Interdisciplinary Treatment

Patient care plans that involve a combination of treatment options provided by healthcare professionals from a wide variety of clinical disciplines.

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. Practitioners who support interdisciplinary care view holistic care as a relationship between mental health and physical well-being. An interdisciplinary treatment team has the ability to pool their knowledge and expertise towards the recovery of the whole individual, not just treat his or her disease or disease symptoms.

The selection of members of an interdisciplinary team is tailored to the individual patient and his or her physical, emotional, and functional needs. Team members may include, but are not limited to, physicians from a variety of clinical disciplines, nurse practitioners, surgeons, psychologists, psychiatrists, psychotherapists, social workers, school counselors, nutritionists, physical therapists, vocational counselors, occupational therapists, and creative therapists (i.e., art therapists, music therapists).

KEY TERMS

Hospice—
A philosophy and type of care focusing on comfort rather than curative treatment for patients who are chronically or terminally ill, including care of physical, emotional, and spiritual needs.
Oncology—
The branch of medicine that involves diagnosis and treatment of cancerous tumors.
Transitional care—
Health care provided during transition from one healthcare setting to another or to care at home; also called continuity of care.

Interdisciplinary treatment was first introduced to clinical psychology and 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.

Research results have indicated that a good interdisciplinary team must include components such as positive leadership, management skills, communication strategies and structure, personal rewards through training and development, appropriate resources and procedures; a supportive team climate, individual characteristics that support team work, a focus on supporting roles, and a focus on quality care and patient outcomes.

Modern psychologists have become an essential part of the treatment team in clinical areas such as oncology, geriatric medicine, internal medicine, cardiology and vascular medicine, pediatric medicine, and other specialties. Cross-disciplinary teams have also become more common in mental healthcare. Individuals with diseases 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 that involves job training or retraining. Patients may receive independent living skills training, social skills training, and receive housing assistance. Specialists outside of conventional medical disciplines may be integrated into the interdisciplinary team for such patients.

Interdisciplinary teams are also becoming more commonplace in clinical settings that involve qualitative healthcare research. For example, at the Univeristy of Minnesota, a program for teen pregnancy prevention is staffed with a team of psychologists, sociologists, physicians, nutritionists, nurses, biostatisticians, epidemiologists, and others. The goal is to provide effective strategies and collect meaningful research data that may contribute to improving the overall quality of care.Studies have shown that the processes involved in effective team work have been linked to improved patient outcomes.

Hospice care, given to terminally ill patients either within an acute care hospital or within an independent treatment setting, 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 focusing on both physical symptom relief and emotional well-being. Their interdisciplinary care may consist of one or more physicians, a psychologist, a family therapist, a priest or pastor, and a range of 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 various 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.

The logistics of an overall care plan are often difficult, given the heavy patient care load of many healthcare providers. The appointment of a case manager responsible for coordinating delivery of treatment and following the patient's progress often helps to organize the joint effort and keep the treatment team informed. The case manager also acts as a “point person” for the patient, making it easy to address 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 continuing care through support groups. Case managers are often licensed social workers, but can also be nurse administrators or trained lay people.

Resources

BOOKS

Kessel, F., Carnegie, P.R., Anderson, N.: American Psychological Association. Interdisciplinary Care: Studies from Health and Social Science: Case Studies from Health and Social Science. New York, NY: Oxford University Press, 2008.

PERIODICALS

Nancarrow, S.A., Booth, A., Ariss, S., Enderby, P.M. “Qualitative evaluation of the implementation of the Interdisciplinary Management Tool: A reflective tool to enhance interdisciplinary teamwork using Structured, Facilitated Action Research for Implementation.” Health Soc Care Community 23 (Jul 2015): 437–438.

Nancarrow, S.A., Booth, A., Ariss, S., et al. “Ten principles of good interdisciplinary team work.” Human Resources Health. 11 (Mar 2013): 19–26.

WEBSITES

Robert Wood Johnson Foundation Interdisciplinary Collaboration Improves Safety, Quality of Care, Experts Say. Nov 2010 (accessed July 30, 2015). http://www.rwjf.org/en/library/articles-and-news/2010/11/interdisciplinary-collaboration-improves-safety-quality-ofcare.html .

ORGANIZATIONS

American Psychological Association (APA)., 750 First Street, NE, Washington, D.C., USA, 20002-4242, 202336-5500, 800-374-2721, public.affairs@apa.org, http://www.apa.org .