Educates each member of the interdisciplinary team on the scope of practice for family therapists and other supervisees and learners. | | 5.2b Ensures that integrated behavioral health and relational care provided by learners are conducted in a competent manner in which ethical and legal practices are maintained. | Verifies that supervisees and learners understand and adhere to applicable laws, policies, and codes of ethics relevant to clinical practice and research. Helps learners differentiate between ethical issues common in integrated care and traditional mental health and substance use disorder treatment settings. Tailors learning strategies to enhance supervisees and learners’ knowledge and skills in the conduct of ethical research and practice. Ensures that learners adhere to policies and procedures in place for ethical, confidential, and secure use of technology including but not limited to telehealth, social media, research involving, and electronic communications between the client/patient, family/ support member(s), supervisee, supervisor, team member(s), and/or community partner(s). Participates in timely evaluation of supervisees’ performance (e.g., clinical work, documentation, reporting, research activity). Ensures ethical representation of self, including professional identity, scope of practice, and training, among learners seeking internships or entrance into the workforce. | | 5.2c Develops and maintains a supervisory relationship that fosters ethical treatment and research involving patients, families, team members, and other relevant partners. | Trains supervisees and learners on how to have ethical relationships with patients/participants, families/support systems, team members, administrators, and community partners. Models ethical behavior in the care and discussion of others. Engages learners and collaborators to resolve ethical dilemmas. | | 5.3 Healthcare Management and Policy | 5.3a Advocates for the improvement of policies regarding the ethical practice of inter-professional collaboration, integrated behavioral health care, and family-centered care. | Attends to and researches the ethical impact of healthcare delivery models on patients, family/support system members, team members, community partners, and healthcare systems. Addresses workplace issues related to variances in ethical guidelines among disciplines in integrated care (e.g., encourages dialogue between team members on how to resolve differences). | | 5.4 Scholarship | 5.4a Conducts and promotes ethical and systemic research. | Adheres to IRB/Human Research requirements as they apply to research conducted in healthcare settings (e.g., appropriate consent, reporting privacy or protocol breaches). Demonstrates an awareness of technical/ethical/legal issues that arise when conducting and reporting on research using patient health data and EHR. Identifies and attempts to resolve potential ethical challenges or negative consequences to the research population and community that are not addressed by the IRB process (e.g., enduring impacts, sustainability of initiative). Adheres to the AAMFT Code of Ethics when conducting research, writing, and/or determining authorship. |
Domain 6: Diversity[18] | COMPETENCIES | KNOWLEDGE/ABILITIES/ PERSONAL CHARACTERISTICS | TARGET INDICATORS | | 6.1 Clinical | 6.1a Demonstrates understanding of different sociocultural and socioeconomic beliefs, practice, and traditions regarding health and health care (including diverse views regarding health disparities and healing across all BPSS dimensions). | Identifies specific healthcare beliefs, practices, and/or traditions that are unique to the populations they serve. Engages in conversations with patients, families, available communities of interest, and other healthcare team members that reflect curiosity, humility, and sensitivity about health and health care (e.g., gathers information about illness narratives/beliefs alongside culturally-informed preferences). Assesses cultural factors prior to making a diagnosis, collaborating, intervening, and/or implementing clinical research. Assesses for healthcare- and language- literacy throughout care processes using multi-modal methods (e.g., confirming patients’ understanding of care plans with interpreters or cultural brokers, healthcare literacy screening, iterative “teach-back” sequences, visual aids). | | 6.1b Demonstrates awareness of and sensitivity to social locations (e.g., ability, age, citizenship, geographic location, race/ethnicity, sexual/gender identity and orientation, socioeconomic status) in relation to assessment, diagnoses, and treatment options. | Responds to unique needs that reflect social locations (e.g., ensuring