Families Systems & Health最新文献

{"title":"Improved pediatric behavioral health appointment scheduling in an integrated primary care program.","authors":"Anjali D Sapkal, Jasmine R Holt, Devin P Adams, Hilary M Bowers, Vanessa Sarabia, Alissa Jae Lazo-Kim, Jason Schweitzer, Andrew Richardson, Anne Bird, Kathryn A Hollenbach","doi":"10.1037/fsh0000985","DOIUrl":"10.1037/fsh0000985","url":null,"abstract":"<p><strong>Introduction: </strong>To better understand appointment scheduling for pediatric behavioral health (BH) referrals, we examined appointment scheduling behavior among patients with and without access to primary care mental health integration (PCMHI).</p><p><strong>Method: </strong>A prospective cohort study compared PCMHI and non-PCMHI pediatric patients with BH referrals from January 17, 2022, to June 10, 2022. Six pediatric primary care clinics affiliated with a southern California Children's Hospital were studied: two PCMHI and four non-PCMHI clinics with similar patient demographic characteristics. BH referrals at PCMHI clinics are directly referred to the embedded integrated health therapists. Non-PCMHI clinics referred patients to community BH services. Data were collected from electronic health record abstraction and telephone interviews.</p><p><strong>Results: </strong>PCMHI (<i>n</i> = 471) and non-PCMHI (<i>n</i> = 97) groups did not differ significantly in patient characteristics. About 87.3% (<i>n</i> = 172) of PCMHI patients eligible for an integrated health therapist initial BH appointment scheduled their appointment within 14 days compared to 9.2% (<i>n</i> = 7) of the non-PCMHI patients (χ² = 148.2, <i>p</i> < .001). There was no difference in median days to initial BH appointment between the cohorts, PCMHI: 21 (interquartile range = 15, 27.5) and non-PCMHI: 23 (interquartile range = 13, 35), <i>p</i> = .71. Primary reasons for not scheduling initial BH appointments were similar for both groups and included confusion about the referral and patient/parent busy schedules.</p><p><strong>Conclusion: </strong>Patients in the PCMHI cohort were more likely to schedule their initial BH appointment compared to the non-PCMHI cohort. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":"3-13"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How they are making it work: Behavioral health consultant perspectives on the integration of behavioral health into primary care.","authors":"Megha Gupta, Alexandra McGarry Williams, Lisa Mikesell, Benjamin F Crabtree, Ann M Nguyen","doi":"10.1037/fsh0001034","DOIUrl":"10.1037/fsh0001034","url":null,"abstract":"<p><strong>Purpose: </strong>Integrated behavioral health (IBH) embeds behavioral health services into primary care settings. Despite evidence of its cost and clinical effectiveness, IBH has had limited widespread implementation. As on-the-ground providers, it is important to understand how behavioral health consultants (BHCs) perceive the state of IBH implementation and to identify key strategies they use to overcome IBH implementation challenges.</p><p><strong>Method: </strong>We conducted qualitative, in-depth interviews with 10 BHCs in different care settings in New Jersey. Interviewees were identified using purposeful, snowball sampling. During data collection, immersion-crystallization review was used to assess thematic saturation, with an editing analysis style conducted in a group setting to identify themes.</p><p><strong>Results: </strong>IBH requires a hard-fought paradigm shift, and the established (biomedical) paradigm remains. BHCs reported continually learning and adapting to \"make it work\" within this paradigm using four key strategies: (a) Changing the mindset of one physician at a time, (b) saying \"yes\" to tasks beyond the role's expectations until trust has been established, (c) proactively identifying patients who may benefit from IBH services, and (d) being physically visible to physicians and staff.</p><p><strong>Conclusions: </strong>Widespread IBH requires a paradigm shift, one in which biomedical and behavioral health are equitably considered as health care. Future physicians need to be socialized to the IBH philosophy early in their training. IBH training should also be offered as continuing education for practicing physicians. Finally, leaders in the field of IBH need to make the BHC role less ambiguous. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":"50-66"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empathy in medical practice.","authors":"Mikal Fikremariam","doi":"10.1037/fsh0001012","DOIUrl":"https://doi.org/10.1037/fsh0001012","url":null,"abstract":"<p><p>Empathy is a fundamental aspect of effective medical care, fostering trust and emotional healing alongside physical recovery. This narrative reflects an experience during a surgical rotation with a patient and their spouse, who had endured a long, painful journey of recurrent small bowel obstructions. Faced with uncertainty and anxiety, the couple desired not only answers but reassurance from their health care providers. Through compassionate communication, active listening, and emotional support, the health care team was able to alleviate the patient's fears and help him move forward with a much-needed surgery. This essay highlights the impact of empathy in medical practice, demonstrating its essential role in building trust, addressing emotional needs, and facilitating healing. By emphasizing empathy, health care providers can significantly improve patient outcomes and restore confidence in the health care system. