Medical family therapy in integrated primary care: An interactional framework

Abstract

The Institute of Medicine (IOM) has described primary health care as "the provision of integrated, accessible healthcare services by clinicians who are accountable for addressing a large majority of personal healthcare needs, developing a sustained partnership with patients, and practicing in the context of family and community" [sic] (1996, p. 31). Frontline primary care providers (e.g., physicians, nurse practitioners, physician assistants) typically work with patients who present with comorbidities that involve often complex and interrelated psychosocial and physiological health issues (Blount & Bayona, 1994; Ostbye, Yarnall, Pollak, Gradison, & Michener, 2005; Robinson & Reiter, 2007). Due to the complexity of patient health problems and the emergence of primary care as the de facto behavioral health system in the USA, providers often find themselves addressing a myriad of patient illnesses and psychosocial issues (Adler, Shaw, Sitt, Maya, & Morrill, 2009; O'Connor, Solberg, & Baird, 1998; Strosahl, 1996). As a consequence, primary care providers may experience role exhaustion (Bodenheimer, 2006).