I had the great fortune of having Wendy Watson as my doctoral chair at BYU. She and her Canadian colleagues formulated Systemic Belief Therapy. SBT was one of the first family therapy approaches specifically targeted to medical family therapy (although the Canadian nurse triumvirate just cringed at my MedFT reference).
SBT was a great fit with my other favorite postmodern approaches: narrative therapy and solution-focused therapy. Coming out of grad school I thought these models were sufficient for everything I would see in medical clinics. As a post-modern therapist I was:
- Opposed to psychopathology (that’s not encopresis or schizophrenia, it’s sneaky poo and the in-the-corner lifestyle);
- Skeptical of psychotropicmedication;
- Hyper-sensitive to physician privilege and the power of the gaze in "La Clinique”;
- Convinced that behaviorism was inhumane.
My internship quickly disabused me of these assumptions. Now 11 years later I still follow many of the post-modern assumptions and I teach residents solution-focused therapy. However my day-to-day therapy would make Skinner smile and I model motivational interviewing and CBT for my residents.
All is not lost, however, I am still acutely aware of the influence of families and am often successful at turning individual referrals into systemic interventions. I still draw genograms for my new patients, but haven’t yet figured out how to integrate them into the EMR.
My guess is that my experience is not unique among medical family therapists—especially among MedFTs who were trained before MedFT existed. In some ways family therapy is a perfect fit for medical settings and in some ways it is severely lacking.
Please take a minute and add your thoughts about the family therapy models that caught your fancy in training and on how you’ve had to either adapt them or abandon them to fit within the medical culture. What other models of therapy do you find most helpful?
||Randall Reitz is the out-going Executive Director of CFHA and the Behavioral Science Faculty at the St Mary's Family Medicine Residency in Grand Junction, Colorado. He family therapy at Brigham Young University and Indiana State University.|
He is the author of CFHA's CollaboBlog.