Child health inequities are largely the result of entrenched, structural barriers created by racism, sexism, xenophobia, classism, and ableism that generally persist across the life course (Braveman & Gottlieb, 2014). The impact of such inequities may be magnified for those with complex needs who face considerable challenges in adulthood (Bethell et al., 2014), such as preterm infants, who experience threats to both short- and longterm health and development. Challenges in integrated care remain for all children, especially this population, despite extensive work across many decades to address such issues. The family-centered medical home has been the dominant pediatric care model in the United States for the last four decades (Stille et al., 2010). Despite emphasizing cultural humility and placing family at the care team core, the medical home model has not been able to deliver on securing equitable, integrated care for all (Bennett et al., 2012). (PsycInfo Database Record (c) 2024 APA, all rights reserved).
{"title":"To achieve equitable, integrated care for children, family-centered work must focus on systems.","authors":"Lindsay Rosenfeld, Jonathan S Litt","doi":"10.1037/fsh0000809","DOIUrl":"10.1037/fsh0000809","url":null,"abstract":"<p><p>Child health inequities are largely the result of entrenched, structural barriers created by racism, sexism, xenophobia, classism, and ableism that generally persist across the life course (Braveman & Gottlieb, 2014). The impact of such inequities may be magnified for those with complex needs who face considerable challenges in adulthood (Bethell et al., 2014), such as preterm infants, who experience threats to both short- and longterm health and development. Challenges in integrated care remain for all children, especially this population, despite extensive work across many decades to address such issues. The family-centered medical home has been the dominant pediatric care model in the United States for the last four decades (Stille et al., 2010). Despite emphasizing cultural humility and placing family at the care team core, the medical home model has not been able to deliver on securing equitable, integrated care for all (Bennett et al., 2012). (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10827344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Increasing the substance use workforce is vital in addressing the many complexities of opioid use among families. The purpose of the present research was to examine 6-month outcomes of a training program focusing on opioid use among families, for master-level family therapy (MFT) and community mental health counseling (CMHC) students.
Method: In total, 58 students participated in self-reported survey assessments at baseline and 6-month follow-up across the following domains: attitudes about substance use, interpersonal professional collaboration, trainee confidence, professional quality of life, and cross-cultural counseling competence.
Results: The study results indicated a significant improvement between scores on attitudes of working with families impacted by substance use disorders from baseline to follow-up. There was a significant positive change in cross-cultural competency, interprofessional competency, and trainee confidence from baseline to follow-up.
Discussion: The findings contribute to extant literature by examining the potential role of participating in substance use training for graduate-level MFT and CMHC trainees and considerations for implementing specific substance use training components among graduate-level trainees. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
导言:要解决家庭中阿片类药物使用的诸多复杂问题,增加药物使用人员队伍至关重要。本研究的目的是对针对家庭治疗(MFT)和社区心理健康咨询(CMHC)硕士生开展的以家庭中阿片类药物使用为重点的培训项目的 6 个月成果进行检验:共有 58 名学生参加了基线和 6 个月随访时的自我报告调查评估,涉及以下领域:对药物使用的态度、人际专业合作、受训者信心、专业生活质量和跨文化咨询能力:研究结果表明,从基线到随访期间,受训人员在与受药物使用障碍影响的家庭合作的态度方面的得分有了明显改善。从基线到随访,跨文化能力、跨专业能力和受训者自信心都有了明显的积极变化:讨论:研究结果通过考察研究生水平的 MFT 和 CMHC 受训人员参加药物使用培训的潜在作用,以及在研究生水平的受训人员中实施特定药物使用培训内容的注意事项,为现有文献做出了贡献。 (PsycInfo Database Record (c) 2024 APA, all rights reserved)。
{"title":"Understanding families impacted by opioid use: Outcomes of a therapist training program.","authors":"Jessica L Chou, Rikki Patton, Asif Zaarur, Heather Katafiasz, Phyllis Swint, Yue Dang, Erika Feeney","doi":"10.1037/fsh0000818","DOIUrl":"10.1037/fsh0000818","url":null,"abstract":"<p><strong>Introduction: </strong>Increasing the substance use workforce is vital in addressing the many complexities of opioid use among families. The purpose of the present research was to examine 6-month outcomes of a training program focusing on opioid use among families, for master-level family therapy (MFT) and community mental health counseling (CMHC) students.</p><p><strong>Method: </strong>In total, 58 students participated in self-reported survey assessments at baseline and 6-month follow-up across the following domains: attitudes about substance use, interpersonal professional collaboration, trainee confidence, professional quality of life, and cross-cultural counseling competence.</p><p><strong>Results: </strong>The study results indicated a significant improvement between scores on attitudes of working with families impacted by substance use disorders from baseline to follow-up. There was a significant positive change in cross-cultural competency, interprofessional competency, and trainee confidence from baseline to follow-up.</p><p><strong>Discussion: </strong>The findings contribute to extant literature by examining the potential role of participating in substance use training for graduate-level MFT and CMHC trainees and considerations for implementing specific substance use training components among graduate-level trainees. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10435621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Darnell N Motley, Jordan Victorian, Kaylah Denis, Byron D Brooks