physical spaces are handicap accessible). Tailors care plans and interventions to specific cultural needs, available resources, and social locations of a patient and family in the context(s) of their community. Facilitates patient’s and family’s communication with inter- professional healthcare team members and/or community partners (e.g., local churches, events, leaders, schools) from backgrounds different than their own to develop and implement a treatment plan that respects varied social locations that impact the care process or outcomes. Attends to strengths and limitations of diagnostic and screening tools with different populations (e.g., using assessments with sensitivity to available data regarding cultural adaptation/norming). Engages team members, patients, families, and community partners with specialized knowledge/skills to identify unique characteristics of the patient population and community that need to be addressed in applying culturally appropriate and integrated behavioral health care. | | 6.1c Designs, implements, and evaluates integrated behavioral healthcare treatment plans that are based on best-practice guidelines recognizing diverse social locations; these are dynamic, flexible, and adaptive enough to treat diverse patients/families. | Facilitates meetings with patient/family advocates, community partners, administrators, staff, and/or healthcare team members to develop and implement a treatment plan that respects varied social locations that impact the care process or outcomes. Modifies interventions that consider the unique social locations and needs of the patients and families being cared for by the healthcare team. Communicates with team members in a manner sensitive to power differentials and other aspects of diversity that may be present. Demonstrates the capacity to discern between personal identity, power dynamics, social context, sociocultural backgrounds, and socioeconomic status in healthcare team members’ and patients’ constructions and experiences of health, health care, and illness. | | 6.1d Demonstrates respect, curiosity, and humility for learning about health and healthcare perspectives of diverse populations. | Inquires about cultural identities, health behaviors, health beliefs, and illness histories as well as traditions of the individual, family, and community. Demonstrates sensitivity to others’ beliefs and experiences regarding BPSS health and health care. | | 6.1e Demonstrates recognition of one’s own personal biases and beliefs about diverse patient populations, healthcare disciplines, or settings and openness to seek support/ training/supervision to improve clinical practice/ clinical research. | Develops awareness regarding personal biases and beliefs through ongoing healthcare diversity training and exposure to and participation in culturally diverse events/contexts. Demonstrates the capacity to discern between personal identity, power dynamics, social context, sociocultural backgrounds, and socioeconomic status in healthcare team members’ and patients’ constructions and experiences of health, health care, and illness. Articulates personal beliefs, difficulties, and biases through self-reflective exercises, collegial conversations/supervision, and other activities. Encourages constructive performance feedback about self and all other team members (e.g., 360-degree annual performance evaluations) in relation to providing a culturally aware context and delivery of care. | | 6.2 Training and Supervision | 6.2a Develops instructional methods that build learners’ and supervisees’ confidence and competence in areas of clinical services, research, and/or teaching with diverse patient/learner/participant populations and diverse inter- professional collaborators. | Provides learners with appropriate materials (e.g., key literature, popular media), examples, and experiences (e.g., introductions to community leaders and cultural events) to understand how to collaborate with diverse groups. Promotes use of evidence-based practice and research and culturally-sensitive measures, assessments, and interventions in clinical, research, supervision, and teaching. Educates and engages learners and integrated healthcare team members in providing care that honors the diversity of patients and members of the healthcare team. Seeks ongoing education to improve supervisory methods and understanding of diverse populations and the influence of social locations on healthcare practice, research, and training. | | 6.2b Trains others in conducting diagnostic assessments and providing interventions using theories and methods that are respectful of patients’/ families’ healthcare beliefs and cultural practices. | Teaches