collaborative family healthcare association 13 th annual conference october 27-29, 2011...
TRANSCRIPT
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Session #ML-1October 29, 2011
2011 Collaborative Family Healthcare Association Annual Meeting
MAINSTREAMING MEDICAL FAMILY THERAPY:The Importance of a Systemic Approach to Integrated Healthcare
Susan H McDaniel PhD, University of Rochester William J Doherty PhD, University of MinnesotaJeri Hepworth PhD, University of Connecticut
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Faculty Disclosure
Please add the commercial interest disclosures that you reported on your signed Disclosure form:
I/We have not had any relevant financial relationships during the past 12 months.
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Need/Practice Gap & Supporting Resources
• Need for a biopsychosocial approach to psychotherapy and behavioral health
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
*Participants can identify the original vision and concepts of Medical Family Therapy, including its use as a metaframework for other approaches such as CBT, DBT, and psychoeducation.*Participants can describe this family systems-based approach to behavioral health in primary care as well as specialty settings.*Participants can discuss the compelling need for Medical Family Therapy as it relates to ethical, interpersonal, and socioeconomic issues in healthcare.*Participants can discuss future opportunities and challenges for family- oriented behavioral health in the emerging healthcare system. *Participants will identify how medical family therapy principles can be helpful in team development and role clarification in the Patient-centered Medical Home.
Objectives
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Expected Outcome
What do you plan for this talk to change in the participant’s practice?
• Incorporate an overall systematic framework for behavioral health in healthcare.
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
MEDICAL FAMILY THERAPYHistory and New Contexts
William J. Doherty, PhDProfessor of Family Social Science & Family and Community Medicine
University of Minnesota
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
• The Origin Story• The biopsychosocial systems approach• Family focus• Medical Family Therapy as metaframework
*Can be used by many disciplines*Can be used with many problems and populations
• Agency and communion still overarching goals • Member of collaborative team: from triangle to team• Health care reform as larger context
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Roles and Strategies for Medical Family Therapists
Jeri Hepworth, PhDProfessor and Vice-Chair of Family Medicine
University of Connecticut
President, Society of Teachers of Family Medicine
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Roles and Strategies for Medical Family Therapists
1) Behavioral Health Consultant
2) Clinical Team Member and Consultant
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Medical Family Therapist as Systemic Behavioral Health Consultant
• Tracking medical and mental health outcomes• Tracking medication and treatment adherence• Supporting the patient’s relationship with the referring provider • Providing psychoeducation about the diagnoses and treatment• Encouraging patient and family activation • Clarifying motivation for change and treatment• Negotiating a mutually-agreeable treatment plan• Facilitating family support• Encouraging psychiatric consultation when needed • Engaging in targeted brief therapy
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Clinical Strategies
• Recognize the Biological Dimension
Patients have bodies and disease• Elicit the family illness history and meaning
Health Beliefs and History• Respect defenses, remove blame, and accept
unacceptable feelings
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Clinical Strategies (continued)
• Provide Psychoeducation and Support Describe Common Patterns of Interaction
• Reinforce the family’s non-illness identity Put the Illness in It’s Place
• Facilitate Communication Within the Family and the Clinical Team
• Attend To Developmental issues
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
• Increase the Family’s Sense of Agency
Patient Activation and Empowerment• Enhance the Family’s Sense of Communion
Allow Others to Help • Maintain an Empathic Presence with the Family
Mindfulness of the Therapist
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Enhancing Team Functioning
• Multi-Level Participation• Respect defenses, remove blame, and accept
unacceptable feelings• Facilitate Communication• Attend to Developmental Issues• Increase Agency and Communion of Team• Mindful Team Practice
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Susan H. McDaniel, Ph.D.Dr. Laurie Sands Distinguished Professor of Families and Health
Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Session #October __, 20110:00 AM
Director, Institute for the FamilyAssociate Chair, Department of Family Medicine
University of Rochester Medical Center
MEDICAL FAMILY THERAPY IN ACTION:GENETIC CONDITIONS
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Most patients, across conditions, are not significantly distressed after testing positive
for a genetic illness
(Lerman, Vroyle, Tercyak & Hemann, 2002, JCCP Review)
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Dealing with familial illness risk is not a rational process
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Coping with Health Information
Monitoring Behavior
-Scan and amplify threatening cues
-Seek Information Blunting Behavior
-Distract from or avoid threatening cues
-Minimize Information
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Medical Family Therapy
Monitoring Behavior
-Benefit from targeted information -Family members provide support & record information
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Medical Family Therapy
Blunting Behavior
-Emphasize future outcome of current behavior
-Family members increase concerns, confront denial, and provide support
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
The Psychology of Genetic Testing
• Huntington Disease
10-20% Sought Testing
• Breast Cancer
35-43% Sought Testing
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
The Psychology of Genetic Conditions
Perceived rather than scientific risk influences: • Behavior• Decision-Making• Emotional Outcome
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4042
1613
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Wanting to know for one’s children is the single biggest reason
that adults choose to get tested for genetic conditions
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The Need to Know
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Clinical Strategies for Medical Family Therapy
1 - Recognize the Biological Dimension 2 - Elicit the family illness history and meaning 3 - Respect defenses, remove blame, and accept unacceptable feelings. 4 - Facilitate communication. 5 - Attend to developmental issues 6 - Reinforce the family’s non-illness identity 7 - Provide psychoeducation and support. 8 - Increase the family's sense of agency 9 - Enhance the family’s sense of communion10 - Maintain an empathic presence with the family
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Behind every health and mental health professional is a person and a family with a history of medical and mental
health issues
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Collaborative Family Healthcare Association 13th Annual ConferenceOctober 27-29, 2011 Philadelphia, Pennsylvania U.S.A.
Medical Family Therapy in the 21st Century
Must be
• Conceptually creative• Clinically innovative• Seek truth through research
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It’s a Bird…Steven T. Seagle and Teddy Kristiansen, DC Comics, 2004
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Session Evaluation
Please complete and return theevaluation form to the classroom monitor
before leaving this session.
Thank you!