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Spring 2006 | Volume 29, Number 2 | Features

Holistic Healing

Collaborative treatment of mind, body, and spirit makes the difference for patients and families

Picture this: You’re training for your first marathon; your family just moved into a bigger house (the kids love their new backyard); and you finally got that promotion at the office. Life seems, well, perfect. Then, crash. You didn’t see that car cross into your lane. You’re alive, but the accident has left you with chronic pain. You spend the next months in and out of treatment centers. Nurses, doctors, and physical therapists swirl around you like worker bees repairing a hive. But they don’t seem to be communicating with each other, and the pain in your body is now causing pain in your mind.

Janae and Travis Wilson at home with their daughters, McKenzie (left) and Emilie (right, held by her father). Emilie was born with a rare brain-damaging disease that has left her with the mind of a 7-month-old infant.

Depressed? I’m not crazy, you tell yourself. But a voice inside is crying out for help. Focused on your physical prognosis, your doctors don’t seem to be concerned that you’ve lost your job and that you may lose the house, too; that your spouse hardly smiles anymore; that your kids’ grades are plummeting. And suddenly, while your body is getting first-class treatment, your mind and spirit are about to signal a code red. Enter collaborative care.

It’s a relatively new trend in medicine based on the principle that body and mind are intertwined and should be treated as such — holistically. Specifically, collaborative care suggests that health care providers of all kinds should work together to meet the full range of a patients’ needs. The movement is gaining momentum across the nation, from universities such as Seattle Pacific to top medical centers and national policymakers.

Last year, the Collaborative Family Healthcare Association (CFHA), in concert with the American Psychological Association (APA), launched the Health Care for the Whole Person Task Force. APA President Ronald Levant has stated, “One core assumption that requires rethinking is the idea of the separation of mind from body … that there are some illnesses that are physical and others that are mental.” By assuming such separation, Levant explains, we have created a dysfunctional health care system: “As we all know, mind and body are not separate, but rather they are inseparable.” The CFHA takes this concept a step further, affirming the “patient, family, community, and provider systems as equal participants in the health care process.”

Adds Levant, “We need to transform our biomedical health care system to one based on the biopsychosocial model, which will emphasize collaboration between medical and behavioral health care providers, and the integration of psychology into the very heart of heath care.”

These ideas are ones that Seattle Pacific has long embraced. The three elements of the biopsychosocial model — bio (physical), psycho (mental), and social (relational) — make up the foundation for the academic program in SPU’s School of Psychology, Family, and Community (SPFC). What is unique, however, to SPFC is the fourth principle it embraces: the spiritual. “Luke 2:52 says, ‘Jesus grew in wisdom, stature, and favor with God’ — that’s our model for biopsychosocial-spiritual care,” says Claudia Grauf-Grounds, chair of the Marriage and Family Therapy program. “It’s not about compartmentalizing faith; it’s about letting faith be an instrument of healing.”

Seattle Pacific’s Medical Family Therapy (MDFT) certificate program, one of only eight such programs in the nation, trains marriage and family therapists and other psychosocial providers to work in outpatient clinical settings alongside physicians. “We are the only program that has a spirituality component as part of our core training,” says MDFT Director Tina Schermer Sellers. As she launched the program in 2000, Sellers drew on her professional experience working with cancer patients. When the patients wanted to talk about issues of faith, she noticed that some of her colleagues were reluctant and unprepared for such dialogue. “Patients want to have these kinds of conversations,” she says. “That’s why we prepare SPU students to be ready.”

It’s the kind of care that considers the mind, body, spirit, and relationships, explains Sellers, that makes a difference in the lives of patients: “When people deal with chronic illness, all aspects of their lives are affected. Current treatment models just don’t deal with the depth and complexity of what patients and their families are experiencing.”

A major roadblock to collaborative care is the “this-is-theway-we’ve-always-done-it” mentality. Medical schools don’t often train their students to engage in conversations about patients’ psychological or spiritual concerns, yet family practice clinics are typical places where depression and other mental illnesses present themselves. “A large accumulation of research says that the way we’re currently treating patients is ineffective,” says Sellers.

She and Grauf-Grounds believe that collaborative care can bridge the gap. Both worked to bring the national Collaborative Family Healthcare Association Conference to Seattle last year and organized a groundbreaking pre-conference event, the Northwest Health Care Summit, which assembled health care leaders such as hospital and insurance company CEOs, legislators, and policymakers to discuss issues related to collaborative care. “There is more readiness for change than I’ve ever seen,” says Sellers, also noting a recent parity law passed in Washington state that levels the playing field between physical and mental health insurance coverage.

For Sellers, the momentum provides hope for the future of collaborative health care: “In 10 years, I believe you’ll be able to gophysito the doctor’s office and also be treated by a psychosocial provider. The family, as well as the individual patient, will become the unit of care.”

In the meantime, she, Grauf-Grounds, and others at SPU are hard at work training students to understand how life stress and illness can affect the mental health of patients and their families. Bringing her clinical experience to the classroom, Sellers often relates experiences from the Northwest Cancer Resource Center, where she worked alongside oncologists treating breast cancer patients. After prepping patients for the inevitable — chemotherapy and the accompanying hair loss and nausea — she helped them with emotional and relational issues as well.

“So often women assume that breast cancer has made them undesirable, and they think their husbands find them unattractive,” she says. But when Sellers encouraged patients to invite their husbands to therapy sessions, she helped the couples discuss their fears. “I found that the men were less physically intimate with their wives because they were afraid of hurting them,” she says. “I got them talking about what they were afraid to say, and before long I’d see the husbands break down and tell their wives, ‘I don’t care if you don’t have breasts. I just love you so much, and want you to be OK.’”

“In medicine, it’s so easy to simply focus on the patients, but so much of what they’re dealing with involves families and relationships,” adds Grauf-Grounds. As part of a patient’s treatment, medical family therapists sometimes bring the entire family together to discuss how the person’s illness affects each family member. In one of her therapy sessions, Sellers encouraged a woman and her family to document her breast cancer experience in a scrapbook. Instead of bottling up their emotions, the children drew pictures of their mother with a bald head, and the scrapbook helped in the healing process.

While collaborative care sounds like a great idea to many physicians and clinicians, there are still obstacles. Many have practical concerns. “They worry that co-locating a behavioral specialist in their practice will be difficult and expensive,” explains Sellers. But placing Seattle Pacific medical family therapy interns in clinics can make it easier for doctors and psychotherapists to embrace the idea of collaborative care. Says Sellers, “Once doctors experience this way of working, and see the benefits to their patients, they never want to go back.”


—By Sarah Jio
— PHOTOS BY Mike Siegel

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