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Collaborative care between family therapists and medical providers: A Delphi study

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Abstract

Over the last few decades, more mental and physical health care providers have been working together, or collaborating, to better serve their patients and the patients' families. There has been a variety of terms used to describe a collaborative relationship between mental and physical healthcare providers. Some of the terms include; "medical family therapy," "family systems medicine," "collaborative family healthcare," "shared care," "collaborative care," "integrated care," "biopsychosocial care," "patient centered care," and "citizen healthcare." At the 2004 Collaborative Family Healthcare Association conference considerable confusion about vocabulary and definition was highlighted as an area that needed to be clarified if the field was to move forward. There is also uncertainty in the literature as to whether these collaborative relationships are a field, area, specialization, specialty, or sub-specialty. Finally, there is confusion as to what role Marriage and Family Therapists (MFTs) are currently performing and what are the possibilities for MFTs in the future within these collaborative relationships, per reports of American Association of Marriage and Family Therapy members at the 2004 national AAMFT conference. The intention of this study was three fold; (1) to gain consensus on defining the collaborative relationship between mental and physical healthcare providers and how this relationship is conceptualized, (2) to identify the key components necessary for mental and physical healthcare professionals to work together successfully, and (3) to identify what it takes from MFTs specifically to participate in a successful collaborative relationship with health care providers. Delphi methodology was used to collect data from a panel of experts in collaborative healthcare. Twenty-three experts in collaborative healthcare participated in the Delphi I, twenty participated in the Delphi II. Analyses of panelists' responses revealed we made significant progress toward our three research objectives. Panelists came to consensus on a single term for the collaboration between mental and physical health care providers, Collaborative Care, and identified specific components that are necessary for Collaborative Care to be successful. Specific focus is given to MFT's in Collaborative Care. Directions for future research as well as implications for the training and practice of MFTs are discussed.

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... Such a cohesive identity is usually systematically constructed by accruing a body of literature and research and establishing specialty training centers in which new professionals can be trained. Whether or not MedFT is a specialty area or a subdiscipline has yet to be decided, as at least one current doctoral dissertation is examining via a Delphi study (Walter, 2005). ...
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Much attention has been given to increased collaborative efforts between psychotherapists and the medical community. Medical family therapy (MedFT) provides a bridge between psychotherapy and medicine for individuals and families. The authors of this article present a literature review of the empirical research on the efficacy and effectiveness of MedFT as the primary form of psychotherapy treatment within an interdisciplinary medical treatment team. This literature review spanned a time period from 1965 through 2004. The authors discuss difficulties in defining MedFT and conducting research in the field, provide a review of the outcome benefits of including mental health professionals on collaborative health care teams, and provide suggestions for future research that demonstrates empirical support for the effectiveness of MedFT. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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