Contemporary Family Therapy

, Volume 34, Issue 2, pp 228–243 | Cite as

Integration: Opportunities and Challenges for Family Therapists in Primary Care

  • Melissa A. Fox
  • Jennifer L. Hodgson
  • Angela L. Lamson
Original Paper


Integration of behavioral and physical health is becoming critical for the overburdened primary care system. Policy changes are needed to accommodate integration nationally. Locally, medical and behavioral health providers are working together to create models that better fit their patients’ comprehensive needs while respecting the clinical, operational, and financial constraints of the current system. Family therapists trained to work in medical settings have an opportunity to emerge as clinical, research, and administrative leaders in this context. However, a paradigm shift is crucial to adapting their systemic orientation to interactions between individual patients, providers, staff, and healthcare and support systems. This article provides family therapists with: (1) an overview of the basic structure and barriers of integration, (2) suggestions on how to deliver quality care despite barriers at the local level, and (3) examples of key advocacy efforts representing possible entryways on a larger scale.


Behavioral health Family therapy Integrated care Integration Medical family therapy Primary care 


  1. Alfuth, R., & Barnard, C. P. (2000). Family physicians and family therapists: Understanding the interdependent synergism. Contemporary Family Therapy, 22, 253–277. doi: 10.1023/A:1007865506702.CrossRefGoogle Scholar
  2. American Academy of Family Physicians. (2011). Mental health care services by family physicians (position paper). Retrieved from
  3. American Association of Marriage and Family Therapy. (2012a). State advocacy: Medicaid fact sheet. Retrieved from
  4. American Association of Marriage and Family Therapy. (2012b). Federal advocacy: Medicare fact sheet. Retrieved from
  5. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, 4th Ed., text revision. Arlington, VA: Author.Google Scholar
  6. Association of American Medical Colleges. (2011). Behavioral and social science foundations for future physicians: Report of the behavioral and social science expert panel. Washington, DC: Author. Retrieved from
  7. Astin, J. A., Soeken, K., Sierpina, V. S., & Clarridge, B. R. (2006). Barriers to the integration of psychosocial factors in medicine: Results of a national survey of physicians. Journal of the American Board of Family Medicine, 19, 557–565.PubMedCrossRefGoogle Scholar
  8. Barry, C. L., & Frank, R. G. (2006). Commentary: An economic perspective on implementing evidence-based depression care. Administration & Policy in Mental Health and Mental Health Services Research, 33, 21–25. doi: 10.1007/s10488-005-4234-2.CrossRefGoogle Scholar
  9. Berk, M. L., & Monheit, A. C. (2001). The concentration of health care expenditures, revisited. Health Affairs, 20(2), 9–18.Google Scholar
  10. Bitar, G. W., Springer, P., Gee, R., Graff, C., & Schydlower, M. (2009). Barriers and facilitators of adolescent behavioral health in primary care: Perceptions of primary care providers. Families, Systems, and Health, 27, 346–361. doi: 10.1037/a0018076.PubMedCrossRefGoogle Scholar
  11. Blount, A. (Ed.). (1998). Integrated primary care: The future of medical & mental health collaboration. New York: Norton.Google Scholar
  12. Blount, A. (2003). Integrated primary care: Organizing the evidence. Families, Systems and Health, 21, 121–133. doi: 10.1037/1091-7527.21.2.121.CrossRefGoogle Scholar
  13. Blount, A., & Bayona, J. (1994). Toward a system of integrated primary care. Families Systems Medicine, 12, 171–182.CrossRefGoogle Scholar