Intersectionality is a transformative analytic tool for identifying and challenging how intersecting, systemic power relations generate differential outcomes in quality of life (P. Collins, 2019; Crenshaw, 1989). Intersectionality identifies how varied forms of power relations are interconnected and mutually constituted: simultaneously influencing and influenced by one another. As these power relations interact to shape social experiences, they result in social inequalities including unequal distributions of harm, violence, and neglect. Too often, social problems are approached through singular categories of experience (e.g., class, race, or gender) under the assumption that these categories are not mutually constituted. Intersectionality instead highlights the intersection and interactions between such categories, with close attention to the social power conferred or limited given inclusion in a given constellation of categories. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
交叉性是一种变革性的分析工具,用于识别和质疑相互交叉的系统性权力关系如何在生活质量方面产生不同的结果(P. Collins,2019 年;Crenshaw,1989 年)。交叉性确定了各种形式的权力关系是如何相互关联和相互构成的:同时相互影响和制约。当这些权力关系相互作用形成社会经验时,就会导致社会不平等,包括伤害、暴力和忽视的不平等分配。社会问题往往是通过单一的经验类别(如阶级、种族或性别)来解决的,假设这些类别不是相互构成的。相反,交叉性强调了这些类别之间的交叉和互动,并密切关注被纳入特定类别群所赋予或限制的社会权力。(PsycInfo Database Record (c) 2024 APA, all rights reserved)。
{"title":"Applying an intersectionality framework to health services research.","authors":"Darnell N Motley, Jordan Victorian, Kaylah Denis, Byron D Brooks","doi":"10.1037/fsh0000859","DOIUrl":"10.1037/fsh0000859","url":null,"abstract":"<p><p>Intersectionality is a transformative analytic tool for identifying and challenging how intersecting, systemic power relations generate differential outcomes in quality of life (P. Collins, 2019; Crenshaw, 1989). Intersectionality identifies how varied forms of power relations are interconnected and mutually constituted: simultaneously influencing and influenced by one another. As these power relations interact to shape social experiences, they result in social inequalities including unequal distributions of harm, violence, and neglect. Too often, social problems are approached through singular categories of experience (e.g., class, race, or gender) under the assumption that these categories are not mutually constituted. Intersectionality instead highlights the intersection and interactions between such categories, with close attention to the social power conferred or limited given inclusion in a given constellation of categories. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This sonnet is a brief symbolic meditation on the brevity of life and the "thin red line": by turns blood (stream/supply and life-giving), a boundary to be crossed (the Rubicon), the limit of our medical (and surgical) endeavors, and finally our horizon. "The thin red line" is also a metaphor for resistance, attributed in part to Kipling's poem Tommy: in particular to resilience by the few, against ostensibly superior forces. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
这首十四行诗是对生命短暂和 "细细的红线 "的简短象征性沉思:红线依次是血液(血流/供给和生命)、需要跨越的边界(卢比肯河)、我们医疗(和外科)工作的极限,最后是我们的地平线。"红线 "也是抵抗的隐喻,部分源自吉卜林的诗歌《汤米》:特别是少数人对表面上的优势力量的抵抗。(PsycInfo Database Record (c) 2024 APA, 版权所有)。
{"title":"The thin red line.","authors":"James Seymour Huntley","doi":"10.1037/fsh0000798","DOIUrl":"10.1037/fsh0000798","url":null,"abstract":"<p><p>This sonnet is a brief symbolic meditation on the brevity of life and the \"thin red line\": by turns blood (stream/supply and life-giving), a boundary to be crossed (the Rubicon), the limit of our medical (and surgical) endeavors, and finally our horizon. \"The thin red line\" is also a metaphor for resistance, attributed in part to Kipling's poem <i>Tommy</i>: in particular to resilience by the few, against ostensibly superior forces. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This poem recounts a patient's experience with pancreatic cancer. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
这首诗讲述了一位胰腺癌患者的经历。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
{"title":"Like a country without NATO.","authors":"Justin C Cordova","doi":"10.1037/fsh0000804","DOIUrl":"10.1037/fsh0000804","url":null,"abstract":"<p><p>This poem recounts a patient's experience with pancreatic cancer. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-05-25DOI: 10.1037/fsh0000801
Lucinda B Leung, Joya G Chrystal, Karen E Dyer, Catherine E Brayton, Michael A Karakashian, Elizabeth M Yano, Alexander S Young, Paul G Shekelle, Alison B Hamilton
Introduction: During the COVID-19 pandemic, primary care providers (PCPs), nurses, and integrated mental health specialists continued to collaboratively manage depression among patients using both in-person and virtual (i.e., hybrid) modalities. Few studies have characterized how hybrid services are currently delivered within interdisciplinary primary care teams. This study aimed to understand frontline PCPs' perspectives on providing hybrid virtual and in-person depression care during the pandemic.
