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50 Shades of Family

Posted By Kaitlin Leckie, Tuesday, August 5, 2014
When I seek to justify the purposeful integration of the family in healthcare, the time I spent practicing analogies for the GRE, SAT and the other equally torturous standardized tests finally pays off. Ask me why family and other social relationships are essential to a patient’s care and—alas! My mad analogy skills finally have a chance to shine. For I will tell you, the patient is to the family as the organ is to the body.

After all, you can take the patient out of the family, but you can’t take the family out of the patient. In a recent presentation for healthcare providers on activating the family in support of the patient, I showed two lists:

Possible Family Roles


Possible Family Actions


Neither list is comprehensive, just compiled in a few minutes based on my experience with patients, but both made their point: whether or not the family is physically present in the exam room, the family is present in the exam room, for good or for bad. Whether or not a healthcare clinician chooses to acknowledge the family’s influence, a 10-60 minute visit with a healthcare provider cannot compare to years spent thriving or surviving with family.

Even when considering the power differential between patient and clinician and the authority the clinician status brings, the influence of the family on the patient cannot be denied and should be considered. From basic hygiene practices and beliefs about healthcare that are developed during childhood to stress surrounding current marital discord, the family’s impact on health is present and pervasive.

Although not everyone shares in my emphasis on the family, many do.

My belief in the importance of “family at the center of healthcare” is shared by other members of CFHA’s Families and Health Interest Group. We are guided by a shared vision of “improved healthcare through engaged families and collaborative relationships.” Our mission is “to promote a family-centered approach within CFHA and other healthcare organizations and to foster collaboration in scholarship, education/training, practice, and policy.”

While it is comforting to know that like-minded individuals exist who share in the “why” behind what I do as a medical family therapist, this knowledge is incomplete. What is needed next is more information about how we center healthcare on the family and what this looks like in the exam room.
Come Join CFHA’s Families and Health Interest Group 

What would a list of standardized approaches & treatments by healthcare providers to show their consideration of these roles look like? If we compiled the techniques used by clinicians when demonstrating family-focused healthcare, what actions would be listed?

We know a lot more about how we treat organs in the context of the body than about how we treat patients in the context of the family. Certainly, we’ve documented and tested physical treatments more extensively. The time has come to study our family-oriented/family-centered care to the same extent that Heimlich perfected his maneuver and dialysis was developed to replace the kidney.

We suspect integrated care is successful. Now let’s explore how we reach this success. We know the value of the family. Now let’s identify specific ways we include them. We will be better equipped to treat patients in the context of the family by systematically studying the tools and techniques that make up our treatments. Not by poking and prodding, but by sharing and observing our successes, failures, nightmares, and dreams. 

You are invited to start by sharing your views and vision in the following brief survey. Just 5-10 minutes of your time will contribute to a knowledge base that will help guide the Families and Health Interest Group (FHIG) in achieving our 2014 deliverables. The survey results will be shared at CFHA’s national conference (Session: What's Next? Advancing Healthcare from Provider-Centered to Patient-Centered to Family-Centered) and will be discussed during future FHIG meetings.  

Whether you are simply curious about the concept of family-centered healthcare or are as passionate as I am for the importance of the family in health, you are invited to join the Families and Health Interest Group, open to CFHA members. The easiest way to get involved is by connecting with us during our upcoming tele-meeting on Friday, August 8th, at 12pm (EST). Simply dial (530) 881-1212 and use meeting ID: 517-873-035. 



Kaitlin Leckie, MS, LMFTA (TX) is completing a Medical Family Therapy fellowship at St. Mary’s Family Medicine Residency in Grand Junction, Colorado. She is a doctoral candidate in Marriage and Family Therapy at Texas Tech University. She currently serves as the Chair-elect of CFHA’s Families and Health Interest Group. Her current research centers on the role of family and social support on patient health activation in high-risk patients, particularly in relation to their use of healthcare services. She is enthusiastic about teaching behavioral sciences and speaks movie quotations fluently.


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Randall Reitz says...
Posted Tuesday, August 5, 2014
Kaitlin, these are great insights about the roles that families play in health and healthcare. It would be interesting to use your word cloud images for family roles and family activities when meeting with patients. My guess is it would stimulate great conversation about dynamics that everyone experiences but no one discusses.
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