  14. Blount, A., DeGirolamo, S., & Mariani, K. (2006). Training the collaborative care practitioners of the future. Families, Systems, and Health, 24, 111–119. doi: 10.1037/1091-7527.24.1.111.CrossRefGoogle Scholar
  15. Bowen, M. (1978). Family therapy in clinical practice. Northvale, NJ: Jason Aronson.Google Scholar
  16. Butler, M., Kane, R. L., McAlpine, D., Kathol, R. G., Fu, S. S., Hagedorn, H., et al. (2008). Integration of mental health/substance abuse and primary care No. 173 (Prepared by the Minnesota Evidence-based Practice Center under Contract No. 290-02-0009). AHRQ Publication No. 09- E003. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from
  17. Chaffee, B. (2009). Financial models for integrated behavioral health care. In L. C. James & W. T. O’Donohue (Eds.), The primary care toolkit: Practical resources for the integrated behavioral care provider (pp. 19–30). New York: Springer. doi: 10.1007/978-0-387-78971-2_3.Google Scholar
  18. Chiles, J. A., Lambert, M. J., & Hatch, A. L. (1999). The impact of psychological interventions on medical cost-offset: A meta-analytic review. Clinical Psychology: Science and Practice, 6, 204–219. doi: 10.1093/clipsy/6.2.204.CrossRefGoogle Scholar
  19. Chiles, J. A., Lambert, M. J., & Hatch, A. L. (2002). Medical cost-offset: A review of psychological interventions on medical utilization over the past three decades. In N. A. Cummings, W. T. O’Donohue, & K. E. Ferguson (Eds.), The impact of medical cost-offset on practice and research: Making it work for you. Reno, NV: Context Press.Google Scholar
  20. Collins, C. (2009). Integrating behavioral and mental health services into the primary care setting. North Carolina Medical Journal, 70(3), 248–252. Scholar
  21. Crane, D. R. (2011). Does family therapy reduce health care costs for more than the identified patient? Clinical Child Psychology and Psychiatry, 16, 3–4. doi: 10.1177/1359104510397607.PubMedCrossRefGoogle Scholar
  22. Crane, D. R., & Christenson, J. D. (2008). The medical offset effect: Patterns in outpatient services reduction for high utilizers of health care. Contemporary Family Therapy, 30, 127–138. doi: 10.1007/s10591-008-9058-2.CrossRefGoogle Scholar
  23. Cummings, N. A. (2001). A new vision of healthcare for America. In N. A. Cummings, W. O’Donohue, S. C. Hayes, & V. Follette (Eds.), Integrated behavioral healthcare: Positioning mental health practice with medical/surgical practice (pp. 19–37). San Diego, CA: Academic Press.Google Scholar
  24. Cummings, N. A. (2002). Are healthcare practitioners economic illiterates? Families, Systems, & Health, 20, 383–394. doi: 10.1037/h0089593.CrossRefGoogle Scholar
  25. Cummings, N. A., Cummings, J. L., & Johnson, J. N. (Eds.). (1997). Behavioral health in primary care: A guide for clinical integration (pp. 37–58). Madison, CT: Psychosocial Press.Google Scholar
  26. Cummings, N. A., O’Donohue, W. T., & Cummings, J. L. (2009). The financial dimension of integrated behavioral/primary care. Journal of Clinical Psychology in Medical Settings, 16, 31–39. doi: 10.1007/s10880-008-9139-2.PubMedCrossRefGoogle Scholar
  27. DeGruy, F. (1996). Mental health care in the primary care setting. In M. S. Donaldson, K. D. Yordy, K. N. Lohr, & N. A. Vanselow (Eds.), Primary care: America’s health in a new era. Washington, D.C: Institute of Medicine.Google Scholar
  28. DeGruy, F. V. (2000). Mental health diagnoses and the cost of primary care. The Journal of Family Practice, 49(4), 311–313.PubMedGoogle Scholar
