How do you know when your product is a smash success? The regulators show up to anoint you with accreditation
standards to establish order in your industry and to separate the sketchy posers
from the rigorous real McCoys. So it is
with collaborative family healthcare. It
is apparent to governmental agents and leaders of various healthcare
disciplines that some form of integrated care will be part of emerging practice
models and the rush is now on to set standards for our field.
The American Psychological Association is
assembling a multidisciplinary group to devise competencies for psychologists
working in collaborative primary care settings.
The SAMSHA-HRSA Center for Integrated Healthcare Solutions (CIHS), run
by the National Council for Community Behavioral Healthcare, has just put out a
brief but far-reaching report—really a framework to spur and direct future
action--entitled "”Primary and Behavioral Healthcare Integration—Guiding
Principles for Workforce Development.” Here’s the link
The CIHS report, written by a stellar committee that included CFHA
stalwarts Sandy Blount and Ben Miller, contains several components of
pertinence to Medical Family Therapy educators:
- It calls for the training of a collaborative workforce steeped in the
principles of the recovery movement, especially patient, family and community self-determination.
The report’s number one core goal (of 7
cited) is "Expand the role of consumers and their families to participate,
direct, or accept responsibility for their own care.” It promulgates the establishment of
competencies and curricula to foster the sharing of integrated care treatment
decision-making with consumers and family members.
- It seeks the implementation of evidence-based training through a
so-called "Learning Home on Integration” that will "link individuals to
sequenced educational opportunities that are reinforced through supervision.”
- It proposes devising a "Faculty Forum on Integration” to identify best
educational practices and resources.
- It calls for the development of core competencies in integrated care
tailored to general healthcare, mental healthcare and peer support. Core curricula would also be developed and
disseminated to foster integrated care practices for specific, highly impacted
In spirit, this report is respectful of families, trying to level the
playing field among healthcare professionals, patients and relatives in their sometimes
testy, sometimes tender collaborative partnerships. However, there is nothing here on training
competent integrated care practitioners in the critical skills of how to
effectively engage family members in medical exam rooms and other settings, nor
how to study their reactions, facilitate their growth or clinically intervene
with them when necessary. Family-centered
care here is an aspiration, not a fully delineated set of techniques as yet.
That’s where we come in. We teach
our trainees just those clinical skills to help family members gain a sense of
agency in the midst of medical crises and to draw strength through communing
with others in similar straits. We have
experientially-based training methodologies that instill self-awareness and
self-efficacy. We have systems expertise
to fine-tune the group dynamics of the emerging integrated healthcare team.
So how do we join the ongoing conversations at CIHS (and other
standard-bearing entities)? I suppose we
could heavily lobby Sandy and Ben. Better
yet, we should make our knowledge more visible to the federal agencies and
healthcare organizations that will be regulating the integrated healthcare of
tomorrow. That will take educational and
clinical research. And
speechifying. And good PR.
What are your thoughts about how to influence the future?