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":"44 1","pages":"104-105"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality improvement study of collaborative care model services at a federally qualified health center: A uniform data system-informed approach.","authors":"Amber Flanigan-Bodrick, Phyllis Solomon","doi":"10.1037/fsh0000955","DOIUrl":"10.1037/fsh0000955","url":null,"abstract":"<p><strong>Introduction: </strong>The Collaborative Care Model (CoCM) is an evidenced based approach to integrating behavioral health into primary care to improve depression outcomes. This quality improvement study explores the utility of implementing CoCM with fidelity at a federally qualified health center to improve depression remission outcomes based on Uniform Data System metrics. Uniform Data System defines depression remission as Patient Health Questionnaire-9 (PHQ-9) score below 5 at 12 months ± 60 days after initial positive depression screening.</p><p><strong>Method: </strong>This study used the CoCM registry and medical record data to generate a sample of 251 patients between 2021 and 2022. PHQ-9 was employed to evaluate depression outcomes. Multiple regression and repeated measures t tests were used for hypothesis testing.</p><p><strong>Results: </strong>The sample consisted of almost three-quarters of women and over half African American with a mean age of 40. CoCM was associated with a 12.60-point reduction in PHQ-9 scores between enrollment and follow-up at 12 months ± 60 days. A 1-point increase in fidelity was associated with a ∼4-point lower PHQ-9 score at posttest, and 1-point increase in treatment adherence was related to a 1-point decrease. Each 25 additional days of enrollment was associated with ∼1/2 point decrease.</p><p><strong>Discussion: </strong>CoCM delivered with fidelity can support federally qualified health centers in improving depression remission rates at 12 months ± 60 days after initial positive depression screen. Fidelity, treatment adherence, length of enrollment, and time in care can positively impact outcomes. Further research is needed to evaluate additional study variables including psychopharmacology, psychiatric, and medical conditions in depression outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":"38-49"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brief introductions to increase engagement with integrated psychology services in primary care.","authors":"Erin T Tobin, Eve DePascale, McKenzie N Berezin, Michael Evitts, Emily Thomas, Anupama Nair, David Willens","doi":"10.1037/fsh0001033","DOIUrl":"10.1037/fsh0001033","url":null,"abstract":"<p><strong>Background: </strong>Warm handoffs have shown to improve engagement in care for integrated services; however, often patients cannot stay for an additional appointment. The current work set out to understand if a brief introduction-a nonbillable encounter where a psychology team member meets with the patient and schedule a future appointment-can improve attendance in care for patients.</p><p><strong>Method: </strong>Participants included 171 patients who were referred to an integrated psychology team with behavioral health consultants (BHCs) within a primary care clinic. Data was tracked from December 2023 until February 2024. Team members were asked to notify the psychology team when placing a referral to complete a warm handoff or brief introduction. Referrals, brief introductions, and attendance were pulled from the electronic medical record.</p><p><strong>Results: </strong>About 38.6% of patients referred to the psychology team completed a brief introduction with a BHC. About 80.3% of patients who completed a brief introduction went on to complete a visit with a BHC whereas 57.1% of those who were referred for an appointment without a brief introduction completed an appointment. There is a significant relationship between the brief introduction and attendance at a future appointment (McNemar's test χ² = 28.99, <i>p</i> < .01).</p><p><strong>Discussion: </strong>Briefly meeting with a BHC is linked with attendance at future visits. The current work extends research with warm handoffs to show that a brief nonbillable encounter is associated with engagement in psychological services in an integrated care setting with a diverse patient population and calls for specificity in strategies to increase patient engagement. