Behavioral medicine is at the intersection of the biological, psychological and social spheres of health care practice, yet what does this really mean? What does this look like in practice? In 2006, there were no core principles for Behavioral Science teaching in Family Medicine defined in the literature or on behavioral medicine websites. The STFM Group on Behavioral Science managed a process to define Behavioral Science core Principles, which were approved by the STFM Board of Directors inNovember, 2008 and published in the STFM Messenger in February, 2009.
Having a universal set of behavioral medicine principles 1) clarifies practice; 2) guides curriculum; 2) establishes standards from which to evaluate our curriculum; and 3) challenges us on how to measure educational outcomes to determine competence. We are excited to have these principles clarified and look forward to future discourse about implications for teaching, practice, and research.
Process of defining the core principles
From February, 2008 to May, 2008, a discussion took place on the Behavioral Science list-serve (email@example.com) to get members ideas about the key components of behavioral medicine principles. After many draft proposals, much discussion, and revisions, a draft set of principles was presented and approved at the May, 2008 STFM Group on Behavioral Science meeting. They recommended that the group co-chairs revise the draft and present to the behavioral science list-serve members for discussion and approval. The following core principles were approved by STFM members on the list-serve (August, 2008); and presented to STFM’s board of directors (November, 2008).
The role of behavioral science faculty is to consult and teach physicians and other health care providers; treat patients and families on emotional, family, and psychosocial issues; contribute to the knowledge base through research, publications and presentations; and continually upgrade one's knowledge and skills in behavioral science. Behavioral science faculty and practitioners operate from a core set of principles, drawing upon behavioral and social science pedagogy and research. The principles include elements of other related evidence-based fields such as behavioral medicine, behavioral health, health psychology, integrative medicine, and integrated mental and behavioral health. These core principles apply, but are not limited to, physicians, nurses, behavioral medicine specialists, social workers, psychologists, psychiatrists, or counselors working in health care or community settings. Those who apply these principles:
- use biopsychosocial and relationship-centered approaches to care;
- promote patient self-efficacy and behavior change as primary factors in health promotion, disease prevention, and chronic disease management;
- integrate mental health and substance abuse care into primary health care services;
- integrate psychological and behavioral knowledge into the care of physical symptoms and diseases;
- promote the integration of sociocultural factors within the organization and delivery of health care services;
- demonstrate the importance to health of familial, social, cultural, spiritual, and environmental contexts in patient care to improve health outcomes;
- practice a developmental and life-cycle perspective with learners and clients; and
- encourage and support provider self-awareness, empathy, and well-being.