Richard J. Bischoff

A biopsychosocial model for treating infertility

With approximately one out of six married couples experiencing infertility, having a basic knowledge of infertility is important to marriage and family therapists. This paper presents important themes that infertile couples often struggle with and stresses the importance of having a biological, psychological, and social understanding of infertility. In addition, the paper suggests possible interventions that family therapists can use in helping infertile couples.

The Pathway Toward Clinical Self Confidence

This study was designed to determine the most common pathway toward the development of clinical self-confidence for therapists during the first year of client contact. Telephone interviews were conducted with 39 recent graduates of a masters level marriage and family therapy program. Subjects were asked to graph their development of clinical self-confidence over the first 12 months of their clinical experience. Results reveal a three-stage model of therapist development. The implications for training within each stage of development are identified with an emphasis on the role of the supervisor.

Finding the Heart of Medical Family Therapy: A Content Analysis of Medical Family Therapy Casebook Articles

In an effort to identify the essential ingredients of medical family therapy, a content analysis of 15 peer-reviewed case studies in medical family therapy was conducted. The case studies were published from 1996 to 2007 in Families, Systems, & Health. Through a qualitative content analysis, three main themes emerged that describe the essence of the practice of medical family therapy: (1) The patients multisystemic experience of disease, (2) treatment is about caring, not just caregiving, and (3) elevating the patient as collaborator in the care team.

Therapist interventions: do they really influence client resistance?

Abstract Client resistance is one of the focal points in most approaches to marital and family therapy. Many approaches conceptualize resistance as something to be reduced for therapy to be effective; however, the structural and strategic therapies are unique because they also conceptualize change as resulting from interventions that use resistance. The present study compared the amount of resistance that was engendered between interventions that use resistance and those that decrease resistance. The interventions that were designed to use resistance as well as defusing conflict both had statistically higher resistance ratios than the rest of the interventions.

Providers' Perspectives on Troublesome Overusers of Medical Services

The purpose of this study was to better understand providers’ perspectives of and experiences with frequent users of medical services. Focus group interviews were conducted with physicians in San Diego, California, and Omaha, Nebraska. Indicators of problematic patient overuse of medical services were identified as well as the common physician experience of overuse that is troublesome and problematic. Qualitative data analysis revealed that physicians did not consider patient overuse, by itself, to be problematic. Overuse became problematic and troublesome when patient behavior violated the physician-patient relationship of trust. All participants described a distinct negative physiological reaction to these patients.

Global Proofing a Collaborative Care Telemental Health Intervention in Brazil.

Rural proofing ensures that policies, practice guidelines, strategies, and techniques can be applied to rural populations with approximately equal benefit as what would be obtained in urban areas. Extending this concept internationally, the authors argue the importance of global proofing mental health strategies developed in well-resourced, high-income areas in order to determine their appropriateness in areas that have resource poverty such as middle- and low-income countries. An example is used to illustrate both rural and global proofing. Through this example, the authors demonstrate how they proofed urban-inspired models of mental health care in rural areas of the United States. The result is a model of rural mental health care that emphasizes collaborative care and telemental health. This model is now being global proofed in Brazil. The authors describe the application of this model in a remote rural town in Brazil. Consistent with World Health Organization recommendations, the integration of mental health care into primary care medical settings is being discovered as essential to addressing mental health disparities worldwide. (PsycINFO Database Record