Todd M. Edwards

Informing mental health policies and services in the EMR: cost-effective deployment of human resources to deliver integrated community-based care.

For EMR countries to deliver the expectations of the Global Mental Health Action Plan 2013-2020 & the ongoing move towards universal health coverage, all health & social care providers need to innovate and transform their services to provide evidence-based health care that is accessible, cost-effective & with the best patient outcomes. For the primary and community workforce, this includes general medical practitioners, practice & community nurses, community social workers, housing officers, lay health workers, nongovernmental organizations & civil society, including community spiritual leaders/healers. This paper brings together the current best evidence to support transformation & discusses key approaches to achieve this, including skill mix and/or task shifting and integrated care. The important factors that need to be in place to support skill mix/task shifting and good integrated care are outlined with reference to EMR countries.

A Guide for Beginning Family Therapy Group Supervisors.

A model for group supervision is presented to guide beginning family therapy supervisors. The stages of the model include: 1) Checking in; 2) Case Presentation; 3) Questions from the Audience; 4) Video Review; 5) Commentator Reflections; 6) Audience Reflections; and 7) Post-supervision Supervisor Reflections. One students perspective on the usefulness of the model is provided.

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.

A Place at the Table: Integrating Diet and Nutrition into Family Therapy Practice

This article describes the role diet and nutrition play in the stress of individuals and families who consult with family therapists. Indications of when to assess a clients diet are provided and methods of a diet inquiry are introduced with a case example for illustrative purposes. Recommendations for MFT training are also discussed.

Global Mental Health: A Call for Increased Awareness and Action for Family Therapists

Global mental health (GMH) is an emerging field that focuses on the need for culturally sensitive mental health services in low- and middle-income countries (LMICs). While many new initiatives have been established worldwide to understand GMH needs and to provide care in LMICs, family therapists have primarily worked with families in high-income countries. The few existing family-based initiatives in GMH focus on psychoeducation and are typically not based on general systems theory. However, emerging trends in family therapy may enable family therapists to impact mental health issues in LMICs. These trends, which are shared interests of both family therapy and GMH, include collaborative care, a growing emphasis on the importance of culture in understanding and treating mental health issues, recognition of the ability of families to support or impede recovery from mental illness, and the use of strength-based and evidence-based treatments. This paper describes ways for family therapists to become active in the GMH community.

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

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.