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The Challenge of Extended, Continuous CollaborationFrom Stress Management to Coping With Terminal IllnessMedical College of Wisconsin Columbia-St. Mary’s Family Practice Program, Milwaukee, dbutler{at}mcw.edu
University of Wisconsin Medical School Aurora Health Care, Milwaukee Most collaborative relationships between psychologists and physicians are of a time-limited, episodic nature because they focus on specific clinical problems. This article describes a longitudinal clinical collaboration that transcended the traditional model because of shifting clinical needs over a continuous, extended period. The collaboration progressed through phases, and because the purpose of treatment changed, it was necessary for the collaborating clinicians to redefine goals, responsibilities, and boundaries. At times, the focus was on medical developments, and at times, treatment was primarily psychological. What began as a routine consultation about stress management developed into a complex collaborative approach that required a biopsychosocial orientation. This article delineates the phases of treatment and identifies factors that facilitated, challenged, and created dilemmas in the collaborative process.
Key Words: collaborative care • terminal illness • end-of-life care • acute stress • disorder • adenocarcinoma
Clinical Case Studies, Vol. 4, No. 2,
173-188 (2005) |
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