Collaborative Family Healthcare Research Articles

Where do we stand?

This president's column provides the current position of the Collaborative Family Healthcare Association (CFHA) in reference to the law passed in North Carolina on March 23, 2016, limiting the civil rights of LGBTQ people. This law troubles the CFHA deeply. This is an organization that promotes collaborative patient- and family-centered care. It currently celebrates diversity and rejects discrimination in any form. After considerable thought and review of alternative actions, the Board of CFHA determined that our best course is to proceed with plans for an annual conference in Charlotte, a city that has attempted to strengthen legal protection of the rights of its LGBTQ citizens. CFHA will use this opportunity to demonstrate our support for inclusion and cultural competence by convening a robust and timely conversation about the underlying issues raised by House Bill 2 and our role as collaborative care professionals. (PsycINFO Database Record

Looking back and looking forward.

As the author's tenure as President of the Board of Collaborative Family Healthcare Association (CFHA) comes to a close it's time for some reflection on CFHA's past year and where the field of integrated behavioral health care is going. In summary, CFHA is growing, maturing and broadening its partners and its reach. CFHA's accomplishments are increasing, but there is an abundance of work still to do.

The fourth aim: How do we care for our healthcare workforce?

In this column, the president of the Collaborative Family Healthcare Association (CFHA) addresses the question of what the CFHA is doing to create and maintain an engaged, motivated, and satisfied workforce, in the midst of its transformational goals and inherent challenges. The president focuses on three strategies that have the potential to sustain and nurture the people who deliver healthcare. (PsycINFO Database Record

Don Bloch's vision for Collaborative Family Health Care: Progress and next steps.

Don Bloch is the central figure in the origin story for the field of collaborative family health care; the journal Families, Systems, & Health; and for the Collaborative Family Healthcare Association (CFHA). He exerted extraordinary intellectual and practical leadership for all 3. He convened a national working session in 1994 that took stock of the field and set out next steps, one of which was to create the interprofessional organization dedicated to collaborative family health care that is now CFHA. As part of honoring Don Bloch's contributions to the field and this journal, this article sets out tenets of his original vision and traces next steps toward this vision generated by national groups between 1994 and 2014, showing what is the same or different over these 20 years, and especially what this means for the field going forward. Precepts of Don Bloch's original vision are drawn from his writings, including the briefing papers he prepared for the national Wingspread group convened in 1994, which also set out next steps for the field. These steps are then compared with next developmental steps for the field generated by CFHA conference attendees in 2004 and again in 2014, after reviewing the history of the organization and the field. Much of Don Bloch's vision has remained relevant to health care transformation, with a number of areas showing significant accomplishment and acceptance, whereas others remain aspirational, and a few others arguably being more difficult to achieve now than when Don articulated them.

Don Bloch’s vision: A commentary.

Comments on the article "Don Bloch's vision for Collaborative Family Health Care: Progress and next steps" by C. J. Peek (see record 2015-25290-002). Every visionary deserves a skilled integrator and synthesizer such as C. J. Peek. Don would have been impressed with this concise account of the evolution of his own ideas and those of his colleagues in the Collaborative Family Health Care Association, which is Don's greatest legacy-a participatory, visionary, nonguild membership organization. Don Bloch's ecosystemic perspective was all about flattening hierarchies conceptually, clinically, and organizationally. His emphasis on families was also connected to this flattening of hierarchies. Inclusion of families creates more potential for true partnership because the patient needs a team as much as the clinician needs one. The current author wants to hold up the issues of hierarchies, power, and guilds.

Unrounding the corners of collaborative family health care.

C. J. Peek has done us two lasting services with this beautiful summary. He has reminded us of Don Bloch's contributions to the beginning of collaborative family health care, and he has catalogued the elements of Don's vision for the field. Don's vision was for "collaborative family health care." Although we have made a great deal of progress developing collaborative health care that he would endorse, the full vision including the family as a basic unit of care and of understanding in health care is still ahead of us. The requirement of the inclusion of the family in the formulation of the patient-centered medical home may provide the impetus for a full realization of the "unrounded corners" version of Don's vision.

Advancing family involvement in collaborative health care: Next steps.

