Primary care settings that provide integrative mental health-medical collaboration offer rich opportunities to enhance the quality of care, improve patient outcome, and highlight the value of psychosocial history taking. The authors illustrate these benefits in a detailed case study of an elderly African American female who presented with depression, hypertension, and “wandering” to a family medicine resident and a behavioral science faculty member in a family medicine residency program. A family genogram served as a psychological assessment technique and helped in the differential diagnosis, treatment planning, and deepening of the physician-patient relationship. Hidden family catastrophic experiences in the past, once identified, helped the patient and providers place the presenting symptoms of non-adherence and tragic losses in the greater context of medical and psychological traumas. The article highlights the benefits of a family system approach with genograms for residency training and enhanced quality of medical care.
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