theories and methods that are oriented toward diverse samples or populations. Mentors learners to use cultural sensitivity when interpreting and applying theories and research (e.g., ensuring that theories or interventions tested only with majority populations are scrutinized before applying with minority populations). | | 6.2c Promotes learners and supervisees’ cultural humility in relational and BPSS practice, research, and teaching initiatives. | Provides learners with individual and/or group reflective exercises to examine personal biases and raise awareness impacting the therapeutic relationship and inter-professional collaboration. Encourages discussion about social locations of self and others among learners and healthcare team members. Models cultural humility for relational and BPSS learners (e.g., engages in regular peer-to-peer supervision, shares personal statements regarding biases that influence clinical practice, research, teaching, and receives continuing education). | | 6.3 Healthcare Management and Policy | 6.3a Recognizes and mitigates the impacts of policies and laws have on diverse populations. | Calls and leads meetings to discuss family-centered policy changes to benefit diverse populations and social locations. Articulates the value of family-centered treatment policies that respect social locations and promote improved access to care for all. Advocates for policies that are inclusive and culturally informed within the healthcare system to reduce health disparities. Promotes policy that supports marginalized populations and reduces health disparities (e.g., tracking healthcare utilization, measuring cost-offset, determining cost-effectiveness). | | 6.3b Demonstrates cultural sensitivity and humility as an integrated behavioral health care and relational researcher. | Engages with communities of interest, elders, mentors, cultural gatekeepers, and others regarding study design (e.g., developing appropriate methods for consent and data collection), interpreting findings, and dissemination (e.g., publications and presentations across professional- and lay- arenas). Conducts research (e.g., program evaluation, quality improvement, CBPR) recognizing BPSS dimensions and diverse social locations and subcultures. Utilizes tools and data collection methods that are accessible to people of different abilities and backgrounds (e.g., screen for health literacy prior to administering self-report measures, use psychometrically sound measures in participants’ native language). Applies best-practice guidelines based on empirical research and customized guidelines for different diverse populations. | | 6.3c Addresses ethical dilemmas pertaining to implementation of research studies with vulnerable populations and minority groups. | Engages in process of reflexivity when conducting research (e.g., audit-trails, reporting violations to an IRB or regulatory body). Adheres to guidelines for conducting research including informed consent and right to withdraw. Meets IRB standards of instituted safeguards when working with vulnerable populations and minority groups. |
Training Training in Medical Family Therapy can range from internships and certificates to academic PhD programs. The main competencies for training and supervision are outlined in the previous section. Below is a listing of academic programs with internships, specializations and degrees in Medical Family Therapy. PROGRAMS All schools on this list met the minimum qualification of having at least one course specifically devoted to issues of medical family therapy, families and health, and/or integrated care.| Coursework | Clinical Training/Internship | Specialization, concentration, or track | Certificate | Degree | Contact | | Doctoral Programs | | Antioch University - New England | x | x | http://www.antiochne.edu/applied-psychology/marriage-and-family-therapy-phd/ | | Drexel University | x | x | x | http://drexel.edu/cnhp/academics/post-masters/Certificate-PM-Medical-Family-Therapy/ | | East Carolina University | x | x | x | PhD | http://www.ecu.edu/che/cdfr/medft/ | | Loma Linda University | x | x | x | x | http://www.llu.edu/behavioral-health/cfs/medft.page | | Northcentral University | x | x | x | x | http://www.ncu.edu/school-of-marriage-and-family-sciences/doctor-of-philosophy-in-marriage-and-family-therapy/medical-family-therapy | | Nova Southeastern | x | x | x | x | http://shss.nova.edu/programs/certificate/familysystems/ | | Ohio State University | x | x | http://ehe.osu.edu/human-sciences/hdfs/couples-and-family-therapy-licensure.php | | Saint Louis University | x | x | ü | PhD | http://www.slu.edu/cft.xml | | Texas Woman's University | x | x | http://www.twu.edu/family-sciences/family-therapy.asp | | University of Georgia | x | http://spock.fcs.uga.edu/cfd/mft/ | | University of Minnesota | x | x | http://www.cehd.umn.edu/FSoS/programs/phd-cft.asp | | University of Nebraska- Lincoln/ Nebraska Medical Center collaboration | x | x | x | http://www.unl.edu/gradstudies/prospective/programs/Cert_MedicalFamilyTherapy | | Masters Programs | | Abilene Christian University | x | x | x | x | http://www.acu.edu/graduate/degree-programs/marriage-family-therapy-online/curriculum/certificate-medical-family-therapy-online-curriculum.html | | Antioch University - New England | x | x | http://www.antiochne.edu/applied-psychology/marriage-and-family-therapy/ | | Drexel | x | x | x | http://drexel.edu/cnhp/academics/post-masters/Certificate-PM-Medical-Family-Therapy/ | | East Carolina University | x | x | http://www.ecu.edu/che/cdfr/medft/ | | Jefferson School of Health Professions | x | x | * | http://www.jefferson.edu/university/health_professions/departments/couple-family-therapy/program/overview.html | | Loma Linda University | x | x | * | x | http://www.llu.edu/behavioral-health/cfs/medft.page | | Mercer University | x | x | https://medicine.mercer.edu/admissions/mft/ | | Northcentral University | x | x | x | * | http://www.ncu.edu/school-of-marriage-and-family-sciences/master-of-arts-in-marriage-and-family-therapy | | Northern Illinois University | x | http://catalog.niu.edu/preview_program.php?catoid=21&poid=3778&hl=%22Medical+Fmily+herapy+and+Counseling%22&returnto=search | | Nova Southeastern | x | x | x | x | http://shss.nova.edu/programs/certificate/familysystems/ | | Oklahoma Baptist University | x | x | x | http://www.okbu.edu/graduate/certificate/medical-family-therapy | | Regis University | x | http://www.regis.edu/RHCHP/Academics/Degrees-and-Programs/Graduate-and-Doctorate-Programs/MA-Marriage-and-Family-Therapy.aspx | | Rochester | x | x | x | https://www.urmc.rochester.edu/psychiatry/institute-for-the-family/family-therapy/post-degree.aspx | | San Diego State University | x | x | http://go.sdsu.edu/education/csp/mft.aspx | | Seattle Pacific University | x | x | x | x | http://spu.edu/depts/spfc/mdft/ | | Saint Louis University | x | x | x | http://www.slu.edu/cft.xml | | Saint Mary's University (MN) – Twin Cities | x | http://www.smumn.edu/graduate-home/areas-of-study/graduate-school-of-health-human-services/ma-in-marriage-family-therapy | | Texas Woman's University | x | x | http://www.twu.edu/family-sciences/family-therapy.asp | | University of Oregon | x | https://education.uoregon.edu/couples-and-family-therapy/program-information | | University of Rochester | x | x | x | https://www.urmc.rochester.edu/psychiatry/institute-for-the-family/family-therapy.aspx | | University of San Diego | x | x | http://www.sandiego.edu/soles/programs/marital_and_family_therapy/about_the_program/medical_family_therapy_emphasis.php | | University of Saint Joseph | x | http://catalog.usj.edu/preview_program.php?catoid=8&poid=810 | | Utah State University | x | x | http://www.usu.edu/degrees/index.cfm?id=183 |
- These offerings are currently being prepared, but were not official by the time of this publication.
| Pre and Post-Doctoral Internships/Fellowships | | Families, Illness, and Collaborative Healthcare Doctoral Fellowship, Chicago Center for Family Health, University of Chicago, Chicago, IL | http://ccfhchicago.org/training/fichprogram/ | | Dartmouth Family Practice Residency, Concord Hospital, Concord, NH | http://www.concordhospital.org/healthcare-professionals/nh-dartmouth-family-medicine-residency/ | | Duke/Southern Regional Area Health Education Center Medical Family Therapy Residency Program, Fayetteville, NC | http://www.southernregionalahec.org/fmresidency/bsresidency.html | | MedFT Fellowship/ Internship, St. Mary’s Family Medicine Residency, Grand Junction, CO | http://www.stmarygj.org/for-medical-professionals/family-medicine-residency-program/medical-family-therapy-fellowship/ |
Further Reading ArticlesAmerican Association for Marriage and Family Therapy. (2018). Competencies for family therapists working in healthcare settings. Retrieved from www.aamft.org/healthcare. Doherty, W.J. (1995). The Why’s and Levels of Collaborative Family Health Care. Family Systems Medicine, 13(3-4), 275-281. doi:10.1037/h0089174 Edwards, T.M., Patterson, J.E., Vakili, S. & Scherger, J.E. (2012). Healthcare Policy in the United States: A Primer for Medical Family Therapists. Contemporary Family Therapy, 34(2), 217-227. doi:10.1007/s10591-012-9188-4 Kessler, R. (2010). What We Need to Know About Behavioral Health and Psychology in the Patient-Centered Medical Home. Clinical Psychology: Science and Practice, 17(3), 215-217. doi:10.1111/j.1468-2850.2010.01212.x Marlowe, D., Hodgson, J., Lamson, A., White, M.,& Irons, T. (2012). Medical Family Therapy in a Primary Care Setting: A Framework for Integration. Contemporary Family Therapy, 34(2), 244-258. doi:10.1007/s10591-012-9195-5 Peek CJ and the National Integration Academy Council. Lexicon for Behavioral Health and Primary Care Integration: Concepts and Definitions Developed by Expert Consensus. AHRQ Publication No.13-IP001-EF. Rockville, MD: Agency for Healthcare Research and Quality. 