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treating posttraumatic stress disorder in Veterans Affairs Primary Care Mental Health Integration settings: What psychological interventions are being used in standard practice?","authors":"Kyle Possemato, Allyson Smith, Kimberly Barrie, Cecilia Zemanek, Emily Johnson, Eric Kuhn","doi":"10.1037/fsh0001031","DOIUrl":"https://doi.org/10.1037/fsh0001031","url":null,"abstract":"<p><strong>Introduction: </strong>Posttraumatic stress disorder (PTSD) among primary care patients is common, associated with negative health outcomes, and has inadequate rates of mental health treatment. Evidence-based interventions for PTSD that are appropriate for Primary Care Mental Health Integration (PCMHI) settings have been developed but are not yet widely disseminated. Therefore, the nature of psychological interventions to treat PTSD in PCMHI settings is largely unknown.</p><p><strong>Method: </strong>The study describes the content of 223 PCMHI sessions delivered as part of normal clinical care for 88 patients with PTSD across two Veterans Health Administration (VHA) health care systems. Session notes were coded using a general inductive approach for (a) assessment content, (b) problem focus, (c) interventions delivered, and (d) referrals to behavioral health services.</p><p><strong>Results: </strong>Assessment was typically included in sessions, but repeated administration of self-report measures was less common. Sessions were most commonly focused on PTSD, stress, and sleep. Common interventions delivered were recommending specific self-help tools (e.g., apps and websites), recommending relaxation strategies, and providing psychoeducation about PTSD and PTSD treatment. Almost half (48%) of patients were referred to additional behavioral health services.</p><p><strong>Conclusion: </strong>Veterans Health Administration PCMHI providers are routinely delivering evidence-informed interventions for PTSD. However, there is room for improvement in adhering to measurement-based care principles and delivering interventions with the strongest evidence for reducing PTSD. The methods of this study can be used to engage in quality improvement efforts to enhance the quality of PCMHI services for PTSD. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distress dynamics in patient and partner dyads early after stroke/transient ischemic attack: A pilot feasibility study.","authors":"Talea Cornelius, Alvis Gonzalez, Danielle A Rojas, Ammie Jurado, Ari Shechter","doi":"10.1037/fsh0001032","DOIUrl":"10.1037/fsh0001032","url":null,"abstract":"<p><strong>Background: </strong>Acute cardiovascular events are highly distressing for patients and their romantic partners. Partner presence in the emergency department (ED) may increase patients' distress due to mutual exposure to hospital stressors and dyadic influences, but studies are lacking. This pilot feasibility study enrolled patients with stroke/transient ischemic attack (TIA) and their partners to complete surveys and physical activity monitoring. Dyadic disruption theory informed hypotheses about distress transmission (i.e., corumination and shared reality as moderators).</p><p><strong>Method: </strong>Partners of stroke/TIA patients were recruited from an ongoing observational cohort study in a large, urban academic medical center. Surveys were conducted at baseline and 1-month posthospital discharge. Partners present during ED evaluation additionally completed accelerometry to monitor physical inactivity. Feasibility outcomes were recruitment, retention, and adherence to study procedures. ED distress, acute stress symptoms, and posttraumatic stress within patients and partners were explored.</p><p><strong>Results: </strong>Of 35 partners contacted, 18 provided consent (51.4%), 16 of whom (88.9%) were retained (<i>M</i>_age = 56.13, <i>SD</i> = 14.73, 56.3% women, 50.0% White). Partner adherence to accelerometry was high (72.7%). ED distress predicted acute stress and posttraumatic stress symptoms for dyads reporting a high degree of shared understanding about the stroke/TIA (\"shared reality\").</p><p><strong>Conclusion: </strong>Despite challenges presented by the COVID-19 pandemic, recruitment rates are typical for this population, and retention was excellent. As hypothesized, ED distress persisted when shared reality was high. Larger studies powered to detect dyadic influence effects in distress development and correspond distress to secondary prevention behaviors are warranted. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12695036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family-centered decision making in living liver transplantation: Analyzing the tripartite physician-patient-family model in Taiwan.","authors":"Ching Fang Wu, Shih-Chieh Fang, Ching Ying Huang, Chen-Wei Yang, Fu-Sheng Tsai, Yih-Jyh Lin, Yi-Hsiu Lin","doi":"10.1037/fsh0001013","DOIUrl":"10.1037/fsh0001013","url":null,"abstract":"<p><strong>Introduction: </strong>Living donor liver transplantation (LDLT) necessitates effective shared decision making (SDM) to ensure optimal outcomes. Traditional models focus on the physician-patient dyad; however, in Taiwan, family involvement is integral to the decision-making process. This study addresses the gap by proposing a tripartite model that incorporates physicians, patients, and family members to capture the cultural nuances influencing LDLT decisions.