Families Systems & Health最新文献

Introduction: During conversations about the goals of care, clinicians sometimes use communication strategies that are inadequate for promoting shared decision making. Instead of jointly constructing an equity-based narrative of the patient's illness with the family, clinical care teams often treat the patient as if they are abstracted from their cultural, social, and family background. This approach to decision making fails to account for health inequities and cultural differences while reinforcing asymmetrical power dynamics that favor the health care team and institution.

Method: After reviewing the literature on health communication and health equity, we determined that language, particularly the use of metaphors, can reinforce systems of power that benefit clinical care teams, often at the expense of patients and their families.

Results: In this article, we offer a novel approach to these conversations that considers tensions between the frames of the dominant narrative of individualism used by clinicians who see a patient in abstraction from systems and an equity-based narrative that is concerned with those systems and their impacts on the patient.

Discussion: This article offers some guidance for clinicians on how to craft goals of care conversations in ways that are meaningful to patients and families while enhancing communication and promoting shared decision making. While this article focuses on a specific discussion about caring for a patient in the intensive care unit, the approach offered here could be applied to any goals of care conversation. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: Despite continued efforts to substantiate models and measures, primary care organizations continue to struggle with the implementation of integrated health care (IHC). The incoming editors of Families, Systems, & Health (FSH), a peer-reviewed journal that promotes IHC, seek to define practical and applicable processes and structures that can be adopted to improve patients' mental and behavioral health outcomes vis-a-vis IHC. This brief report assessed coverage of the IHC content areas in articles published in FSH between 2018 and 2023 and informs the coeditors next steps in adopting a framework focused on sustainable integration efforts.

Method: To assess coverage, we conducted a rigorous and comprehensive analysis following the PSALSAR method. A total of 357 articles were analyzed and categorized across 15 thematic content areas operationalized according to the Lexicon for Behavioral Health and Primary Care Integration.

Results: Findings showed that practice management (17.8%), family systems (14.6%), workforce development (13.2%), and diversity (13.2%) have been the most common content areas published in FSH. The least identified content areas included technology (5.6%), personal narratives (6.1%), and dissemination and implementation (7.4%).

Conclusion: We recommend that FSH maintains its emphasis on practice management, workforce development, and related other topics informative to the effective practice(s) of IHC. Moving forward, we also encourage a more balanced pairing of these works with research regarding ways to organize and financially sustain said practice(s) effectively. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

This short 55-word story highlights a clinical psychology doctoral student's work in therapy with individuals diagnosed with rare diseases. Upon diagnosis, clients may experience a range of emotions and feel isolated. Connection with a social network and support can increase hope and promote well-being. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: System-level initiatives are key to promoting health and well-being among young families, yet agencies and organizations who support those families often do not coordinate their delivery of supportive services and resources. We describe the South Carolina (SC) two-generation (2Gen) community of practice (CoP) and its early efforts to foster statewide adoption of "whole family" centered approaches.

Method: This mixed-methods study evaluated the impact of the CoP. Quantitative data were gathered from CoP participants to assess its impact on their increased knowledge and use of the 2Gen approach, as well as on new peer connections and individual professional development. Qualitative data were gathered on the perceived value of the CoP, as well as opportunities for growth.

Results: Data indicate that SC 2Gen CoP meetings have been well received by participants. Data from meeting evaluations demonstrate that the information increased participants' knowledge on the 2Gen approach and that it contributed to their growth and professional development. Meetings have also been effective in promoting connections between like-minded professionals, as well as in providing useful information to integrate 2Gen approaches into their work.

Discussion: These early findings demonstrate the continued need for the SC 2Gen CoP and its potential to grow into a robust outlet to support family-serving professionals in SC. More efforts are needed to promote systems coordination and integration among family-serving professionals. CoPs are one way to integrate system-level strategies, such as the 2Gen approach, to support family-serving professionals and enhance the integration of resources provided to families. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Background: The benefits of utilizing virtual simulation in substance use disorder (SUD) training are emerging in the literature. However, a clear understanding of how behavioral health graduate trainees experience virtual simulation as part of an interprofessional SUD training is still needed.

Method: Graduate-level health professions students (N = 69) from four different behavioral health disciplines completed an interprofessional training program, including completion of two virtual simulations, that addressed SUD screening, brief intervention, and referral to treatment (SBIRT) and teamwork topics using an interprofessional lens. Participants completed a baseline and posttraining survey, pre- and postsimulation surveys, and a recorded debrief meeting postsimulation completion.

Results: Quantitative results indicated statistically significant changes for drug perceptions (p < .001), interprofessional competency (p < .001), and preparedness and confidence implementing the SBIRT model between baseline and posttraining. Two overarching themes were identified as part of the qualitative analysis, including (a) the benefits and limitations of utilizing a structured virtual simulation within the context of interprofessional SUD training and (b) the benefits of utilizing interprofessional knowledge and teamwork when completing the simulation.