2013. Available at: http://integrationacademy.ahrq.gov/sites/default/files/Lexicon.pdf. Tyndall, L. Hodgson, J.L., Lamson, A.L., White, M. & Knight, S.M. (2012). Medical Family Therapy: A Theoretical and Empirical Review. Contemporary Family Therapy, 34(2), 156-170. 10.1007/s10591-012-9183-9 BooksHodgson, J.L., Lamson, A., & Reese, L. (2007). The biopsychosocial-spiritual interview method. In D. Linville & K.M. Hertlein (Eds.), The therapist’s notebook for family health care: Homework, handouts, and activities for individuals, couples and families coping with illness, loss and disability. New York: Haworth. Hodgson, J.L., Lamson, A., & Mendenhall, T., D. Crane, R. (2014). Medical Family Therapy. New York:Springer. Mendenhall, T., Lamson, A., Hodgson, J., Baird, M. (2018). Clinical Methods in Medical Family Therapy (Focused Issues in Family Therapy). New York:Springer McDaniel, S., Campbell, T. Hepworth, J., & Lorenz, A. (2004). Family-oriented primary care 2nd edition. New York: Springer-Verlag. McDaniel, S., Hepworth, J., & Doherty, W. J. (1992). Medical family therapy: A biopsychosocial approach to families with health problems. New York: Basic Books. McDaniel, S., Doherty, W. J., & Hepworth, J. (2013). Medical family therapy: A biopsychosocial approach to families with health problems 2nd edition. New York: Basic Books. Rolland, J. S. (1994). Families, illness and disability: An integrative treatment model. New York: Basic Books. Rolland, J. S. (2018). Helping Couples and Families Navigate Illness and Disability: An Integrative Approach References 1. ^{{Cite book|url=https://www.worldcat.org/oclc/34640751|title=Beliefs : the heart of healing in families and illness|last=1944-|first=Wright, Lorraine M.,|date=1996|publisher=BasicBooks|others=Nelson, Wendy Watson, 1950-, Bell, Janice M.|isbn=9780465023172|location=New York|oclc=34640751}}
2. ^{{Cite book|url=https://www.worldcat.org/oclc/841468|title=Families & family therapy|last=Salvador.|first=Minuchin,|date=1974|publisher=Harvard University Press|isbn=0674292367|location=Cambridge, Massachusetts|oclc=841468}}
3. ^{{Cite book|url=https://www.worldcat.org/oclc/29848184|title=Families, illness, and disability : an integrative treatment model|last=1948-|first=Rolland, John S.,|date=1994|publisher=BasicBooks|isbn=9780465029150|location=New York|oclc=29848184}}
4. ^1 {{Cite journal|last=Engel|first=G. L.|date=1977-04-08|title=The need for a new medical model: a challenge for biomedicine|url=http://science.sciencemag.org/content/196/4286/129|journal=Science|volume=196|issue=4286|pages=129–136|doi=10.1126/science.847460|issn=0036-8075|pmid=847460}}
5. ^1 {{Cite book|url=https://www.worldcat.org/oclc/1465|title=General system theory : foundations, development, applications|last=1901-1972.|first=Bertalanffy, Ludwig von,|year=1969|origyear=1968|publisher=George Braziller|isbn=9780807604533|location=New York|oclc=1465}}
6. ^1 2 3 4 {{Cite book|url=https://www.worldcat.org/oclc/25788707|title=Medical family therapy : a biopsychosocial approach to families with health problems|last=H.|first=McDaniel, Susan|date=1992|publisher=BasicBooks|others=Hepworth, Jeri, 1952-, Doherty, William J. (William Joseph), 1945-|isbn=9780465044375|location=New York, NY|oclc=25788707}}
7. ^{{Cite book|url=https://www.worldcat.org/oclc/864393267|title=Medical family therapy and integrated care|last=H.|first=McDaniel, Susan|date=2014|publisher=American Psychological Association|others=Doherty, William J. (William Joseph), 1945-, Hepworth, Jeri, 1952-|isbn=9781433815188|edition=2nd|location=Washington, D.C.|oclc=864393267}}
8. ^1 {{Cite journal|last=Doherty|first=William J.|last2=McDaniel|first2=Susan H.|last3=Hepworth|first3=Jeri|date=1994-02-01|title=Medical family therapy: an emerging arena for family therapy|url=http://doi.wiley.com/10.1111/j.1467-6427.1994.00775.x|journal=Journal of Family Therapy|volume=16|issue=1|pages=31–46|doi=10.1111/j.1467-6427.1994.00775.x|issn=1467-6427}}
9. ^Tyndall, L., Hodgson, J., Lamson, A., White, M., & Knight, S. (2010). Medical family therapy:Conceptual clarification and consensus for an emerging profession (Unpublished doctoraldissertation). East Carolina University, Greenville, NC.
