Are your healthcare providers communicating? Do your doctors talk to each other? Are they collaborating with your therapist? Your dietician?
If not, it’s time they do! Here’s why…
We are all interconnected beings! Parts of us do not exist outside of our whole being. Systems thinking — the Marriage and Family Therapy (MFT) education — is the foundation for my therapeutic degree and practice. Understanding that we are based in connections (systems) — everything is interconnected. Social systems, family systems, and all the systems inside of you!
Every one of us is an individual who is composed of many systems — both inside and outside our bodies — whether we realize it or not.
We know:
- Depression, anxiety, and trauma (all mood disorders) can impact gut health
- Chronic physical pain can impact mood
- Gut health affects mood
- Loneliness, isolation, and lack of self-compassion can impact sexual health
- Social and emotional pain feel almost identical in your brain to physical pain
- Adverse Childhood Experiences (ACEs) can impact long term physical health
- Trauma survivors operating in a chronic state of hypervigilance have a higher likelihood of adverse health outcomes and chronic physical conditions
We know that the nervous system responds to stress and traumatic events happening in the here and now, and also responds to flashbacks or feelings reminding of the perception of threat.
The mind-body connection is real. Wouldn’t it be helpful if all the healthcare practitioners who were dealing with the different parts of your body could get on the same page?! I think so, too. That’s what I’m suggesting today.
If you change one part of your system, it changes the whole system!
If your GI issues, anxiety, or sleep issues are connected to your trauma history, I want your doctors to know, so they can provide you the best care. And if you have physical health issues that don’t come up in our session, I want to know, because something that you may not see as related could absolutely be related and helped in therapy.
What if healing the nervous system can improve or eliminate your physical ailments? And what if doctors are prescribing treatments that either help or hinder this healing — or that doesn’t take your trauma history into consideration at all?
If your providers are working in isolation, they could be missing out on critical information that can keep you safe, help you heal, and improve your overall health. Not only that. You could be missing out on the power of connection that can help you heal!
What to do as a system:
Can there be recognition by both healthcare providers and clients that collaborative care is best?!
I know that everybody in healthcare is overworked — and has been for years. Healthcare providers are overwhelmed and isolated, and never have enough time in the day. The idea of collaborating may seem impossible when you’re busy. I get it.
What if patients or clients helped their providers collaborate?
IF we could be more collaborative, we would all be helped. Yes, both clients or patients AND providers!
Collaboration is a way to achieve better, faster outcomes for our clients — and a way to reduce stress and increase connection for healthcare providers. We have to look at the big picture for all of us.
Who should be collaborating?
At the very least, therapists and psychiatrists need to be collaborating. Ideally your therapist and any provider prescribing you medication that could impact or influence your mood or mental health (psychiatrist, primary care physician, gynecologist, endocrinologist, cardiologist, rheumatologist, and the list goes on) are collaborating! Also, if you have a nutritionist or dietician, they also need to be collaborating with your therapist.
Requesting that your healthcare providers collaborate
Your medical providers — everyone who is caring for your health — all need to be on the same page. This requires a few steps from you:
- Operate from this truth: You are worthy of excellent care.
- Request that providers collaborate around your care. Here is some language you can use: I want all of my doctors to be on the same page about my care. Can you collaborate with my therapist and other doctors to make sure that everyone is considering the big picture of my health? … And if they aren’t willing…
- Find providers who are willing to collaborate on your behalf.
How incredible would it be if every medical or healthcare provider was treating individuals from a systems-based, trauma-informed perspective — looking at everything? It makes for a better team. And you deserve the best team!
I’m not the only one who thinks collaboration is essential. My colleagues do too! Here’s why:
1. Collaboration in care can be a corrective emotional experience for trauma survivors. Understandably, trauma survivors have trouble trusting, as the important people in their lives, maybe even caregivers, have failed them. This is a way to not fail them. If they see healthcare practitioners working together to help them, it shows they matter. It also models the behavior we want to teach — that it can be safe to ask for help. Collaboration can truly be a corrective emotional experience!
“The need for collaboration amongst providers for individuals seeking mental health treatment is of paramount importance to provide comprehensive, ethical, and holistic treatment for individuals. Consultation, coordination, and collaboration amongst providers will help to ensure that we are looking at the individual through many different lenses. It will provide a comprehensive view of the person and the social, physical, and emotional issues that the individual is dealing with and the adaptations they are making to those issues. Collaboration may also reveal biases that treatment providers may have and the development of strategies to reduce those biases to provide a positive treatment outcome for the individual.”
-Denise Tordella, MA, LPC, Therapist, Alexandria, VA
“That which is created in a relationship can be fixed in a relationship.”
-Murray Bowen
2. Collaboration can speed up healing, while increasing safety and compliance in care. We want our clients to heal as quickly as possible. This means maximizing efficiency! We can avoid wrong paths and detours when we are all on the same page.Imagine if all this time — something you’ve been doing to help someone get better has been directly negated by something another healthcare provider is doing — and you don’t know. The medical world is now talking about how collaborative care will save money. Can we afford not to collaborate? What are we missing that will cost us more work and time on the backend?