Method: From September to November 2020, 12 semistructured individual interviews focused on depression management were conducted with PCPs in two Veterans Health Administration (VA) clinics in Los Angeles, which resumed in-person services while balancing rising COVID-19 cases. Interviews were audio-recorded, transcribed, and coded for depression management patterns. Themes were derived using a team-based constant comparative analytic approach.
Results: The pandemic and subsequent expanded use of virtual care necessitated clinic adaptations to depression assessments and procedures. PCPs perceived increased depression and anxiety among patients with existing psychiatric conditions, attributed to social distancing and isolation restrictions. They expressed acceptance of virtual care modalities for patients' depression management. PCPs did not perceive a delay in mental health care delivery in the shift to virtual care but noted the possibility of patients being lost to follow-up.
Conclusions: During the pandemic, there has been heightened PCP concern for patients' emotional well-being and adaptations of clinic processes to meet needs for depression care. While PCPs were optimistic about new virtual care options for depression management, virtual care transfers remained poorly defined and the extent to which patient care experiences and health outcomes have been disrupted remains unknown. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
{"title":"Primary care provider perspectives on virtual and in-person depression management during the COVID-19 pandemic.","authors":"Lucinda B Leung, Joya G Chrystal, Karen E Dyer, Catherine E Brayton, Michael A Karakashian, Elizabeth M Yano, Alexander S Young, Paul G Shekelle, Alison B Hamilton","doi":"10.1037/fsh0000801","DOIUrl":"10.1037/fsh0000801","url":null,"abstract":"<p><strong>Introduction: </strong>During the COVID-19 pandemic, primary care providers (PCPs), nurses, and integrated mental health specialists continued to collaboratively manage depression among patients using both in-person and virtual (i.e., hybrid) modalities. Few studies have characterized how hybrid services are currently delivered within interdisciplinary primary care teams. This study aimed to understand frontline PCPs' perspectives on providing hybrid virtual and in-person depression care during the pandemic.</p><p><strong>Method: </strong>From September to November 2020, 12 semistructured individual interviews focused on depression management were conducted with PCPs in two Veterans Health Administration (VA) clinics in Los Angeles, which resumed in-person services while balancing rising COVID-19 cases. Interviews were audio-recorded, transcribed, and coded for depression management patterns. Themes were derived using a team-based constant comparative analytic approach.</p><p><strong>Results: </strong>The pandemic and subsequent expanded use of virtual care necessitated clinic adaptations to depression assessments and procedures. PCPs perceived increased depression and anxiety among patients with existing psychiatric conditions, attributed to social distancing and isolation restrictions. They expressed acceptance of virtual care modalities for patients' depression management. PCPs did not perceive a delay in mental health care delivery in the shift to virtual care but noted the possibility of patients being lost to follow-up.</p><p><strong>Conclusions: </strong>During the pandemic, there has been heightened PCP concern for patients' emotional well-being and adaptations of clinic processes to meet needs for depression care. While PCPs were optimistic about new virtual care options for depression management, virtual care transfers remained poorly defined and the extent to which patient care experiences and health outcomes have been disrupted remains unknown. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10674027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9573516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-07-20DOI: 10.1037/fsh0000822
Diana M Ohanian, Grayson N Holmbeck
Introduction: Chronic pain does not reside within an individual. Pain is affected by and affects larger systems (e.g., families). We examined longitudinal, bidirectional associations between chronic pain and family functioning in spina bifida (SB). We hypothesized a bidirectional association between pain and family functioning (cohesion and conflict); youth chronic pain status would be associated with maladaptive family functioning and maladaptive family functioning would be associated with youth chronic pain status.