10. ^1 Hodgson, J., Lamson, A., Mendenhall, T., & Crane, R. (2012). Medical family therapy:Opportunity for workplace development in healthcare. Contemporary Family Therapy, 34, 143-146.
11. ^{{Cite book|url=https://www.worldcat.org/oclc/874851248|title=Medical family therapy : advanced applications|others=Hodgson, Jennifer,, Lamson, Angela,, Mendenhall, Tai,, Crane, D. Russell,|isbn=9783319034829|location=Cham|oclc=874851248}}
12. ^1 2 {{Citation|last=Tyndall|first=Lisa|date=2014|url=https://link.springer.com/10.1007/978-3-319-03482-9_2|work=Medical Family Therapy|pages=13–32|publisher=Springer International Publishing|doi=10.1007/978-3-319-03482-9_2|isbn=9783319034812|access-date=2018-07-10|last2=Hodgson|first2=Jennifer|last3=Lamson|first3=Angela|last4=White|first4=Mark|last5=Knight|first5=Sharon|chapter=A Review of Medical Family Therapy: 30 Years of History, Growth, and Research|title=Medical Family Therapy}}
13. ^1 {{Cite book|url=https://link.springer.com/chapter/10.1007/978-3-319-03482-9_2|title=Medical Family Therapy|last=Tyndall|first=Lisa|last2=Hodgson|first2=Jennifer|last3=Lamson|first3=Angela|last4=White|first4=Mark|last5=Knight|first5=Sharon|date=2014|publisher=Springer, Cham|isbn=9783319034812|pages=13–32|doi=10.1007/978-3-319-03482-9_2}}
14. ^{{Cite journal|last=Lask|first=Bryan|date=February 1994|title=The illness network - commentary on Doherty et al.|url=http://doi.wiley.com/10.1111/j.1467-6427.1994.00776.x|journal=Journal of Family Therapy|volume=16|issue=1|pages=47–51|doi=10.1111/j.1467-6427.1994.00776.x|issn=0163-4445}}
15. ^{{Cite journal|last=Doherty|first=William J.|last2=McDaniel|first2=Susan H.|last3=Hepworth|first3=Jeri|date=February 1994|title=Medical family therapy: an emerging arena for family therapy|url=http://doi.wiley.com/10.1111/j.1467-6427.1994.00775.x|journal=Journal of Family Therapy|volume=16|issue=1|pages=31–46|doi=10.1111/j.1467-6427.1994.00775.x|issn=0163-4445}}
16. ^Kerr, M. E., & Bowen, M. (1988). Family evaluation: An approach based on Bowen theory. New York, NY, US: W W Norton & Co.
17. ^{{Cite book|url=https://www.worldcat.org/oclc/841468|title=Families & family therapy|last=Salvador.|first=Minuchin,|isbn=0674292367|location=Cambridge, Massachusetts|oclc=841468}}
18. ^1 2 3 4 5 American Association for Marriage and Family Therapy. (2018). Competencies for family therapists working in healthcare settings. Retrieved from www.aamft.org/healthcare.
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