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Family-Oriented Patient Care through the Residency Training Cycle

Received October 2, 2006; revised March 13 and August 14, 2007; accepted August 22, 2007. Dr. Berman is affiliated with the Department of Psychiatry at the University of Pennsylvania in Philadelphia. Dr. Heru is affiliated with the National Jewish Medical and Research Center and the Department of Psychiatry at the University of Colorado in Denver, Colorado. Dr. Grunebaum is affiliated with the Department of Social Medicine at Harvard Medical School in Boston, Mass. Dr. Rolland is affiliated with the Department of Psychiatry and the Center for Family Health at the University of Chicago Pritzker School of Medicine in Chicago, Ill. Dr. Sargent is affiliated with the Departments of Psychiatry and Pediatrics at Baylor College of Medicine in Houston, Tex. Dr. Wamboldt is affiliated with the Departments of Child and Adolescent Psychiatry and Psychiatry at the University of Colorado in Denver, Colo., and Psychiatry and Behavioral Sciences at The Children’s Hospital in Aurora, Colo. Dr. McDaniel is affiliated with the Departments of Psychiatry and Family Medicine and the Institute for the Family at the University of Rochester School of Medicine and Dentistry in Rochester, N.Y. Address correspondence to Ellen Berman, M.D., 321 Mallwyd Rd., Merion, PA 19066; emberman{at}yahoo.com (e-mail).

OBJECTIVE: Because family oriented patient care improves patient outcome and reduces family burden, clinical family skills of communication, assessment, alliance, and support are part of core competencies required of all residents. Teaching residents to "think family" as part of core competencies and to reach out to families requires change in the teaching environment. METHODS: This article advocates teaching residents family skills throughout the training years as an integrated part of routine patient care rather than in isolated family clinics or a course in "family therapy." It reviews family skills required of residents in all treatment settings and family skills that are specific to inpatient, emergency room, outpatient, and consultation-liaison services. RESULTS: Families can be seen in multiple treatment settings throughout resident training using recent research to support appropriate interventions for patients and caregivers. CONCLUSION: The process of establishing change in the training environment requires a commitment on the part of the training faculty to include families, but is possible within the current training framework.

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