Medical Family Therapy (MedFT) supervisees require specific supervision and training to achieve competency to practice collaborative or integrated care within healthcare settings (Hodgson, Rambo, Boyd, Koehler, & Lamson, 2013; Lamson, Pratt, Hodgson, & Koehler, 2014). The goals of MedFT supervision include helping the supervisee adjust to brief behavioral health encounters, learn, understand and apply the medical language, and to navigate the medical world hierarchy and culture (Lamson et al., 2014). To be a qualified MedFT supervisor, one should have spent time shadowing and interacting within healthcare settings, be able to advise and increase supervisee skills in patient-care interactions, and practice not only from a family systems lens, but also from a biopsychosocial-spiritual perspective (Lamson et al., 2014; Edwards & Patterson, 2006). Supervisee skill development includes learning to obtain patient illness stories and patient healthcare biases, learning to use brief behavioral interventions within healthcare settings, and learning how to collaborate with a multi-disciplinary healthcare team (Lamson et al., 2014).
MedFTs come from various fields, which may have different supervision requirements that vary by state (Lamson et al., 2014). These fields include Marriage and Family Therapy, Counseling, Nursing, Psychology and Social Work. The supervisee should consider these requirements when seeking a MedFT supervisor. Beyond these state-specific licensure requirements, Lamson and colleagues (2014) recommend that when seeking a credible supervisor, the supervisee should know (Lamson et al., 2014):
The existence of any ethical violations on public record
If the supervisor is credible and licensed
The supervisor’s previous healthcare, systemic, and relational work experiences
How the supervisor sees their supervisory role and their expectations in relation to the supervisee and context
At which levels of integrated care the supervisor can adequately provide supervision
Over the course of supervision, it is expected that a supervisee with systemic training will follow Pratt & Lamson’s adaptation of Doherty, McDaniel, & Baird’s five levels of Primary Care/Behavioral Healthcare collaboration (PCBHC), which integrates a five-level systemic supervision framework within the model (Lamson et al., 2014; Doherty, McDaniel, & Baird, 1996). Lamson and colleagues recommend either using the Medical Family Therapy in Healthcare Continuum (MedFT-HCC) or PCBHC to gauge supervisee advancement and training completion (Lamson et al., 2014). These models adapt to the changing needs and expectations of the supervisee and the role of the supervisor over five levels of supervision or care integration (Lamson et al., 2014).
During MedFT supervision, several challenges specific to the MedFT field may arise including:
Multiple on-site and off-site administrative or clinical supervisors
Needs of the healthcare setting, which vary depending on if the scope of treatment is specialized or generalized
The presence or absence of other behavioral healthcare providers in the healthcare setting
These challenges may warrant special considerations and adaptations in the proposed supervisor models. It is recommended that if any challenges do arise that they be considered on a case-by-case basis as each workplace has unique needs and demands (Lamson et al., 2014).
Training and supervision can be expanded to include not only MedFT supervisees, but to other interested providers within healthcare settings (Pratt & Lamson, 2012). The biopsychosocial-spiritual (BPSS) and systemic tools associated with MedFT training are dynamic and allow for a wider scope of understanding surrounding patient health and behaviors (Lamson, 2014). It is recommended that MedFT supervisors that intend to engage in this training utilize a transdisciplinary approach (Tyndall, Hodgson, Lamson, White, & Knight, 2014). A transdisciplinary approach is one where knowledge, expertise and skills are freely, respectfully, and equally shared between disciplines (Hodgson, Lamson, Mendenhall, & Crane; Reitz & Sudano, 2014). The end goal is to better meet patient needs by encouraging healthcare providers to use a relational and systems lens in direct patient care (Hodgson, Lamson, Mendenhall, & Tyndall, 2013).