Promoting a holistic family care model: Ethical and practical considerations for treating adult caregivers in integrated pediatric settings

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Clinical Practice in Pediatric Psychology


Objective: As pediatric behavioral health concerns are increasingly identified and addressed within pediatric primary care and family medicine practices, behavioral health providers (BHPs) in integrated primary care (IPC) are often faced with not only addressing the psychosocial needs of their child patients, but also confronting the needs of those patients' caregivers. Given the extensive body of evidence demonstrating that child mental health is associated with caregiver mental health, continued discussions of addressing caregiver mental health within the integrated care context are warranted. Method: The current paper will discuss obstacles to establishing family-centered comprehensive behavioral care including ethical concerns around informed consent, scope of practice, and dual relations, and various practice considerations. Results: The obstacles are greater for establishing family-centered comprehensive behavioral care within pediatric settings compared to family practice settings due to the additional practice considerations. The potential benefit to children and the broader family system may warrant the effort. Conclusions: By identifying and discussing these issues, BHPs working within pediatric and family medicine settings are encouraged to engage in active dialogue with hospital and clinic administrators to overcome systemic barriers and to think flexibly about how BHPs might expand upon existing approaches in order to utilize the IPC opportunity to address parent mental health concerns that may otherwise impede a child's treatment progress.

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