Method: Participants were from an ongoing longitudinal study of adolescents with SB (N = 140, 53.6% female, ages 8-15 at Time 1). Data were collected every 2 years, with this study using data from Times 1 and 2 (T1, T2; T1: 2006-2009, T2: 2008-2011). Parents reported on youth demographics and family functioning. Youth reported on family functioning and pain; pain was dichotomized into a categorical variable (chronic pain vs. no chronic pain). Family functioning (cohesion and conflict) was also assessed using observational data.
Results: Youth chronic pain status was associated with decreased family conflict (child report) and increased cohesion (parent report) over time. Increased family conflict (parent report) was associated with a greater likelihood of reporting chronic pain 2 years later. Findings were nonsignificant between observed family conflict or cohesion and chronic pain in either direction.
Discussion: With the presence of an additional stressor (chronic pain) families increase cohesion and reduce conflict. Increased conflict may increase a child's vulnerability of developing chronic pain. It is critical that interventions for both pain and family functioning in SB are guided by a strengths-based model. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
{"title":"Bidirectional, longitudinal associations between chronic pain and family functioning in youth with spina bifida.","authors":"Diana M Ohanian, Grayson N Holmbeck","doi":"10.1037/fsh0000822","DOIUrl":"10.1037/fsh0000822","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain does not reside within an individual. Pain is affected by and affects larger systems (e.g., families). We examined longitudinal, bidirectional associations between chronic pain and family functioning in spina bifida (SB). We hypothesized a bidirectional association between pain and family functioning (cohesion and conflict); youth chronic pain status would be associated with maladaptive family functioning and maladaptive family functioning would be associated with youth chronic pain status.</p><p><strong>Method: </strong>Participants were from an ongoing longitudinal study of adolescents with SB (<i>N</i> = 140, 53.6% female, ages 8-15 at Time 1). Data were collected every 2 years, with this study using data from Times 1 and 2 (T1, T2; T1: 2006-2009, T2: 2008-2011). Parents reported on youth demographics and family functioning. Youth reported on family functioning and pain; pain was dichotomized into a categorical variable (chronic pain vs. no chronic pain). Family functioning (cohesion and conflict) was also assessed using observational data.</p><p><strong>Results: </strong>Youth chronic pain status was associated with decreased family conflict (child report) and increased cohesion (parent report) over time. Increased family conflict (parent report) was associated with a greater likelihood of reporting chronic pain 2 years later. Findings were nonsignificant between observed family conflict or cohesion and chronic pain in either direction.</p><p><strong>Discussion: </strong>With the presence of an additional stressor (chronic pain) families increase cohesion and reduce conflict. Increased conflict may increase a child's vulnerability of developing chronic pain. It is critical that interventions for both pain and family functioning in SB are guided by a strengths-based model. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10799168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9828797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-07-20DOI: 10.1037/fsh0000817
Julie C Gass, Stephen A Maisto, David Edelman, Jennifer S Funderburk
Introduction: Conjoint visits utilize the expertise of primary care providers (PCPs) and behavioral health providers (BHPs) to address complex comorbidities in patients. The objectives were to describe the use and features of conjoint visits and identify barriers and facilitators as described by BHPs in integrated settings.
Method: Three hundred and forty-five BHPs who worked in integrated primary care, a majority identifying as female and white, completed an online survey between October 2018 and July 2019.
Results: Results indicated common reasons for conjoint visits were for mental or behavioral health concerns. Though they reported high comfort using conjoint visits (M = 4.3/5), 56.5% of BHPs participated in them less than monthly or never. Using a constant comparison approach, qualitative data were coded to reveal six categories of barriers and five categories of facilitators to conjoint visits. The most common barriers were a result of a lack of systemic support, such as 73.5% reporting lack of time, while the most common facilitators were coordination (60.7%) and interprofessional communication (39.3%).