</p><p><strong>Method: </strong>A retrospective chart review was conducted on 105 LDLT cases from the Transplant Surgery Department at National Cheng Kung University Hospital (2015-2022). The study employed thematic analysis to examine qualitative data extracted from medical records, including medical, psychiatric, and social evaluations, thereby identifying key themes in the decision-making process.</p><p><strong>Results: </strong>Analysis revealed that LDLT decision making in Taiwan is predominantly family-centered. Three main themes emerged: the initiation of SDM by physicians and primary caregivers, a comprehensive risk assessment process integrating both clinical and psychosocial perspectives, and a final decision-making stage driven by collective family consensus. These findings highlight the complex interplay between medical factors and familial dynamics in donor selection and transplant outcomes.</p><p><strong>Discussion: </strong>The study extends traditional binary decision-making models by highlighting the critical role of family involvement in LDLT. The tripartite framework not only reflects Taiwan's cultural context but also offers valuable insights for improving clinical practices and health care policies. Integrating family-centered approaches into SDM processes may enhance patient safety, promote ethical practices, and ultimately lead to better transplant outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":"708-723"},"PeriodicalIF":1.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis in the digital age.","authors":"Sai S Kurapati, Antonio Yaghy, Ingrid U Scott","doi":"10.1037/fsh0000961","DOIUrl":"https://doi.org/10.1037/fsh0000961","url":null,"abstract":"<p><p>The integration of artificial intelligence (AI), algorithms, and digital tools into healthcare diagnostics is rapidly transforming the field. This piece explores the interplay between these technological advancements and the continuing need for human empathy in medical care. By examining how AI is reshaping the doctor-patient relationship, the piece emphasizes both the promises and uncertainties of digital medicine. The recurring phrase, \"this is diagnosis in the digital age,\" metaphorically represents AI's integration into healthcare, while highlighting the need to hear the human voice behind the technology. Accompanying the work is a unique visual representation, created with OpenAI's DALL·E 3 and refined by the authors using Adobe Firefly, which further illustrates the fusion of technology and humanity. By merging artistic expression with medical themes, this poem provides a nuanced view of AI in healthcare. It serves as both a reflection on the future of medical practice and a reminder of the fundamental human elements that remain vital to patient-centric care. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":"43 4","pages":"766-767"},"PeriodicalIF":1.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective associations of insomnia and nightmares with suicidal behavior among primary care patients.","authors":"Logan M Smith, Justin C Baker, Craig J Bryan","doi":"10.1037/fsh0000973","DOIUrl":"10.1037/fsh0000973","url":null,"abstract":"<p><strong>Introduction: </strong>Insomnia and nightmares have both been associated with suicide risk and are both known to be commonly reported in a primary care setting. However, we are unaware of any studies examining the sleep-suicide relationship in the primary care setting. Clarifying these relationships could reveal important clues for improving suicide prevention efforts in primary care and other medical settings.</p><p><strong>Method: </strong>Participants included 2,744 primary care patients recruited from six clinics located at five U.S. military installations. Participants completed measures of suicidal ideation, insomnia, and nightmares at baseline and suicidal ideation and suicide attempts were tracked at 6- and 12-month follow-up interviews.</p><p><strong>Results: </strong>Of the 1,792 patients with follow-up data, 57 (3.2%) attempted suicide during the 12-month follow-up. Patients who attempted suicide during follow-up were more likely than patients who did not attempt suicide to have clinical insomnia and nightmares at least weekly. When adjusting for baseline suicidal ideation, clinical insomnia and nightmares at least weekly remained significant predictors of follow-up suicide attempts.</p><p><strong>Conclusions: </strong>Our findings suggest that insomnia and nightmares are accurate predictors of subsequent suicidal behavior among a primary care population and may offer positive predictive value for suicidal behavior over and above what can be provided by assessing suicidal ideation alone. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":55612,"journal":{"name":"Families Systems & Health","volume":" ","pages":"667-674"},"PeriodicalIF":1.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}