  29. DeGruy, F. V., & Etz, R. E. (2010). Attending to the whole person in the patient-centered medical home: The case for incorporating mental healthcare, substance abuse care, and health behavior change. Families, Systems, & Health, 28, 298–307. doi: 10.1037/a0022049.CrossRefGoogle Scholar
  30. Dickinson, W. P., & Miller, B. F. (2010). Comprehensiveness and continuity of care and the inseparability of mental and behavioral health form the patient-centered medical home. Families, Systems, & Health, 28, 348–355. doi: 10.1037/a0021866.CrossRefGoogle Scholar
  31. Doherty, W. J. (2007). Fixing health care: What role will therapists play? Psychotherapy Networker, 31(3), 24–60.Google Scholar
  32. Doherty, W. J., McDaniel, S. H., & Hepworth, J. (1994). Medical family therapy: An emerging arena for family therapy. The Association for Family Therapy, 16, 31–46. doi: 10.1111/j.1467-6427.1994.00775.x.CrossRefGoogle Scholar
  33. Doherty, W. J., McDaniel, S. H., & Baird, M. A. (1996). Five levels of primary care/behavioral healthcare collaboration. Behavioral Healthcare Tomorrow, 5(5), 25–27.PubMedGoogle Scholar
  34. Druss, B. G., & Bornemann, T. (2010). Improving health and health care for persons with serious mental illness: The window for US federal policy change. JAMA, 303, 1972–1973. doi: 10.1001/jama.2010.615.PubMedCrossRefGoogle Scholar
  35. Druss, B. G., Bornemann, T., Fry-Johnson, Y. W., McCombs, H. G., Politzer, R. M., & Rust, G. (2006). Trends in mental health and substance abuse services at the nation’s community health centers: 1998–2003. American Journal of Public Health, 96, 1779–1784. doi: 10.2105/AJPH.2005.076943.PubMedCrossRefGoogle Scholar
  36. Druss, B. G., Hwang, I., Petukhova, M., Sampson, N. A., Wang, P. S., & Kessler, R. C. (2009). Impairment in role functioning in mental and chronic medical disorders in the United States: Results from the national comorbidity survey replication. Molecular Psychiatry, 14, 728–737. Retrieved from
  37. Dym, B., & Berman, S. (1985). Family systems medicine: Family therapy’s next frontier? The Family Therapy Networker, 9, 20–66.Google Scholar
  38. Dym, B., & Berman, S. (1986). The primary health care team: Family physician and family therapist in joint practice? Family Systems Medicine, 4(1), 9–21.CrossRefGoogle Scholar
  39. Edwards, T. M., & Patterson, J. E. (2006). Supervising family therapy trainees in primary care medical settings: Context matters. Journal of Marital and Family Therapy, 32, 33–43. doi: 10.1111/j.1752-0606.2006.tb01586.x.PubMedCrossRefGoogle Scholar
  40. Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129–136. doi: 10.1126/science.847460.PubMedCrossRefGoogle Scholar
  41. Engel, G. L. (1980). The clinical application of the biopsychosocial model. American Journal of Psychiatry, 137, 535–544. Retrieved from
  42. Fries, J., Koop, C., & Beadle, C. (1993). Reducing health care costs by reducing the need and demand for medical services. New England Journal of Medicine, 329, 321–325. doi: 10.1056/NEJM199307293290506.PubMedCrossRefGoogle Scholar
  43. Future of Family Medicine Project Leadership Committee (FFMPLC). (2004). The future of family medicine: A collaborative project of the family medicine community. Annals of Family Medicine, 2(Supp 1), S3–S32. Retrieved from
  44. Gatchel, R. J., & Oordt, M. S. (2003). Clinical health psychology and primary care: Practical advice and clinical guidance for successful collaboration. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  45. Hepworth, J., & Cushman, R. A. (2005). “Biopsychosocial”—essential but not sufficient. Families, Systems, & Health, 23, 406–409. doi: 10.1037/1091-7527.23.4.406.CrossRefGoogle Scholar
