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Link to Recent Re:activation Blog Posts:

March 16, 2012

A KISS to Make it Better: A Two Step Model of Behavior Change

Why is it the more educated we become the more complicated we make things?

 I was facilitating a Motivational Interviewing [MI] group the other day and during a discussion on the 5A's, the topic of Prochaska and DiClemente's Transtheoretical model [TTM] came up; specifically the stages of change. This got the entire group thinking about the complexities of behavior change and the most prolific model we use to describe here to read more.

February 3, 2012

The Pros and Cons of Patient Portals: Can Integrated Electronic Health Records Help Empower Patients?

Providers spend a significant amount of time with patients problem solving effective ways to manage chronic health issues. Through the use of Motivational Interviewing for example, providers focus on increasing patient self efficacy; "how do I guide this patient in owning their own health?".

With the rapid grown of Health Information Technology (HIT) I'm optimistic that HIT, specifically the use of patient portals, will provide more tools for not only improving patient satisfaction and reducing costs, but also in addressing another real issue in healthcare: Increasing patient here to read more

October 13, 2011

Talk About Situational Stress: Multigenerational Living is on the Rise

My two sons attend a daycare in the same building as a nursing home which has a multigenerational program integrating the wee tots with the geriatric populations. They pass the time singing songs, playing games and I’m sure, laughing at each other’s idiosyncrasies.  My wife and I purposefully chose this daycare for this reason.  We felt that there, both the young and the old had a lot to offer one another and that it would be a wonderful learning experience for our two young boys who unfortunately do not live near either set of their her to read more
July 7, 2011
What Collaborative Care Can Learn From Chaos

A client once told me, "Humans pray for outcomes and God laughs. Now that’s chaos”

Chaos Theory is paradoxical; sort of like when you see an object clearer in the dark when you don’t stare directly at it. Chaos theory for me reminds me of this concept. It comes more into focus the less and less I try to figure it out. The mathematics behind chaos theory are extremely abstract and difficult to conceptualize and I’ll be the first to admit quite frankly they are way over my head. That being said, in my interpretation the basic premise is simple: We need not waste time seeking control of a system, instead we seek order within the here to read more
May 12, 2011
Goodbye Old Friend, I've Known You Far Too Long

We are all aware of the dangers of smoking. Yet the CDC reports that in the United States over 46 million people (20.6%) over the age of eighteen and 2.7 million (17%) of all high school students are current smokers. Out of the 46 million adult smokers, the CDC reports that over 40% of them tried to quit in the past year. The implication here is that to some degree they wanted to quit, but were unable to to actually stop smoking. It is hard, very hard, to separate oneself from the addictive nature of nicotine....Click here to read more.
July 21, 2010
Who's The Boss of Me?

Good Question. A few weeks back my almost three year old son and I were looking at a poster of the 8 planets. After reviewing the names together it was his turn to try solo. He began with the sun then to the subsequent planets--pointing to each one he said "Mercury, Venus, Earf, Mars, Jupatewr, Saturn, Myanus, and Neptewn”. I offered him encouragement for his job well done and of course just one correction…”Isn’t it Uranus” I asked him with a slight grin. "No it’s mine Papa!” he insisted. At that point I could not help but appreciate what ownership he had of his body. Later, I asked my wife "At what point do we lose that ownership”?....Click here to read more
February 8, 2010
Listening is Good Medicine

The National Day of Listening happens every year, the day after Thanksgiving. I know it was a while back but due to both a past blog and a recent patient encounter I began thinking about this concept again. This year during National Day of Listening, I chose to interview my father. He has lived a fulfilling life in his 78 years. When we sat down to kick the "interview” off he, with sincere curiosity, asked "You are not doing this because you think I’m going to die are you”? After I debunked this myth of his, we proceeded. With a digital recorder on the table, we sat and talked over coffee for about two hours. My entire life, I have had a great communicative relationship with my father but something was different this time. This time my sole intent was just to listen, nothing else. I had no intentions, no predispositions, no expectations, just open ears. I learned a lot about my father that day that I had never known before...Click her to read more

January 11, 2010
How to Make A New Year's Resolution 101

During New Year's Day the media was so inundated with Resolution oriented commercials you could almost see the affirming banners of declaration whizzing by your head--"Quit smoking now" or "Lose that weight you always wanted to" were repeated ad-nauseum. Although the barrage was inexorable, there was good reason for the timing of it all-to take advantage of a state of readiness; regardless of how fleeting it may be. Everyone has good intentions around this time of year, what we need help with is follow-through. And now that we are into the second week of the New Year I thought it would be good to check in on the progress...Click here to read more

November 19, 2009
Smoking Cessation in Primary Care

The facts regarding the pernicious nature of smoking, second and third hand smoke ( are abundant and clear. Tobacco use is the leading cause for preventable morbidity and mortality and quitting is the number one thing our patients can do to better their health. The problem: tobacco is extremely addictive. Back in the 80’s C. Everett Koop declared tobacco "as addictive as heroin and cocaine”. For many reasons an integrated primary care setting is an excellent place to help patients end their nicotine addiction.Although I have owned the book for years, I most recently rediscovered and read Coyote Medicine a book by Lewis Mehl-Madrona, M.D., Ph.D. What a fantastic read. To my pleasant surprise, just yesterday, I found out that the author will be presenting at the CFHA conference in San Diego CA this October 2009...Click here to read more

October 11, 2009
Psychiatric Consultation in Primary Care

I have been fortunate enough to be part of the nascent stages of two integrated primary care programs. In both programs efforts to create a useful psychiatric consultation program were made. The goal: To provide psychiatric consultation to the primary care providers regarding the care of patients presenting with co-occurring medical and mental health issues. An expected result of this process was a reduced level of provider apprehension regarding the prescription of psychopharmaceuticals....Click here to read more
September 21, 2009
Mental Health vs. Behavioral Health?

In a past CBC blog there was a brief discussion around the difference between "Collaborate and Integrate”. Although to some it may only appear to be an issue of semantics, to others there is a need to create consistent definitions in our profession. A reliable discourse within our profession could facilitate the relay of ideas concerning policy, process and practice...Click here to read more

June 9, 2009
Coyote Medicine

Although I have owned the book for years, I most recently rediscovered and read Coyote Medicine a book by Lewis Mehl-Madrona, M.D., Ph.D. What a fantastic read. To my pleasant surprise, just yesterday, I found out that the author will be presenting at the CFHA conference in San Diego CA this October 2009...Click here to read more

 Peter Fifield is an integrated Behavioral Health Consultant at Families First Health and Support Center; an FQHC in Portsmouth NH. In his off time he is the Managing Editor of CFHA Blog and makes all attempts to keep up with his wife and two sons.

Blog Disclaimer

The view expressed in the blogs and comments should be understood as the personal opinions of the author and do not necessarily reflect the opinions and views of the Collaborative Family Healthcare Association (CFHA). No information on this blog will be understood as official. CFHA offers this blog site for individuals to express their personal and professional opinions regarding their own independent activities and interests.



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