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A Vision for Families, Systems, and Health

Posted By Sandy Blount, Thursday, September 03, 2009
Updated: Thursday, June 09, 2011

From its earliest days as Family Systems Medicine, under Don Bloch, its founding Editor, this journal has occupied a unique position in the landscape of healthcare journals. Rather than carving out a new, more specialized area, it has been placed at the confluence of health and mental health, the individual and the family, personal and population approaches. Under Susan McDaniel and Tom Campbell, the editorial team that renamed Families, Systems, & Health (FSH) and guided it for twelve years, it has been brought to the high level of influence and stability that it enjoys today. Its title promises, and the journal has delivered, a balance of types of articles from its nexus at the role of relationship in health.

The change that I see that is most important to FSH is in the environment. FSH is just beginning to cease being ahead of its time. Some of the people central to the developing life of the journal have also been important in the transition that has created the current flowering of collaborative care. The forces that are driving this flowering are much larger than the group of us who have been supportive of FSH. These forces have created a renewed need for a multidisciplinary journal that can address practice and theory in addition to education and research. The "systems” in the title can refer to systems of healthcare delivery in addition to systems of human interaction.

The service model of the Medical Home has provided a locus for primary care providers, insurance companies, and government health authorities to come together to provide better care at lower cost. Exactly how that model will develop will be discussed in the literature for some time. The "patient centered medical home,” the "collaborative healthcare home,” the "family medical home” and probably others, will need to be vetted in print. FSH is an excellent venue for this sort of systems discussion.

FSH is or should be the first journal for collaborative practice, for research on the influence of the family in health and illness, for family interventions in health and illness, and for systems thinking as it applies to health and illness. For people doing research whose primary academic commitment is with a particular discipline, such as health psychology, behavioral medicine, marriage and family therapy, family medicine, internal medicine, pediatrics, or medical specialties, we can be the locus for articles about collaborative practice. For the field as a whole, we should be the journal for rigorous descriptions of the reciprocal evolution of the routines of practice, the delineation of social roles in service delivery, and models of phenomena underlying collaborative healthcare.

Gregory Bateson said that being able to rigorously articulate patterns that connect seemingly disparate domains of phenomena must certainly be a non-trivial accomplishment. I cannot improve on that idea as a reason for intellectual endeavor. We need to be much better at articulating the patterns that connect different domains if we are to be able to think better about phenomena like "mind” and "body” that we have dichotomized so thoroughly. In what other field does common parlance, such as "that child is a pain in the neck,” carry a more sophisticated synthesis of physical and behavioral experience than the language professionals usually deliver? Producing a journal that regularly offers clear articulations from many domains of relationship and occasionally offers a new articulation of the patterns that connect across domains is the first goal the new editorial team has set itself. The second is making FSH an accepted and well-used outlet in the worlds of medicine, mental health and systems thought.

As an approach to both goals, we want to broaden the readership and the contributors to FSH by making the journal accessible to authors who do their scholarly writing in Spanish. To this end, Gonzalo Bacigalupe has joined as Associate Editor. We will be inviting leading scholars from the Spanish speaking world to join us as reviewers. We want to be able to take a manuscript in Spanish from submission, through all the steps in the editing process to an accepted final form before it is translated. To be a true "agora” for ideas and science, we want to encourage submissions from authors in English and Spanish that have not contributed in the past. We hope to set the bar for publication high, and to take steps to help new authors meet the standard.

To this end, FSH will now be archived in Medline making its contents more accessible to scholars in medical disciplines.

If anyone is interested in reviewing manuscripts for CFHA, please send a CV, your contact information and a list of key words that describe the subject areas in which you want to review to

What do you think would make this a better journal for CFHA members?

What aspects or departments of the journal in the past should we be sure to maintain?

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