Jo Ellen Patterson

Relationships, Environment, and the Brain: How Emerging Research is Changing What We Know about the Impact of Families on Human Development

Recent research is providing family therapists with new information about the complex interaction between an individuals biological makeup and his/her social and physical environment. Family and social relationships, particularly during sensitive periods early in life, can affect a childs biological foundation. Additionally, stress during the early years can have a lasting effect on an individuals physical and mental health and contribute to the onset of severe mental illness. Community programs have been developed to intervene early with families who have an at-risk child to prevent or minimize the onset of mental illness including providing partnerships with at-risk mothers of infants to shape attachment relationships. Programs are also developing individual and family interventions to prevent the onset of psychosis. Practicing family therapists can incorporate emerging neuroscience and early intervention research and leverage the growing base of community programs to enhance the effectiveness and sustainability of mental health outcomes for clients. Additionally, family therapy education programs should broaden student training to incorporate the growing body of information about how family relationships affect individual mental health development.

Introduction to Family Therapy

Family therapy emerged in the 1950s and offered a new way of assessing and treating mental health problems. Family therapy explicitly focuses on altering the interactions between or among family members and seeks to improve the functioning of the family as a unit, or its subsystems, and the functioning of individual members of the family. Legitimate family treatments may focus on the symptoms and functioning of the index patient, or on the qualitative aspects of relationships between or among family members.

A “Golden Girl” Tarnished

Medical family therapy has become a popular specialization in family therapy, resulting in more and more clinicians pursuing clinical opportunities in primary and tertiary care. We believe it is important for family therapists to understand the differences between medical settings, particularly the diversity in patient presentations. The purpose of this paper is to present some unique characteristics of mental health services in family medicine. Because family physicians are often the first contact for someone coping with a mental health and/or family concern, they provide emotional support and direction to mental health services. A case example helps illustrate a common patient presentation in family medicine and the role family therapists can play in providing mental

Policy and Practice: A Primer on the Past, Present, and Future of Healthcare Reform in the United States

Excessive costs and the inconsistent quality of healthcare in the United States have driven policymakers and healthcare professionals to advocate for a new approach. Revised goals for the delivery of healthcare (the Triple Aim Initiative), a new structure to support the goals (accountable care organizations), and integrated care entities that provide the care (patient-centered medical homes) are key elements of a new system that will be implemented in the coming years. Medical family therapists (MedFTs) will play an important role in this reformed healthcare system. To be successful participants, MedFTs will need to understand how the model works and how to get involved in decision-making entities and policy think tanks. In this chapter, the authors provide an overview of the changing healthcare system, illustrate the benefits that will be experienced by patients and their families as these changes are implemented, and identify ways that MedFTs can successfully integrate into the changing healthcare environment.

Pulling it all together: Meeting varying training requirements on national, state, and university levels for marriage and family therapy education

Marriage and family therapy programs face many challenge in trying to meet different sets of criteria including national, state, and university requirements. State regulation of the marriage and family therapy profession is a much sought after commodity. Currently 22 states have some type of MFT licensure or certification. MFT regulation criteria established by states to restrict title and function can differ in varying degrees from criteria established by the AAMFTs Commission on Accreditation. At the university level, MFT programs continue to be housed in a variety of schools including social work, education, psychology and home economics, as universities attempt to define a proper place for family therapy training. Confusion exists about whether MFT is a separate discipline or a specialization of another profession. The task of pulling it all together is addressed using one programs experience as an example.

Family Focused Care for Refugees and Displaced Populations: Global Opportunities for Family Therapists

Recent global crises have created a significant increase in the number of people leaving their countries. Distress experienced by these refugees often leads to posttraumatic stress disorder and depression and can also result in psychotic disorders, substance abuse, and interpersonal violence. The World Health Organization leads the organizing of refugee services as part of a larger initiative to provide mental health services to citizens in low- and middle-income countries. The World Health Organization has identified challenges in providing care, including a provider shortage, issues with how refugees access and receive care and a lack of uniformity in mental health services. By applying the values and systemic orientation of the profession, family therapists can address some of the challenges in treating mental health concerns of these at-risk populations.

An introduction to global mental health.

In general, readers of Families, Systems, and Health (FSH) practice in high income countries and in settings that have adequate resources. Providers can usually count on being able to offer the material resources and skills that patients need to heal. This bounty of resources is in contrast to many clinics in low- and middle-income countries (LMICs). The need for mental health services in LMICs is significant and growing because of upheaval caused by war and other disasters. The topics in this issue talk about the obstacles to obtaining mental health services, trends in global mental health, and FSH in the global mental health movement. (PsycINFO Database Record

Training for teamwork: A case study.

As the field of collaborative care, or integrated behavioral health, continues to develop, lessons are learned from attempts to establish such programs (Sieber et al., 2012; Unützer, 2014). Part of the success of collaborative care programs is the function of an interdisciplinary team. In this article, faculty from University of San Diego (USD) and University of California, San Diego (UCSD) share changes needed to curriculum and career development to support leadership and teamwork skills essential to program development, implementation, and sustainability for integrated behavioral health. This article uses Unützers (2014) 4 factors of creating a successful collaborative care program (i.e., shared vision, leadership, staffing, and financial sustainability) to discuss implications for effective collaboration between 2 universities and the training of primary care providers in teamwork and leadership skills for overcoming barriers and pitfalls to expand collaborative care beyond their initial training.

The daily events and emotions of master's-level family therapy trainees in off-campus practicum settings.

The Day Reconstruction Method (DRM) was used to assess the daily events and emotions of one programs masters-level family therapy trainees in off-campus practicum settings. This study examines the DRM reports of 35 family therapy trainees in the second year of their masters program in marriage and family therapy. Four themes emerged from the results: (i) Personal contact with peers-in-training engenders the most positive emotions during practicum; (ii) Trainees experience more positive emotions during therapy with families and couples in comparison with therapy with individuals; (iii) Positive affect increases over the course of a students practicum year; and (iv) Trainees experience less positive affect in individual supervision in comparison with most other training activities. Flow theory offers guidance for supervisors helping trainees face developmental challenges of clinical training.