Rehabilitation medicine, systems, and health: A biopsychosocial perspective.

Implementing team approaches in primary and tertiary care settings: Applications from the rehabilitation context.

“…Primary and tertiary care settings in particular have been described as contexts in which there is substantial need for interdisciplinary approaches with a focus on team intervention and family-centered care (e.g., Bickler, 1994; Blount, 1998; Bray, 1996; Grant, 1995; Mancini, 1995; McNamara & Sullivan, 1995). Importantly, team approaches have been suggested as one of the best possible means for achieving decreased costs to the patient and to society at large (e.g., Katon, 1995; Mullins, Chaney, & Frank, 1996).…”

“…The subspecialty of rehabilitation care was born from the need for comprehensive long-term healthcare to treat vast numbers of injured servicemen after World War I and World War II (e.g., Frank, Gluck, & Buckelew, 1990). Notably, these early rehabilitation efforts were uniquely characterized by the inclusion of biopsychosocially-oriented treatment strategies, with an emphasis on multidisciplinary or interdisciplinary care (Mullins et al, 1996). In fact, it is now widely accepted that collaborative team efforts are the hallmark of rehabilitation (Diller, 1990; Halstead, 1976; Keith, 1991).…”

“…), and a given patient and his or her family are likely to be seen by all or most team members during the course of rehabilitation. Thus, rehabilitation invariably is a biopsychosocial enterprise in which medical/physical, psychological, and social/familial dimensions represent simultaneous points of intervention (Mullins et al, 1996). Importantly, because patients are often “co-treated” between disciplines, ongoing communication and coordination of care is deemed essential to the rehabilitation process.…”

“…Specific, pragmatically-based models of team approaches have been described (e.g., Woodruff & McGonigel, 1988), yet this work has been rarely tied to any well-defined theoretical framework. Notably, only occasionally have the explicit tenets of systems theory been involved in discussions of developing team approaches to rehabilitation (Mullins, et al, 1996). Certainly, one can argue that theory (particularly systems approaches) has implicitly driven the formation of team models, yet this is insufficient in our opinion.…”

Plessner's Philosophical Anthropology. Perspectives and Prospects

“…While neuropsychiatric adaptation problems need to be explained in terms of pathophysiology, identity problems and changes in the familiar coping setting require a broader theoretical framework to be explained with sufficient depth. A sociological perspective within a biopsychosocial framework (Mullins et al 1996) is needed. But what is evident at first sight proves to be a very difficult problem in research.…”