Comments on the article "Don Bloch's vision for Collaborative Family Health Care: Progress and next steps" by C. J. Peek (see record 2015-25290-002). C. J. Peek has provided us with a masterful integration of Don Bloch's vision of collaborative family health care and the evolution over the past 20 years of the field. The current author was very fortunate to be part of the initial meeting at Wingspread in 1994. As a family systems-oriented community and public health-trained psychiatrist, my primary focus over 30 years has been on families facing chronic illness and disability and collaborative care efforts in specialty, primary, rehabilitation, and palliative care medicine. In my view, the ability of the health care consumer (patient and his or her family members) and professional worlds to collaborate in a more egalitarian and less hierarchical and wary manner remains a significant constraint to progress.

The next frontier: Bringing collaborative care to scale.

In my position as CEO of the Health Federation of Philadelphia (HFP), I am acutely aware of the effort required to implement practice transformation, including fully integrated behavioral health (IBH) and primary care. We integrate knowledge of our marketplace, best practices from the field, and the wisdom of our providers to achieve our practice goals. We have found this to be a key to the success of our advocacy, efficient replication, and rapid regional spread of IBH. Even when payment models, the other driving barrier to IBH, catch up and reflect a better fit with the demands of efficiently integrated, whole-person, teambased care, the challenges resulting from lack of implementation support will still exist. That's where the Collaborative Family Healthcare Association (CFHA) comes in. CFHA can be that centralized and reliable structure to help guide the planning and application of the essential core elements of integrated care: aligned systems, metrics and operations; patient and family centered approaches; workforce competencies; and strategies for stakeholder engagement. In spite of its influence, integrity, and accomplishments, CFHA is still a "too-well-kept secret." By embracing a focused approach, strategic partnerships, clear communication of our unique strengths and capabilities, and the collective might that exists within our own CFHA family, CFHA can grow and thrive and continue to lead the field of collaborative family health care. (PsycINFO Database Record

Inspiration and instruction: Commentary on C. J. Peek's study of Don Bloch's legacy.

Comments on the article "Don Bloch's vision for Collaborative Family Health Care: Progress and next steps" by C. J. Peek (see record 2015-25290-002). C. J. offers us a breathtaking, magnificent gift, itself made from gifts. He has taken something good-Don's seminal contributions- and by showing them off in their properly revealed context, like a stone in a setting, has multiplied their value and created something new in its own right. Make no mistake: this article is a work of serious research, conducted according to the methods of the longest-running research tradition of all-historical research, and specifically, comparative historical research (Turner, 2014).

Building the science: Join us.

Comments on the article "Don Bloch's vision for Collaborative Family Health Care: Progress and next steps" by C. J. Peek (see record 2015-25290-002). As Peek points out, Don Bloch's vision is alive and well. Teams of health and behavioral health professionals are now working in concert with a shared biopsychosocial frame of reference to improve care and health. You have the opportunity to be involved and move science forward. Seek out like-minded colleagues and expect your system to collect process and outcome metrics. Learn and disseminate your knowledge so that we can provide the outstanding services we all deserve.

Supplemental Material for Don Bloch’s Vision for Collaborative Family Health Care: Progress and Next Steps

Supplemental Material for Don Bloch’s Vision for Collaborative Family Health Care: Progress and Next Steps

Collaborative Family Healthcare Association commentary on the "joint principles: Integrating behavioral health care into the patient-centered medical home".

The Collaborative Family Healthcare Association (CFHA) welcomes the opportunity to comment on the complementary set of Joint Principles underscoring the Integration of Behavioral Health Care Into the Patient-Centered Medical Home (The Working Party Group on Integrated Behavioral Healthcare et al., 2014). CFHA is an organization that promotes comprehensive and cost-effective models of health care delivery that integrate mind and body, individual and family, patients, providers, and communities. CFHA appreciates that the Joint Principles do not explicitly endorse any single model of collaboration between behavioral health and medical practice. Rather, they broadly emphasize integration, affirming the only way to have a whole person orientation is to adopt a biopsychosocial-spiritual perspective. This commentary will highlight areas of notable strength within the Joint Principles, as well as challenge the language, if not perspective, on a few critical elements.

Meta-Kucha: The margin or the mainstream?

