Family Medicine

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World Book of Family Medicine – European Edition 2015 2012;25:565-71. 4. Irish Primary Care Research Networks [cited 2014 Nov 30]. Available from: www.ipcrn.ie 5. Rortveit G. Research networks in primary care: An answer to the call for better clinical research. Scand J Prim Health Care. 2014;32:107-9. 6. Pharmaceutical Product Development: Advantages of Being a Clinical Trial Investigator. [cited 2014 Nov 30]. Available from: www.ppdi.com/Participate-In-Clinical-Trials/Become-an-Investigator/Advantages.aspx 7. Peppercorn JM, Weeks JC, Cook EF, Joffe S. Comparison of outcomes in cancer patients treated within and outside clinical trials: conceptual framework and structured review. Lancet. 2004;363:263-70. 8. Comis RL, Miller JD, Aldige CR, Krebs L, Stoval E. Public attitudes toward participation in cancer clinical trials. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2003;21:830-5. 302
World Book of Family Medicine – European Edition 2015 Radkin Honzák, MD vselek@lf1.cuni.cz 99 – Family Therapy Skills for Medical Practitioners Radkin Honzák, MD Institute of General Practice, First Faculty of Medicine, Charles University in Prague Co-author Bohumil Seifert, MD, PhD Introduction Despite societal changes, the family remains the most basic unit in society. The general practitioner is, more than other health care providers, involved and associated with the family and develops a perceptive awareness of a family´s nature and style of living. One challenge in general practice is the need to pay attention to the stresses, social changes, and expectations of family members over time, as well as the effect that these and other family interactions have on the health of the individual patient (1). The concern is not only with psychological and psychosomatic disorders, but it is also emerging with chronic disease management in particular, which is becoming the major topic for general practice in our time. One example is the importance of the family's perception of disease and the treatment of diabetes (2). A family-oriented approach is one of the basic attributes of general practice (3, 4). Family-oriented primary care involves thinking about the patient's problem in the context of the whole person and the person's significant others. These other persons, such as family members, can eventually be invited to help or be involved in the assessment or treatment processes. Although this can be considered a simplified model of family therapy in general practice, family therapy is in fact a much more complicated method, requiring specific competence, technique and allocated time, all of these conditions being barely achievable in daily routine practice. Family therapy is one of the psychotherapeutic techniques used primarily in the treatment of psychosomatic disorders. It is proposed that – whenever possible – the whole family, not just the individual labelled as the bearer of the symptoms, enters into the treatment. A symptom is considered a stabilizing element in a dysfunctional family. The aim of treatment is to improve communication in the family and improve its functioning in order to stabilize the illness into healthier patterns without symptoms. Family therapy uses a range of counselling and other techniques including: Structural therapy, Strategic therapy, Systemic/Milan therapy, Narrative therapy, Transgenerational therapy. Therapy usually takes place in multiple sessions spaced out over several months. Family therapy can be used in a variety of clinical settings, including general practice. There are few reports in the literature about the use of family therapy in general practice (5,6). However, under current health care systems, it is not the task of a family doctor to engage in family therapy – unless they hold a particular interest and special training. Rather, it is the task of a family doctor to look for signals that make a contextual approach necessary, and then act upon it appropriately. In order to find signals one has to undergo training in: 303
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Family Medicine

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