  46. Hodgkin, D., Horgan, C. M., Garnick, D. W., Merrick, E. L., & Goldin, D. G. (2000). Why carve out? Determinants of behavioral health contracting choice among large US employers. The Journal of Behavioral Health Services & Research, 27, 178–193. doi: 10.1007/BF02287312.CrossRefGoogle Scholar
  47. Hodgson, J. L., Lamson, A., & Reese, L. (2007). The biopsychosocial-spiritual interview method. In D. Linville & K. M. Hertlein (Eds.), The therapist’s notebook for family health care: Homework, handouts, and activities for individuals, couples, and families coping with illness, loss, and disability (pp. 3–12). New York: Haworth Press.Google Scholar
  48. Institute of Medicine. (1994). Defining primary care: An interim report. Washington, D.C.: National Academies Press. Retrieved from
  49. Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, D.C.: National Academies Press.Google Scholar
  50. Institute of Medicine. (2002). Fostering rapid advances in healthcare: Learning from systems demonstrations. Washington, D.C.: National Academies Press. Retrieved from
  51. Katerndahl, D. A. (2008). Impact of spiritual symptoms and their interactions on health services and life satisfaction. Annals of Family Medicine, 6, 412–420. doi: 10.1370/afm.886.PubMedCrossRefGoogle Scholar
  52. Kathol, R. G., Butler, M., McAlpine, D. D., & Kane, R. L. (2010). Barriers to physical and mental condition integrated service delivery. Psychosomatic Medicine, 72, 511–518. doi: 10.1097/PSY.0b013e3181e2c4a0.PubMedCrossRefGoogle Scholar
  53. Kessler, R. (2008a). How I learned about integrated care by failing miserably: The deadly sins of integration. In R. Kessler & D. Stafford (Eds.), Collaborative medicine case studies: Evidence in practice (pp. 39–50). New York: Springer. doi: 10.1007/978-0-387-76894-6_4.CrossRefGoogle Scholar
  54. Kessler, R. (2008b). Integration of care is about money too: The health and behavior codes as an element of a new financial paradigm. Families, Systems, and Health, 26(2), 207–216. doi: 10.1037/a0011918.CrossRefGoogle Scholar
  55. Kessler, R., & Stafford, D. (2008). Primary care is the de facto mental health system. In R. Kessler & D. Stafford (Eds.), Collaborative medicine case studies (pp. 9–24). Evidence in practice New York: Springer. doi: 10.1007/978-0-387-76894-6_2.CrossRefGoogle Scholar
  56. Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62, 617–627. doi: 10.1001/archpsyc.62.6.617.PubMedCrossRefGoogle Scholar
  57. Klees, B. S., Wolfe, C. J., & Curtis, C. A. (2010). Brief summaries of Medicare and Medicaid: Title XVIII and Title XIX of The Social Security Act as of November 1, 2010. Centers for Medicare & Medicaid Services, Department of Health and Human Services, Baltimore, MD. Retrieved from
  58. Kroenke, K., & Mangelsdorff, D. (1989). Common symptoms in ambulatory care: Incidence, evaluation, therapy and outcome. American Journal of Medicine, 86, 262–266. doi: 10.1016/0002-9343(89)90293-3.PubMedCrossRefGoogle Scholar
  59. Law, D. D., & Crane, D. R. (2000). The influence of marital therapy on health care utilization in a health-maintenance organization. Journal of Marital and Family Therapy, 26, 281–291. doi: 10.1111/j.1752-0606.2000.tb00298.x.PubMedCrossRefGoogle Scholar
  60. Law, D. D., Crane, D. R., & Berg, J. M. (2003). The influence of individual, marital, and family therapy on high utilizers of health care. Journal of Marital and Family Therapy, 29, 353–363. doi: 10.1111/j.1752-0606.2003.tb01212.x.PubMedCrossRefGoogle Scholar
  61. Levant, R. F., House, A. T., May, S., & Smith, R. (2006). Cost offset: Past, present, and future. Psychological Services, 3, 195–207. doi: 10.1037/1541-1559.3.3.195.CrossRefGoogle Scholar