The inexorable push in integrated care is to move collaboration between biomedical and psychosocial clinicians into the mainstream of health care. This effort requires expanding small models to scale, convening statewide transformation initiatives, and leaving the comfortable confines of safety net clinics to prove integration in the for-profit systems that dominate American health care. CFHA's (Collaborative Family Health care Association's) Pecha Kucha Plenary assembled compelling narratives from the fringes of our health care system. The competing calls from the mainstream and from the margins force tension into our dialogue. However, for our model to be widely embraced, we need blueprints that fit most patients in most clinics. What we learned from the Pecha Kucha narratives is that people at the margins find ways of asserting their voices and achieving their needs. Sometimes it is through their own resilience and disruptiveness; other times it is through an advocate from the mainstream who shares their stories in such a compelling way that they bypass our well-crafted models and spark our souls.

Don Bloch Award, 2013.

Frank deGruy, as recipient of the 2013 Don Bloch Award, presents a brief history of Bloch's contributions to the concept of collaboration in primary and mental health care. Bloch focused on the family as the unit of care for people with mental health problems, but saw something else: a person's psychological state was inextricably linked to his or her physical state. The health of one depended on the health of the other. Bloch started the journal that is now called Families, Systems, & Health, and then decided there was a need for an organization, which became the Collaborative Family Health care Association.

A tribute to Frank V. deGruy on the occasion of honoring him with the Donald Bloch Award.

Recognizes Frank V. deGruy as the recipient of the Donald Bloch Award. deGruy is a leader in integrated, collaborative primary care. He goes so far as to describe mental health and primary care as inseparable, saying attempts to segregate the two inevitably lead to inferior care. His accomplishments include the presidency of Collaborative Family Healthcare Association, during which he involved the organization in grant-getting, to study all aspects of the implementation of integration on the ground. In addition, he argued for and implemented collaboration with other like-minded organizations.

Health care reform, 2014: no matter what the question, mission is the answer.

In this column, the president of the Collaborative Family Healthcare Association (CFHA) addresses the lack of understanding and agreement to the question What is health care reform? It is a daunting task to understand, let alone redesign, the most expensive (but not most effective or most efficient) health care system in the world. In this critical window of opportunity, influencing positive movement through leadership, communication, and teamwork is a strategic priority of the CFHA and its journal, Family Systems & Health. The emphases on comprehensive, coordinated, and cost-effective care, although novel concepts for many, have been core features of CFHA's philosophy for almost two decades (see CFHA's mission statement). As we mark the halfway point in this pivotal year in health care reform, we continue to struggle. CFHA can help illuminate the path of what health care reform can be and what it can do for each citizen in our communities.

Reflections on the fifteenth annual meeting of the Collaborative Family Healthcare Association: Broomfield, Colorado.

The fifteenth annual Collaborative Family Healthcare Association (CFHA) meeting truly "disrupted the status quo." Perhaps part of the disruption came from a "less is more" approach. The combination of brief, focused presentations on either side of a cross national policy discussion pushed us all to reflect and react about what to do next. We look forward to harvesting and sharing your learning about collaborative family health care in future issues of the Journal.

The 2012 Don Bloch Award: Presented October 5, 2012 at the Collaborative Family Healthcare Association Conference, Austin, Texas.

In this article, Larry Mauksch thanks the Collaborative Family Healthcare Association (CFHA) board for the honor in receiving the 2012 Don Bloch Award. The Don Bloch Award is presented annually to a person who has made singular contributions to forwarding the cause of collaborative family health care.

The 2012 Don Bloch Award: Presented by the Collaborative Family Healthcare Association to Larry Mauksch, MEd, October 5, 2012.

The Don Bloch Award is presented annually by the Collaborative Family Healthcare Association (CFHA) to a person who has made singular contributions to forwarding the cause of collaborative family health care. At the 2012 conference in Austin, Texas, the award was presented to Larry Mauksch of the Department of Family Medicine at the University of Washington. Three nominating talks given at that occasion and Larry's acceptance remarks are provided.

The Don Bloch Award: Presented by the Collaborative Family Healthcare Association to Alexander Blount, EdD October 29, 2011.

The Don Bloch Award: Presented by the Collaborative Family Healthcare Association to Alexander Blount, EdD October 29, 2011.