A. M. Heru: Working with Families in Medical Settings: A Multidisciplinary Guide for Psychiatrists and Other Health Professionals

Abstract

Working with Families in Medical Settings: A Multidisciplinary Guide for Psychiatrists and Other Health Professionals by Alison Heru is written for physicians who practice psychosomatic medicine, including psychiatrists, psychiatric residents, and psychosomatic medicine fellows. It also has applications for nurses, social workers, marriage and family therapists in providing services to families in medical settings. Finally, it also is intended to help hospital administrators and their patient committees in developing family oriented patient care. Part I of the book provides a review of current and past family theory and research. Although research on families of the medically ill is vast, it is scattered among many books and journals. Consequently, her review of the literature accomplishes the task of pulling that literature together for practitioners to use as a quick reference and resource. Of particular interest is her description of McCubbin’s resiliency model of family stress, adjustment and adaptation that describes how a family’s ability to handle the stress of illness is moderated by their strengths. A strength-based approach to assessment and intervention sets the tone for practitioners to look at families as their own resource for healthily coping with medical trauma and chronic illness. This strength-based approach is also in alignment with the sweeping changes in the field of mental health that focuses upon recovery and resiliency as a lifestyle that is goal and action oriented, rather than passive and expert driven. Applications of successful strength-based models result in empowerment and increased likelihood of family self-direction and positive adaptation to chronic and traumatic illness. Part II of the book describes the involvement of the family in the health-care system. Heru adequately describes what Family Centered Care (FCC) looks like, and effectively utilizes data from current health care systems utilizing FCC, such as with the Medical College of Georgia and Cincinnati Children’s Hospital. Increases in patient satisfaction, decreases in length of stay, and reduction in medical errors are powerful outcomes to support the FCC model. Heru’s follow-up of specific examples of the use in FCC in patient care setting further drives home the point that involving families in treatment and care is not just a good idea, but an absolute necessity for improving healthcare outcomes. Part II also provides interesting descriptions and support for behavior support plans for disruptive families. The behavior support plans seem to be more of a tool to actively and positively engage disruptive families to focus on the shared desires for patient recovery and wellness. For example, the behavior support plans identify staff and family concerns, and negotiate solutions and clearly inform the family of interventions when the disruptive family member does not meet expectations of the plan. Behavior support plans are not widely used in medical healthcare settings, especially for families, but Heru strongly demonstrates how these plans can give direction to staff, as well as provide expectations for families. Part III provides an analysis of family systems and interventions. This section describes coping styles of individuals, couples and families of illness, models of family assessment, and specific family interventions, and concludes with an analysis of multi-family group interventions. The description and examples of adaptive versus less adaptive coping skills will be particularly helpful for G. Harris (&) Benchmark Human Services, 530 C West Thomas Street, Milledgeville, GA 31061, USA e-mail: gharris@benchmark-hs.com