  62. Linville, D., Hertlein, K. M., & Prouty Lyness, A. M. (2007). Medical family therapy: Reflecting on the necessity of collaborative healthcare research. Families, Systems, and Health, 25, 85–97. doi: 10.1037/1091-7527.25.1.85.CrossRefGoogle Scholar
  63. McCann, C. M., & LeRoux, P. (2006). Individual, family, and group therapy for adolescents. Adolescent Medicine Clinics, 17, 217–231. doi: 10.1016/j.admecli.2005.09.003.PubMedGoogle Scholar
  64. McDaniel, S. H., & Campbell, T. L. (1985). Physicians and family therapists: The risk of collaboration. Family Systems Medicine, 4(1), 4–8.CrossRefGoogle Scholar
  65. McDaniel, S. H., Hepworth, J., & Doherty, W. J. (Eds.). (1992). Medical family therapy: A biopsychosocial approach to families with health problems. New York: Basic Books. doi: 10.1080/01926189208250882.Google Scholar
  66. McDaniel, S. H., Campbell, T. L., Hepworth, J., & Lorenz, A. (2005). Family-oriented primary care (2nd ed.). New York: Springer.Google Scholar
  67. Miyamoto, R. E. S. (2006). Billing effectively with the new health and behavior current procedural terminology codes in primary care and specialty clinics. Journal of Clinical Psychology, 62, 1221–1229. doi: 10.1002/jclp.20299.PubMedCrossRefGoogle Scholar
  68. North Carolina Center of Excellence for Integrated Care. (2011). Behavioral health provider billing and coding: ICARE 102—billing/coding/documentation. Retrieved from
  69. Novack, D. H., Volk, G., Drossman, D. A., & Lipkin, M. (1993). Medical interviewing and interpersonal skills teaching in US medical schools. JAMA, 269, 2101–2105. doi: 10.1001/jama.269.16.2101.PubMedCrossRefGoogle Scholar
  70. O’Donohue, W. T., Cummings, N. A., & Ferguson, K. E. (2003). Clinical integration: The promise and the path. In N. A. Cummings, W. T. O’Donohue, & K. E. Ferguson (Eds.), Behavioral health as primary care: Beyond efficacy to effectiveness (pp. 15–30). Reno, NV: Context Press.Google Scholar
  71. O’Donohue, W. T., Cummings, N. A., & Cummings, J. L. (2009). The unmet educational agenda in integrated care. Journal of Clinical Psychology in Medical Settings, 16, 94–100. doi: 10.1007/s10880-008-9138-3.PubMedCrossRefGoogle Scholar
  72. Onarecker, C. D., & Sterling, B.C. (1995). Addressing your patient’s spiritual needs. Family Practice Management, 2, 44–49. Retrieved from
  73. Oser, M., & O’Donohue, W. T. (2009). How to determine the need: A readiness assessment system. In L. C. James & W. T. O’Donohue (Eds.), The primary care toolkit: Practical resources for the integrated behavioral care provider (pp. 3–12). New York: Springer. doi: 10.1007/978-0-387-78971-2_1.Google Scholar
  74. Patterson, J., Peek, C. J., Heinrich, R. L., Bischoff, R. J., & Scherger, J. (2002). Mental health professionals in medical settings: A primer. New York: Norton.Google Scholar
  75. Peek, C. J. (2008). Planning care in the clinical, operational, and financial worlds. In R. Kessler & D. Stafford (Eds.), Collaborative medicine case studies: Evidence in practice (pp. 25–38). New York: Springer. doi: 10.1007/978-0-387-76894-6_3.CrossRefGoogle Scholar
  76. Peek, C. J., & Heinrich, R. L. (1995). Building a collaborative healthcare organization: From idea to invention to innovation. Family Systems Medicine, 13, 327–342. doi: 10.1037/h0089218.CrossRefGoogle Scholar
  77. Peek, C. J., & Heinrich, R. L. (1998). Integrating primary care and behavioral health in a health care organization: From pilot to mainstream. In A. Blount (Ed.), Integrated primary care: The future of medical and mental health collaboration (pp. 167–202). New York: Norton.Google Scholar