Conclusions: Completing an interprofessional training for SUD and SBIRT using simulation may help better prepare behavioral health trainees in applying both SBIRT and interprofessional teamwork principles in their clinical work, thereby addressing the needs of their future patients. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

In this section of the journal, we hope to shine a light on the inventive, innovative, and interprofessional work of integrated behavioral health care for older adults and their families. Traditional geriatric approaches focus on people within a specific age range. We conceptualize interprofessional geriatrics as focusing on people's experiences related to health changes as they age and transition through life stages, engage in wellness and prevention, cope with ramifications of chronic illness, and care for loved ones who are aging themselves. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: According to the biobehavioral family model, family emotional climate and physiobehavioral aspects of emotional reactivity influence the physiological processes underlying health conditions. This research explored the association between family stress, emotional reactivity, and overweight in women.

Method: Participants were patients at cardiovascular risk seen at a cardiovascular wellness center for women. A psychologist conducted semistructured interviews with participants, asking specific questions to address the presence or absence of family stressors. Emotional reactivity was measured using a validated version of the Depression, Anxiety and Stress Scale-21. Logistic and linear regressions were used to calculate relationships between specific family stressors, emotional reactivity scores, and body mass index (BMI).

Results: The final sample included 237 women, mean age of 60.8, who were primarily Jewish residents of Jerusalem. Increased anxiety was consistently associated with high BMI, whether in the context of parenting stress (OR = 1.33, 95% confidence interval [CI, 1.05, 1.69], p < .05), extended family stress (OR = 1.34, 95% CI [1.05, 1.71], p < .05), or marital stress (OR = 1.41, 95% CI [1.05, 1.90], p < .05). While marital stress was not directly associated with BMI, women with higher levels of general stress who also reported marital stress were more likely to exhibit high BMI (OR = 4.14, 95% CI [1.17, 14.59], p < .05).

Discussion: The interaction of marital stress and emotional reactivity (i.e., the experience of general stress) was associated with increased BMI. Further studies should evaluate the interactions between family stressors and emotional factors, which may enable the design of more effective interventions. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Introduction: Strong support for family-based interventions in child and adolescent weight management exists. However, family-based interventions have not been as well documented in adult populations. Given that many adults operate within family systems that could influence their weight management behaviors, research is needed to establish possible family-level variables as intervention targets for adult weight loss programs.

Method: This study tested the relationship between family functioning (defined as support and bonding), chaos (defined as disorder in the home), and weight loss in adults with overweight or obesity participating in a behavioral weight-loss program. Participants (N = 118; baseline mean body mass index 33.8 ± 3.7; 69.5% female; 97.5% White; 67.8% with a combined annual income of $75k or above; 90.7% completed some college or above) were from a randomized controlled trial examining weight loss ripple effects (Gorin et al., 2018) in individuals assigned to either 6 months of WW (formerly Weight Watchers) or a self-guided approach.

Results: Higher family support and bonding at baseline were associated with greater percent weight loss at 6 months. Family support and bonding at baseline were associated with lower chaos in the home at 6 months. However, this was moderated by condition such that this association was significant in the WW but not the self-guided group.

Discussion: Results provide theoretical support that targeting family dynamics may improve weight loss outcomes in behavioral weight loss programs for adults. Future research should test whether family support, bonding, chaos, or other related variables such as family cohesion and adaptability-focused interventions improve weight loss outcomes for adults. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Reviews the book, A Systemic Approach to Behavioral Healthcare Integration: Context Matters by Nancy Ruddy and Susan McDaniel (2024). This book's contributions significantly advance the field with a strategy that advocates for biopsychosocial systemic integrated health care. It is skillfully structured and ideal for professionals and practices ready to embrace change. Whether you are a novice or a seasoned health care professional, this approach allows for actionable insights to enhance the alignment between all health care system levels, ultimately leading to better health outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

While the current workforce shortages are alarming, lack in the face of necessity provides fertile ground for ingenuity. Integrated care (IC) holds the potential for impactful solutions and is, arguably, the best hope on the horizon for improving access to needed care. A larger workforce is necessary but not sufficient to fully address unmet needs. We need IC teams made of health care professionals who understand and are responsive to the patients and communities they serve, the dynamic and interdependent systems in which they provide care, and each other. The way forward will require us to (a) continue the shift from siloed models of professional training and health care delivery to fully integrated communities of interprofessional learning, research, and practice; (b) develop and test theoretical models upon which IC workforce development (WD) efforts can be confidently built, adapted, and systematically studied; (c) embrace all perspectives and incorporate the input and participation of patients and community stakeholders in the design/conduct of IC research, the education and training of the IC workforce, and in WD efforts like recruitment and retention practices; and (d) use systems and design thinking to engineer healthy, supportive, psychologically safe work environments where the tools, tasks, and technology support rather than hinder the work of IC. (PsycInfo Database Record (c) 2025 APA, all rights reserved).