Conversations with the Pioneers of Integration

The first interview is with Larry Mauksch. Not only was Larry a very early
innovator, but in his interview he describes his relationship with Wayne Katon, an innovator and researcher who should be part of any list of pioneers of integration. Unfortunately, Dr. Katon died in 2015. It is an example of how teams formed in those days, in their case, on the tennis court.

Tom Campbell, MD, and Susan McDaniel, PhD, were the team that showed us how multidisciplinary collaboration could be done.  In their training workshops they would role play the stereotypes of the day:  Medical (results oriented, hurried, intellectual, male) vs. Behavioral (process oriented, reflective, emotional, female).  Then they would demonstrate how to get beyond the stereotypes and show what collaboration in practice can look like.  They were the first example of the new world of teamwork for much of the field.

Macaran Baird (Mac) and William Doherty (Bill) taught us so many things so early.  Among them was 1. that a shared interest in family systems ideas makes a solid grounding for a physician/behavioral health clinician team, and 2. that no matter how much one person is trained in both the biological and psychosocial side of primary care, it takes a team with different roles to deliver that care.  Their first book on the “Primary Care of Families” was published in 1983.

Alexander Blount (Sandy) saw the phenomenon of integrated care coming “over the horizon,” though he was not a pioneer working in an integrated setting.  He coined the term, “integrated primary care,” and wrote the first book on the topic.  In his story from 1983, he describes having to develop the warm handoff in a medical clinic in a mental health center to enable some patients to receive any mental health care.  He is interviewed by Michael Bruner.

Michael Glenn (Internist and Psychiatrist) and Barry Dym (family therapist) worked as a team early in the game.  They are particularly interesting because of their role in launching Family Systems Medicine, the first journal devoted collaborative care.  Their story shows the connection this new way of thinking and working (integration) had to a larger movement for change that was being enacted in the culture as a whole in those days.

Physicians Want a Colleague Who Works Like They Do:

Kirk Strosahl was first to develop and to articulate what he called the “primary mental health care paradigm.”  This paradigm, with the work of Patti Robinson and others, developed into what we now call the Primary Care Behavioral Health Model.  It is eye-opening to hear him describe how the model developed, particularly the role of some very psychosocially sophisticated physicians in demanding that it be a true primary care service rather than a transplanted specialty service.

C.J. Peek was the lead health psychologist in a large HMO in the Twin Cities in Minnesota in the early days of integrated care.  He was a creator of integrated care in primary care and specialty settings, functioning as a clinician, administrator and trainer.  He was/is always one of the clearest voices in defining the field of Behavioral Health integration, e.g., the Lexicon project for the National Integration Academy.