  78. Peyrot, M., Rubin, R. R., Lauritzen, T., Snoek, F. J., Matthews, D. R., & Skovlund, S. E. (2005). Psychosocial problems and barriers to improved diabetes management: Results of the cross-national diabetes attitudes, wishes and needs (DAWN) Study. Diabetic Medicine, 22(10), 1379–1385.PubMedCrossRefGoogle Scholar
  79. Pomerantz, A. S., Corson, J. A., & Detzer, M. J. (2009). The challenge of integrated care for mental health: Leaving the 50 minute hour and other sacred things. Journal of Clinical Psychology in Medical Settings, 16, 40–46. doi: 10.1007/s10880-009-9147-x.PubMedCrossRefGoogle Scholar
  80. President’s New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America. Rockville, MD. Retrieved from
  81. Prest, L. A., & Robinson, W. D. (2006). Systemic assessment and treatment of depression and anxiety in families: The BPSS model in practice. Journal of Systemic Therapies, 25(3), 4–24. doi: 10.1521/jsyt.2006.25.3.4.CrossRefGoogle Scholar
  82. Regier, D. A., Goldberg, I. D., & Taube, C. A. (1978). The de facto US mental health services system: A public health perspective. Archives of General Psychiatry, 35, 685–693. Retrieved from
  83. Regier, D. A., Narrow, W. E., Rae, D. S., Manderscheid, R. W., Locke, B. Z., & Goodwin, F. K. (1993). The de facto US mental and addictive disorders service system: Epidemiologic catchment area prospective 1-year prevalence rates of disorders and services. Archives of General Psychiatry, 50, 85–94. Retrieved from
  84. Reiss-Brennan, B. (2010). Cost and quality impact of Intermountain’s mental health integration program. Journal of Healthcare Management, 55(2). Retrieved from
  85. Robert Wood Johnson Foundation. (2011). Health care’s blind side: The overlooked connection between social needs and good health. Retrieved February 12, 2011 from
  86. Robert Wood Johnson Foundation. (nd). AcademyHealth policy brief. Public perspectives on health delivery system reforms: Changes in health care financing & organization. Retrieved from
  87. Robinson, P. J., & Reiter, J. T. (2007). Behavioral consultation and primary care: A guide to integrating services. New York: Springer.CrossRefGoogle Scholar
  88. Robinson, P. J., & Strosahl, K. D. (2009). Behavioral health consultation and primary care: Lessons learned. Journal of Clinical Psychology in Medical Settings, 16, 58–71. doi: 10.1007/s10880-009-9145-z.PubMedCrossRefGoogle Scholar
  89. Ruddy, N. B., & McDaniel, S. H. (2003). Medical family therapy. In T. L. Sexton, G. R. Weeks, & M. S. Robbins (Eds.), Handbook of family therapy: The science and practice of working with families and couples (pp. 365–379). New York: Brunner-Routledge.Google Scholar
  90. Seaburn, D. B., Lorenz, A. D., Gunn, W. B, Jr, Gawinski, B. A., & Mauksch, L. B. (1996). Models of collaboration: A guide for mental health professionals working with health care practitioners. New York: Basic Books.Google Scholar
  91. Seattle Pacific University. (2010). Medical family therapy (MDFT) program overview:Program philosophy. Retrieved from
  92. Strosahl, K. (1994). New dimensions in behavioral health/primary care integration. HMO Practice, 8, 176–179. doi: 10.1016/S1077-7229(05)80084-7.PubMedGoogle Scholar
  93. Strosahl, K. (1997). Building primary care behavioral health systems that work: A compass and a horizon. In N. A. Cummings, J. L. Cummings, & J. N. Johnson (Eds.), Behavioral health in primary care: A guide for clinical integration (pp. 37–58). Madison, CT: Psychosocial Press.Google Scholar
  94. Strosahl, K. (1998). Integrated primary care behavioral health services: The primary mental health care paradigm. In A. Blount (Ed.), Integrated primary care: The future of medical and mental health collaboration (pp. 139–166). New York: Norton.Google Scholar