Discussion: Although conjoint visits are used infrequently, findings suggest it is not because they are unhelpful as providers generally found this type of appointment favorable. Rather, they and their teams lack time, training, and support needed for implementation. This research provides an introduction for researchers or clinicians to better understand the use of conjoint visits for patients with high needs and complexities. Future work focused on addressing barriers cited by providers regarding conjoint visits would increase providers' ability to use this form of care when it is needed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
{"title":"Brief conjoint visits between an embedded behavioral health provider and primary care team member: When are they used and what are the barriers and facilitators?","authors":"Julie C Gass, Stephen A Maisto, David Edelman, Jennifer S Funderburk","doi":"10.1037/fsh0000817","DOIUrl":"10.1037/fsh0000817","url":null,"abstract":"<p><strong>Introduction: </strong>Conjoint visits utilize the expertise of primary care providers (PCPs) and behavioral health providers (BHPs) to address complex comorbidities in patients. The objectives were to describe the use and features of conjoint visits and identify barriers and facilitators as described by BHPs in integrated settings.</p><p><strong>Method: </strong>Three hundred and forty-five BHPs who worked in integrated primary care, a majority identifying as female and white, completed an online survey between October 2018 and July 2019.</p><p><strong>Results: </strong>Results indicated common reasons for conjoint visits were for mental or behavioral health concerns. Though they reported high comfort using conjoint visits (<i>M</i> = 4.3/5), 56.5% of BHPs participated in them less than monthly or never. Using a constant comparison approach, qualitative data were coded to reveal six categories of barriers and five categories of facilitators to conjoint visits. The most common barriers were a result of a lack of systemic support, such as 73.5% reporting lack of time, while the most common facilitators were coordination (60.7%) and interprofessional communication (39.3%).</p><p><strong>Discussion: </strong>Although conjoint visits are used infrequently, findings suggest it is not because they are unhelpful as providers generally found this type of appointment favorable. Rather, they and their teams lack time, training, and support needed for implementation. This research provides an introduction for researchers or clinicians to better understand the use of conjoint visits for patients with high needs and complexities. Future work focused on addressing barriers cited by providers regarding conjoint visits would increase providers' ability to use this form of care when it is needed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9835219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01Epub Date: 2023-09-28DOI: 10.1037/fsh0000827
Brianna M Lombardi, Catherine Greeno, Lisa de Saxe Zerden
Introduction: Despite evidence to support the integration of behavioral health and physical health care, the adoption of Integrated Behavioral Health (IBH) has been stymied by a lack of reliable and sustainable financing mechanisms. This study aimed to provide information on the use of Psychiatric Collaborative Care Model (CoCM) and behavioral health integration (BHI) codes and the implementation of IBH in federally qualified health centers (FQHCs).
Method: This cross-sectional, mixed-methods study involved an electronic survey of administrators and follow-up qualitative interviews from a subset of survey respondents. Quantitative data were analyzed using descriptive analysis and thematic coding was used to analyze qualitative data to identify salient themes.
Results: Administrators (N = 52) from 11 states completed the survey. Use of CoCM (13%) or BHI codes (17.4%) was low. Most administrators were not aware that CoCM (72%) or BHI codes (70%) existed. Qualitative interviews (n = 9) described barriers that further complicate IBH and code use like workforce shortages and insufficient reimbursement for the cost to deliver CoCM services.
Discussion: Although FQHCs are working to meet the needs of the communities they serve, a lack of billing clarity and awareness and workforce issues hinder the adoption of the CoCM. FQHCs face many demands to provide care to safety net populations, yet are not fully equipped with the resources, workflows, staffing, and payment structures to support CoCM/BHI billing. Increased financial and logistical support to build practice infrastructure is needed to reduce the administrative complexity and inadequate reimbursement mechanisms that currently hinder the implementation of the CoCM and integrated care delivery. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