“The crisis of isolation is a problem that affects professionals as much as it affects the clients we serve. As mental health professionals, we see daily the enormous costs of disintegrated living in our clients… but the costs can also impact the way we take care of them. We take better care when, as caregivers, we collaborate; we are less likely to miss important findings, we are less likely to under- or over-treat, and we are more likely to see the person as a whole being rather than in pieces and as just symptoms. As we break out of the isolation of our own professional practices, we become better caregivers, and in the process, we too become beneficiaries of community and connection.”
-Dr. Yasmin Banaei, MD, Psychiatrist, Washington D.C.
3. Collaboration provides another professional’s insight — another perspective that can inform your own. We are all human.We all have blind spots. We can’t see everything all the time. Sometimes another professional’s perspective is just what we need to find the breakthrough that changes everything.
“As a Certified Emotionally Focused Therapist seeing couples, collaboration with other clinicians can be so powerful. It’s invaluable to learn more about the individual work that each partner is doing with their own therapist. It’s useful to offer my perspective on the couples’ dynamic as a neutral third party, a viewpoint that the individual therapist may never have. My goal in those conversations always is to ensure that I am supporting the other therapist’s work, when appropriate, and that we are not working at cross-purposes. It’s also an excellent opportunity to learn about other clinicians and their skillsets – when I make a referral to another therapist it’s important to know about their actual clinical work, rather than just go on reputation or my collegiality with that person. Really considering the case in a collaborative manner helps me to know the therapist’s approach more deeply than what I could glean in a professional development atmosphere. I also think it’s interesting to meet new clinicians in this manner and be asked to think about my work through a different lens.”
-Stacy Notaras Murphy, LPC, EMDR-C, Therapist, Washington, D.C.
4. Collaboration takes the burden of self-reliance off trauma survivors. Speaking up about their health (or going to the doctor in the first place) doesn’t always come easily for trauma survivors. In fact, many are in a state of fight or flight just from being in a healthcare office. Expecting trauma survivors to readily remember and disclose all relevant healthcare history and treatment, and to advocate for their best care, puts a massive burden of aloneness on the individual who is seeking help.
“If you don’t ask a patient about their psychological health and/or social stressors that they are experiencing, you are missing a big piece of the whole medical picture – physical health is really only 1/3 of the whole wellness equation. Looking at a patient through a biopsychosocial lens allows one to see a more comprehensive version of complete health.”
“When a patient comes to you as a medical provider, one has to understand the vulnerability that they may be feeling. Sharing confusing or frightening thoughts about their bodies is not easy, and confiding this with a stranger can be even more difficult. Creating a safe space for patients to share their concerns, and by having a working relationship with their mental health care provider, allows for even more security to develop. Furthermore, the collaboration of care that comes from this relationship enhances the effectiveness of the treatments that we give.”
“Consistency of messaging is very important in the care of patients. By working closely with a mental health professional, I can use the most effective strategies in communicating with patients so that they understand the care that I am trying to provide. We can reinforce each other’s recommendations and provide safety and reassurance around the care that we are directing.”
“Patients like to know that they have a ‘team’ of collaborating professionals working with them and advocating on their behalf. Feeling secure in the care that they are receiving and knowing that there is open communication flowing between the team members, delivers a higher level of care overall. It may even encourage better compliance with treatment and follow through. This is the power of a good team collaboration.”
-Dr. Cecily Havert, MD, Northern Virginia Family Practice, Alexandria, VA
5. Collaboration between healthcare providers fuels us, too. The feeling of working in isolation isn’t good for practitioners. Connection is healing and energizing! Working towards a common goal can make providers more resilient and fulfilled. Over my decades of practice, some collaborative providers have become my friends — we see the world with similar curiosity and connectedness. It takes a village!
**Connection helps trauma survivors (and all humans) hold hope in life! If you haven’t read Dr. Vivek Murthy’s book, I recommend it: Together: The Healing Power of Human Connection in a Sometimes Lonely World.
“As a dietitian working with eating disorders, I know it is very rarely about the food itself. Disordered eating is about so much more. Working with a team is the best way to fully address behaviors from all lenses while also providing a safe community of support both for our clients and ourselves.”
-Mary Frances Hartley, MS, RD, LD, Dietician, Tepper Nutrition,
6. Collaboration between healthcare providers doesn’t have to be hard or time-consuming. Time for collaboration of care is part of the treatment we provide. It sometimes looks like exchanging voicemails, sending a letter or fax, mailing a copy of notes, or having a quick phone call. Important information that increases quality of care can be exchanged in less than two minutes. Here’s what is showing up that might be helpful for you to know…
We are all the healthiest when all of our systems are working together!
As a therapist I know that connection is like a magic salve. Why don’t we spread this intention of connection further, in a way that can have a universal benefit?
I believe it’s a trauma-informed therapist’s job to do more than provide support. And collaboration is one of the many things I see as part of my role. I have the great privilege of collaborating with a number of trauma-informed healthcare colleagues (and many have shared their thoughts here)! I’m honored to work with wonderful providers who help my clients feel safe, cared for and important — and I think every healthcare professional can have beneficial collaborative networks.
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