Family Systems Therapy in a Primary Care Medical Setting: The Rochester Experience

Abstract

Collaboration between family therapists and physicians has attracted increasing attention in the field of family therapy. Family therapists practicing in medical settings encounter many stimulating oppoutunities and challenges. This paper focuses on the experience of the authors providing family therapy in a primary care medical setting which is also a family medicine residency program. The authors discuss the role of physician and patient expectations in treatment as well as the influence of the medical context on the development of family therpists.

Engaging African Americans in Therapy: Integrating a Public Policy and Family Therapy Perspective

“…There is an increasing interest in the integration of family therapy and medicine with more MFT training programs focusing on coursework and clinical experiences in primary care settings (Edwards et al 2001;McDaniel et al 1992;Seaburn et al 1993). A best practice, therefore, might be the integration of mental health care into primary care settings across the country.…”

Family systems medicine: Systemic-constructivist perspectives

“…Without denying her or his expertize, the therapist acknowledges that the illness experience makes the patient an expert too. Therefore, the clinician chooses to approach the illness experience as a new area, not operating on preconceived ideas of what exactly the problem should be (Seaburn et aL, 1993;Anderson, 1994). Systemic hypotheses about the existence of a problem are not assumptions made on a truth-based reasoning, and are always tested in relation to the patient's own definition of what the problem is (Bor et al, 1992).…”

“…Curiosity, as defined by Cecchin (1987), is a stance on the part of the therapist that indicates his or her respect and interest toward the patient's story and irreverence toward 'truth'-based beliefs, assumptions, and hypotheses (including the therapist's own). Although it is jargon, often proved vague and problematic, it is frequently used in literature to denote the clinical utility of letting the patient tell their stories, without discarding them as unscientific and irrelevant, and reveal the importance of learning from the patient's experience as it is shaped through language (Seaburn et al, 1993;Shapiro, 1993;Hoffman, 1992). Connected to the concept of curiosity is the therapeutic 'not-knowing' position (Anderson, 1994).…”

“…A systemic oriented therapist who works in a medical setting is bound to interact with the other members of the health care system. For this reason, it is crucial that the therapist learns not only the patient's language, but the medical language as well (Seaburn et al, 1993).…”

What influences patients to change?: a qualitative exploration of health decision-making factors among diabetes patients

“…In short, the fields of therapy and medicine have been intertwined for 50 years, since marriage and family therapy's inception (Broaderick & Schrader, 1981;Nichols & Schwartz, 1991). Physicians and therapists occasionally collaborate in medical settings (Coyne & Anderson, 1988;Minuchin, Rosman, & Baker, 1978;Seabum, et al, 1993). Frequently, both have as their objective behavior change, though the presenting problems are usually different.…”