{"title":"Examining the use of psychiatric collaborative care and behavioral health integration codes at federally qualified health centers: A mixed-methods study.","authors":"Brianna M Lombardi, Catherine Greeno, Lisa de Saxe Zerden","doi":"10.1037/fsh0000827","DOIUrl":"10.1037/fsh0000827","url":null,"abstract":"<p><strong>Introduction: </strong>Despite evidence to support the integration of behavioral health and physical health care, the adoption of Integrated Behavioral Health (IBH) has been stymied by a lack of reliable and sustainable financing mechanisms. This study aimed to provide information on the use of Psychiatric Collaborative Care Model (CoCM) and behavioral health integration (BHI) codes and the implementation of IBH in federally qualified health centers (FQHCs).</p><p><strong>Method: </strong>This cross-sectional, mixed-methods study involved an electronic survey of administrators and follow-up qualitative interviews from a subset of survey respondents. Quantitative data were analyzed using descriptive analysis and thematic coding was used to analyze qualitative data to identify salient themes.</p><p><strong>Results: </strong>Administrators (<i>N</i> = 52) from 11 states completed the survey. Use of CoCM (13%) or BHI codes (17.4%) was low. Most administrators were not aware that CoCM (72%) or BHI codes (70%) existed. Qualitative interviews (<i>n</i> = 9) described barriers that further complicate IBH and code use like workforce shortages and insufficient reimbursement for the cost to deliver CoCM services.</p><p><strong>Discussion: </strong>Although FQHCs are working to meet the needs of the communities they serve, a lack of billing clarity and awareness and workforce issues hinder the adoption of the CoCM. FQHCs face many demands to provide care to safety net populations, yet are not fully equipped with the resources, workflows, staffing, and payment structures to support CoCM/BHI billing. Increased financial and logistical support to build practice infrastructure is needed to reduce the administrative complexity and inadequate reimbursement mechanisms that currently hinder the implementation of the CoCM and integrated care delivery. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41160316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Reviews the book The empathy exams: Essays. Empathy is a universally important aspect of both life and medicine that helps cultivate a therapeutic relationship between healthcare professionals and patients, family and loved ones, community members and friends, and beyond. As the times have evolved, empathy has become increasingly essential in not only elevating the quality of patient-centered care but also nurturing meaningful relationships and compassionate bonds among communities and families. Empathy encompasses an emotional understanding of another's pain and suffering and also invites self-reflection and humility. In The Empathy Exams, the author sheds light on the meaning of empathy through her memoir of experiences and perspectives as a nonhealthcare professional, community member, patient, family member, and friend. Even though the author herself does not practice in the medical setting, from the bond between the physician and patient to the empathetic connection between patients and families, The Empathy Exams explores a thematic and insightful discussion on empathy as a lifelong exploration through multidimensional angles from experiencing personal illness to caring for a loved one. Ultimately, The Empathy Exams encourages all-both medical professionals, nonhealthcare communities and families-to reflect and rethink about empathy in themselves, patients, and loved ones, transforming individual pain and suffering into communal hope and humanity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
评论《移情考试》一书:论文。同理心是生活和医学中一个普遍重要的方面,有助于培养医护人员与患者、家人和亲人、社区成员和朋友等之间的治疗关系。随着时代的发展,移情变得越来越重要,它不仅能提高以病人为中心的护理质量,还能培养社区和家庭之间有意义的关系和富有同情心的纽带。同理心包括对他人痛苦的情感理解,也包括自我反省和谦逊。在《同理心考试》一书中,作者通过她作为非医疗专业人士、社区成员、病人、家庭成员和朋友的经历和观点回忆录,揭示了同理心的意义。尽管作者本人并不从事医疗工作,但从医生与病人之间的纽带到病人与家人之间的共情联系,《共情考试》通过从亲身经历疾病到照顾亲人等多维角度,对共情作为一种终身探索进行了主题鲜明、深入浅出的探讨。最终,《同理心考试》鼓励所有人--无论是医疗专业人士、非医疗界人士还是家属--反思和重新思考自己、病人和亲人的同理心,将个人的痛苦和折磨转化为共同的希望和人性。(PsycInfo Database Record (c) 2024 APA,保留所有权利)。
{"title":"Review of The empathy exams: Essays.","authors":"Julia H Miao","doi":"10.1037/fsh0000824","DOIUrl":"10.1037/fsh0000824","url":null,"abstract":"<p><p>Reviews the book <i>The empathy exams: Essays</i>. Empathy is a universally important aspect of both life and medicine that helps cultivate a therapeutic relationship between healthcare professionals and patients, family and loved ones, community members and friends, and beyond. As the times have evolved, empathy has become increasingly essential in not only elevating the quality of patient-centered care but also nurturing meaningful relationships and compassionate bonds among communities and families. Empathy encompasses an emotional understanding of another's pain and suffering and also invites self-reflection and humility. In The Empathy Exams, the author sheds light on the meaning of empathy through her memoir of experiences and perspectives as a nonhealthcare professional, community member, patient, family member, and friend. Even though the author herself does not practice in the medical setting, from the bond between the physician and patient to the empathetic connection between patients and families, The Empathy Exams explores a thematic and insightful discussion on empathy as a lifelong exploration through multidimensional angles from experiencing personal illness to caring for a loved one. Ultimately, The Empathy Exams encourages all-both medical professionals, nonhealthcare communities and families-to reflect and rethink about empathy in themselves, patients, and loved ones, transforming individual pain and suffering into communal hope and humanity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}