As healthcare reform evolves, the role of psychologists as health service providers evolves, as well. Family psychologists are particularly well suited to working in health settings because a systemic orientation facilitates effective consultation with healthcare teams, patients and family members. They offer critical input and skills because family and relational interventions are key in successful health service provision. Family members influence health behaviors, treatment decisions, treatment adherence, stress levels and adaptation to illness. Further, families are the "front line" care providers. However, family psychologists must develop new competencies in order to make a successful transition to a health care setting, particularly a primary care setting. Assessment, intervention and consultation strategies must be adapted to the unique challenges encountered by families facing illness, and to the healthcare environment itself. This article reviews the adaptations family therapists can make to be successful in primary care. In addition, medical family therapy concepts and techniques useful in work with families facing illness are reviewed. The role of the family psychologist in a primary care setting and medical family therapy interventions are illustrated via case examples.

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This paper highlights the difficulties facing medical and mental health professionals in helping families in which there is violence. Emphasis is placed on how domestic violence presents in primary care medical settings. Physician and patient characteristics that interfere with domestic violence detection are reviewed. A role is outlined for psychologists in primary care settings to facilitate detection and treatment. Facilitative efforts include educating physicians through collaboration and serving as an on-site resource for information and consultation.

Primary care clinicians have responsibility for providing comprehensive, continuous care in the context of the family and the community. To meet this charge, they must collaborate and consult with professionals from many other health disciplines. As noted in other chapters of this volume, psychology professionals have unique skills and expertise to offer the primary care health team. It is, however, often difficult for psychologists to make the transition to this medical setting. In this chapter we present some of the practical issues that must be considered when psychologists are planning to work with primary health care professionals. We present various models of medicine-psychology collaboration and discuss the pros and cons of psychologists collaborating with medical professionals. We also review practical ideas on how to foster a successful collaborative health care team, and we describe the innovative roles taken by psychologists in primary care settings.

Integrating behavioral health into primary healthcare offers multiple advantages for patients and health professionals. This model requires a new skill set for all healthcare professionals that is not emphasized in current educational models. The new skills include interprofessional team-based care competencies and expanded patient care competencies. Health professionals must learn new ways to efficiently and effectively address health behavior change, and manage behavioral health issues such as depression and anxiety. Learning environments that co-train mental health and primary care professionals facilitate acquisition of both teamwork and patient care competencies for mental health and primary care professional trainees. Family Medicine Residency programs provide an excellent opportunity for co-training. This article serves as a "how to" guide for residency programs interested in developing a co-training program. Necessary steps to establish and maintain a program are reviewed, as well as goals and objectives for a co-training curriculum and strategies to overcome barriers and challenges in co-training models.