Origins and applications
Patient care plan that involves healthcare professionals from a wide variety of areas.
Holistic healthcare, the concept that the body is not just a collection of separate and distinct parts but rather an assemblage of interrelated components that form a unified whole, is at the root of interdisciplinary treatment. The holistic viewpoint is that mental health is related to and interdependent on physical well-being, and viceversa. An interdisciplinary treatment team has the ability to pool their knowledge and expertise towards the recovery of the whole individual, not just his or her disease.
The members and make-up of the interdisciplinary team are tailored to the patient and his or her physical, emotional, and functional needs. Team members may include, but are not limited to, physicians (from a variety of medical specialties), nurse practitioners, surgeons, psychologists, psychiatrists, social workers, school counselors, nutritionists, physical therapists, vocational counselors, occupational therapists, and creative therapists (i.e., art therapists, music therapists).
Origins and applications
Interdisciplinary treatment was first introduced to mental healthcare in the United States in the late 1940s by Dr. William Menninger and colleagues. Menninger, who was then chief of Army neuropsychiatry and president and co-founder of the renowned Menninger Clinic, would become the 75th President of the American Psychological Association (APA) in 1949, providing him the opportunity to promote the benefits of treatment teams to a wide audience of healthcare professionals.
Today, mental healthcare professionals are becoming involved in a wider spectrum of what have been traditionally considered physical ailments. Psychologists have become an essential part of the treatment team in oncology (cancer medicine), geriatric medicine, cardiology (heart and circulatory medicine), pediatric medicine, and other specialties. Likewise, cross-disciplinary teams have become more common in mental healthcare. Individuals suffering from a disease such as schizophrenia, for example, may be treated by a team consisting of a psychiatrist, a psychologist, a neurologist, a vocational counselor, a family therapist, an art therapist, and a social worker.
Some patients may require ancillary services and after-care support such as vocational rehabilitation (job training or retraining), independent living skills training, social skills training, and housing assistance. For these individuals, specialists outside of traditional medical disciplines may be integrated into the interdisciplinary team.
Interdisciplinary teams are becoming more commonplace in clinical settings that involve healthcare research, also. A program for teen pregnancy prevention started at the University of Minnesota in 1997 is staffed with a team of psychologists, sociologists, physicians, nutritionists, nurses, biostatisticians, epidemiologists, and others who can provide effective strategies, and translate their results into meaningful research data that can improve quality of care.
Hospice care, a treatment setting for terminally ill patients, is another example of interdisciplinary treatment at work. Hospice patients, who are often coping with chronic pain and with emotional and spiritual issues related to the end of life, require care that focuses on both physical symptom relief and emotional wellbeing. Their interdisciplinary care may consist of one or more physicians, a psychologist, a family therapist, and other healthcare professionals. In addition, bereavement care for the patient's family is often worked into the overall interdisciplinary treatment plan.
One of the challenges of an interdisciplinary treatment approach is harmonizing the varying methods and philosophies of different professionals into a cohesive care plan that works toward a unified treatment goal. One approach is for the interdisciplinary team to perform the intake interview (or initial assessment) of the patient in a group setting to ensure unity in their treatment approach, and then follow up with regularly scheduled meetings to create the treatment plan and adjust it as necessary as they follow the patient's progress.
However, the logistics of such a plan are often difficult, given the patient care load of many healthcare providers. What is more common is the appointment of a case manager, who is responsible for coordinating delivery of treatment and following the patient's progress, to organize and inform the treatment team. The manager provides the patient with a "point person" to approach with any problems or concerns. They also have responsibility for scheduling therapies and treatments in the correct sequence for maximum benefit to the patient, and for coordinating aftercare services such as housing assistance and networking the patient with support groups. Case managers are often licensed social workers, but can also be laypeople.
Satcher, David. Mental Health: A Report of the Surgeon General. Washington, D.C.: Government Printing Office, 1999. [available online at www.surgeongeneral.gov]
American Psychological Association (APA). 750 First Street, NE, Washington, D.C., USA. 20002-4242, 202-336-5500, 800-374-2721. Email: firstname.lastname@example.org. http://www.apa.org.