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History of Medical Family Therapy

 

The practice of what is now known as Medical Family Therapy (MedFT) emerged in the late 1970s/early 1980s to address the gap in the healthcare system between biological and psychosocial health (Tyndall, Hodgson, Lamson, White & Knight, 2014a). Clinical, academic, and administrative professionals in the healthcare field began to recognize the importance of collaboration between medicine and behavioral health, which resulted in a growing relationship between family medicine and marriage and family therapy (MFT) practitioners.1 Across the country, different family therapists worked together with family physicians and began publishing on family oriented care and collaboration (Doherty & Baird, 1983; McDaniel & Campbell, 1986; McDaniel, Campbell, & Seaburn, 1990).

MFT applies Systems Theory to treat individuals, couples, and families struggling with emotional and relational challenges (von Bertalanffy,1968). MedFT is grounded in this practice as well as the biopsychosocial approach, proposed by George Engel in 1977 (Engel, 1977). The biopsychosocial approach was expanded to the biopsychosocial-spiritual after MedFT pioneers recognized the importance of including spirituality in whole-person care.(Wright, Watson, & Bell, 1996). As it is practiced today, MedFT is based in a biopsychosocial-spiritual systems model and encourages active collaboration between members of the healthcare team.

The term Medical Family Therapy first emerged in the literature by McDaniel, Hepworth, and Doherty (1992) in a text titled Medical Family Therapy: A Biopsychosocial Approach to Families with Health Problems (McDaniel, Hepworth, & Doherty, 1992). MedFT addressed the need for systemic and family-oriented approaches across all facets of healthcare. Since its initial evolvement in practice in the 1980s and in the literature in the 1990s, it has developed as an independent field, with MedFTs practicing in primary, secondary, and tertiary healthcare settings (McDaniel, Doherty, & Hepworth, 2014). In response to this expansion in the mid-1990s and 2000s, prominent scholars called for the inclusion of MedFT training within MFT programs, and the field responded (Campbell & Patterson, 1995). The first accredited MedFT doctoral program was established in 2005 at East Carolina University. There are currently 2 PhD programs and 17 MedFT professional programs and training opportunities available in the US (Tyndall, Hodgson, Lamson, White, & Knight, 2014b). Please see section on training for further information.

It is important to note that this growth has not come without controversy. Some initial critics had concerns that the approach was not unique. In the United Kingdom, a biopsychosocial approach to care had been practiced for years. Others agreed, but highlighted MedFTs uniqueness of bringing this perspective to primary care and its foundation in MFT (Tyndall et al., 2014a). At present, the underlying biopsychosocial-spiritual lens and emphasis on collaboration with the medical team remain hallmarks of MedFTs. How this plays out in practice, professional training to become a MedFT, and trueness to McDaniel and colleagues initial text is varied. Therefore, the field of MedFT is currently focused on setting core competencies and evaluation methods.(Tyndall et al., 2014a).