  95. Strosahl, K. (2005). Training behavioral health and primary care providers for integrated care: A core competencies approach. In W. T. O’Donohue, M. R. Byrd, N. A. Cummings, & D. A. Henderson (Eds.), Behavioral integrative care: Treatments that work in the primary care setting (pp. 15–52). New York: Brunner-Routledge.Google Scholar
  96. Strosahl, K., & Robinson, P. (2008). The primary care behavioral health model: Applications to prevention, acute care and chronic condition management. In R. Kessler & D. Stafford (Eds.), Collaborative medicine case studies: Evidence in practice (pp. 85–96). New York: Springer. doi: 10.1007/978-0-387-76894-6_8.CrossRefGoogle Scholar
  97. Strosahl, K., Baker, N. J., Braddick, M., Stuart, M. E., & Handley, M. R. (1997). Integration of behavioral health and primary care services: The group health cooperative model. In N. A. Cummings, J. L. Cummings, & J. N. Johnson (Eds.), Behavioral health in primary care: A guide for clinical integration (pp. 61–86). Madison, CT: Psychosocial Press.Google Scholar
  98. Thielke, S., Vannoy, S., & Unutzer, J. (2007). Integrating mental health and primary care. Primary care: Clinics in office practice, 34, 571–592. doi: 10.1016/j.pop.2007.05.007.PubMedCrossRefGoogle Scholar
  99. Tyndall, L., Hodgson, J., Lamson, A., White, M., & Knight, S. (2012a). Medical family therapy: A theoretical and empirical review [Special issue]. Contemporary Family Therapy. doi: 10.1007/s10591-012-9183-9.
  100. Tyndall, L., Hodgson, J., White, M., Lamson, A., & Knight, S. (2010). Medical family therapy: Conceptual clarification and consensus for an emerging profession (Unpublished doctoral dissertation). East Carolina University, Greenville, NC.Google Scholar
  101. Tyndall, L., Hodgson, J., White, M., Lamson, A., & Knight, S. (2012b). Medical family therapy: Charting a course in competencies. Contemporary Family Therapy. doi: 10.1007/s10591-012-9191-9.
  102. US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. (2010). The National Survey of Children’s Health 2007. Rockville, Maryland: Author. Retrieved from
  103. US Government Printing Office via GPO Access. (2009). Code of federal regulationsTitle 42Public HealthChapter 1Public health service, Department of health and human servicesPart 5, Appendix CDesignation of health professional(s) shortage areas (10-01-2009 version, pp. 74–78). Retrieved from
  104. VonBertalanffy, L. (1968). System theory: Foundations, development, applications. New York: George Braziller.Google Scholar
  105. Waldman, J. D., Smith, H. L., & Hood, J. N. (2003). Corporate culture: The missing piece of the healthcare puzzle. Hospital Topics, 81, 5–14. doi: 10.1080/00185860309598010.PubMedCrossRefGoogle Scholar
  106. Waldstein, S. R., Neumann, S. A., Drossman, D. A., & Novack, D. H. (2001). Teaching psychosomatic (biopsychosocial) medicine in United States medical schools: Survey findings. Psychosomatic Medicine, 63(3), 335–343. Retrieved from
  107. Watzlawick, P., Weakland, J., & Fisch, R. (1974). Change: Principles of problem formation and problem resolution. New York: Norton.Google Scholar
  108. Wright, L. M., Watson, W. L., & Bell, J. M. (1996). Beliefs: The heart of healing in families and illness. New York: Basic Books.Google Scholar
  109. Yapko, M. D. (2008). Skills or pills? What MFTs can do better than antidepressant medications. Family Therapy Magazine, 7(6), 18–23.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Melissa A. Fox
    • 1
  • Jennifer L. Hodgson
    • 2
  • Angela L. Lamson
    • 2
  1. 1.East Carolina UniversityGreenvilleUSA
  2. 2.East Carolina UniversityGreenvilleUSA

Personalised recommendations