In an effort to identify the essential ingredients of medical family therapy, a content analysis of 15 peer-reviewed case studies in medical family therapy was conducted. The case studies were published from 1996 to 2007 in Families, Systems, & Health. Through a qualitative content analysis, three main themes emerged that describe the essence of the practice of medical family therapy: (1) The patient's multisystemic experience of disease, (2) treatment is about caring, not just caregiving, and (3) elevating the patient as collaborator in the care team.

Getting divorced directly and indirectly affects men's biological, psychological, social, and even spiritual health. For example, divorced men have higher rates of mortality, substance abuse, depression, and lack of social support. In this case report we review current literature on the sequelae of divorce on men's health, and highlight key features of divorce from a multi-disciplinary lens using the example of a 45-year-old male from the authors' clinical practice. We provide assessment and treatment recommendations for care providers according to current clinical guidelines, and conclude with a detailed discussion of the case resolution.A 45-year-old Caucasian male presented to his family physician with the complaints of sleep disturbance and moderate, persistent, burning upper abdominal pain that had been increasing in severity over recent months. He often awakened several times each night for no apparent reason. This was his initial visit with this physician, as he had not seen any physician in over 10 years, and his past medical history was significant only for mild hypertension. When asked about alcohol use, he reported that he drinks ''about a six pack of beer a day.'' At the time of his visit he was employed as a midlevel manager at a local bank and stated that he used to like his job, but has become irritated with his co-workers and has lost respect for his boss. The thought of changing jobs was appealing, but he did not want to put forth the necessary effort to find other employment. This patient told his boss he ''was fine,'' but admitted to his physician that he was often so tired and late to work in the mornings due to poor sleep. He complained of endless worries and cyclical thoughts at bedtime, and very seldom felt fully rested upon waking.Nearly 2 years prior, this patient had endured a very difficult divorce. During his first visit to his primary care physician he reported having very limited access to his children and was paying a significant amount of child support. He reported having very limited social support at home because his family lived over 1000 miles away and his ex-wife ''took all our friends with her after the divorce.'' His physical examination revealed an overweight, wellgroomed, quiet male who appeared mildly lethargic, but was in no acute distress. His vital signs were stable with a mildly elevated blood pressure, and a body mass index of 32. He was cooperative but not very talkative with seemingly depressed mood and mildly blunted affect. On abdominal examination, he had mild epigastric tenderness to palpation and a slightly enlarged liver. The remainder of his physical exam was unremarkable. Literature ReviewAlthough divorce rates and rituals vary from society to society, 1 getting divorced is a common occurrence facing men of many nationalities and cultures. Nearly one third of marriages end in divorce for Australian, English, and Welsh couples. 2,3 One quarter of Japanese marriages 4 and more than one half of United States marriages terminate in divorce. 5 As seen in the cas...

Training physicians to effectively assess, diagnose, and treat patients' behavioral health concerns begin in residency. While this training is increasingly more common in outpatient educational settings, there is also a great need to teach physicians to practice behavioral medicine with patients who are hospitalized. However, teaching family medicine resident physicians to understand, value, and practice essential behavioral health knowledge and skills during inpatient rotations can be a challenge for both residents and educators. In this article, we describe three models of inpatient behavioral medicine teaching, each with examples of practical content and teaching methods. We discuss strategies for success and potential barriers to overcome while teaching in the inpatient setting. Helping patients choose to change their health behaviors, which likely contribute in part to the reasons for their hospitalizations in the first place, should begin while patients are still in the hospital. Models of teaching, such as those presented here, can help improve the way we train physicians to address behavioral health needs with hospitalized patients.

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