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    Sandy Blount: A Vision for Families, Systems, & Health

    September 3, 2009 - CBC Admin

    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 Alexander.Blount@umassmemorial.org.

     

    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? 

    9 Responses to "Sandy Blount: A Vision for Families, Systems, & Health"
    1.
    September 3, 2009 at 6:11am

    Sandy,  I think the 2nd paragraph gets to the heart of the matter.  For decades, FSH (and CFHA) have been ahead of their time, setting a direction that few wanted to follow.  Now it seems like collaborative care has moved to the mainstream and many tier-1 journals publish collaborative care research.  Most noteworthy, the IMPACT group has published nationwide RCT data in JAMA.

     

    Why is it that the standard-bearers of collaborative care (including key CFHA figures) have looked elsewhere to publish their best research?  How do we reverse this trend?

    2.
    September 3, 2009 at 8:56am

    CFHA's voice is strong in FSH. As CFHA has evolved, so has FSH. I look forward to seeing where the journal goes under Dr. Blount's leadership. Dr. Reitz is correct in saying that there is more research and articles published on collaborative care than ever before, and FSH has a significant role to play in the  dissemination of this research. I would highly encourage interested individuals to email Dr. Blount and get involved as a reviewer for FSH. 

    I would like to see a 'policy' section of the journal exist. Just as many other associational journals have their policy corner, so too should FSH/CFHA. I recognize there are likely many complexities as to why this would be hard to do, but see it as a benefit to readers, members, etc.

    3.
    September 3, 2009 at 9:48am

    Ben,

    I really like the idea of a policy section.  This fits in nicely with CFHA's strategic vision to become more involved on a policy/advocacy level (see Frank deGruy's post coming in the next 2 weeks!).  I think this is especially important because FSH is one of the only true inter-disciplinary journals.  The APA's and AMA's of the world are going to mostly advocate for their territory, whereas FSH brings voice to DMZ's between these territories.

    4.
    September 3, 2009 at 11:33am

    Randall  I appreciate your reference to the DMZ regarding how "integrated/collaborative" care navigates between significantly embedded entities such as the AMA and APA.  Case in point is the dissemination of patient information and how it is "siloed" in the Mental Health, Substance Abuse and General Medical realms.  To perpetuate change, more philosophical ruminations must occur (hence this blog) but what may prove very effective is continued lobbying to actually address the HIPPA and state/federal regulations and laws (not just the ethical codes) regarding how patient information is distributed and shared among providers.  I think having a policy section in the FSH journal is key!  I'd love to share some of my mistakes!

    Pete

     

    5.
    September 6, 2009 at 1:30pm

    Sandy,

    Congratulations on getting FSH into medline.  Your work on this issue, on the shoulders of Susan McDaniel, PhD, Tom Campbell, MD (immediate past editors), is in my view the most signficant single change in the last decade to increase FSH visability and value. Do past FSH articles get listed in Medline?  When will FSH publication listing in Medline begin?

    Larry

    6.
    F. Blount Says:
    September 7, 2009 at 7:46am

    Thanks very much for your responses.  This gives me a list of needed responses.

     

    The credit for the listing on Medline, I am afraid, goes entirely to Susan McDaniel and the staff of APA.  It was a committment of mine as I came in as Editor, but I only have to reap the benifits, not do the work.  Will back articles be on Medline and when will it go on?  My understanding is that the back articles will be archived and that is why it takes a long time between decision and availablility.  I will get in touch with Jessica Karp at APA, and try to update this info.

     

    How about a policy corner?  That is a very interesting idea.  We have a terrific Department Editor for Policy in Margy Heldring.  She is working on a special edition on health policy.  I will talk to her about whether a piece on policy in each issue or every other issue is more doable.  It does seem a shame to wait to get all the pieces for a special issue together because it takes so long and the world of policy is moving at lightening speed. 

     

    How about more editorial reviewers?  Please encourage people with an interests that fall within the broad areas of families, systems, health and healthcare to contact me.  I will get them into the database.  They don't need to be an expert on integrated care.  That is part of what we do, but we do a great deal more.  You might say we are looking at the influence of relationships in health and healthcare.  Not every reader needs to be equally expert in a content area.  People who are able to read for clarity and organization of writing, who can say, "if you move the last paragraph to the front of this section, you can cut the middle four paragraphs with no loss of clarity" are very valuable.  In addition, it really helps to have people who can read in fairly narrow areas.  Any content area in which a person can look at a list of references and notice important references that are missing is an area we would like to have them listed to read in.

    7.
    September 10, 2009 at 11:28am

    Sandy,

     

    Your thoughts on timeliness of policy discussions are right on.  In some ways it is a new media versus old media issue.  The value of journals is that they create a permanent record and have high credibility among their readership.  The value of blogs and other electronic media comes from their expediency, ease of transmission, low cost, and public access.  The downside of each format is the opposite of the other's upside.

     

    Regarding policy specifically, in some ways policy changes at a glacial pace, but in other ways, the verdant moments pass very quickly.  The current health-care debate seems particularly labile.  The long-term policy discussions are well-suited for journals, whereas the day-to-day conversation is a good fit for a blog.

     

    I'm curious if it would be possible for CBC to bring added value to FSH's on-going policy work.

    8.
    F. Blount Says:
    September 28, 2009 at 7:21pm

    I think you might be interested in all the places that Families, Systems, & Health is indexed.  For the whole list, go to  http://www.apa.org/journals/fsh/abstracting.html 

    9.
    Guest Says:
    February 22, 2010 at 1:44pm

    Name: maryanna hathaway

    Email: bugrush@aol.com

    I am a registered nurse and a licensed professional counselor and I am interested in starting to open the eyes and the ears of a small conservative community in Northern Michigan.  Does anyone have good ideas as to where to start?

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