The word “integration” comes from the Latin root word integratio which means renewal.  Integration is defined as follows:  1) An act or instance of combining into an integral whole.  2) An act or instance of integrating a racial, religious, or ethnic group.  3) An act or instance of integrating an organization, place of business, school, healthcare, etc.  It reflects the behavior of an individual that is one of harmony with the environment.  In psychology, it is the organization of the constituent elements of the personality into a coordinated, harmonious whole (www.dictionary.com).

There is a new paradigm of healthcare and wellness that is qualitatively different in the approach to the interaction of the mind, body, and environment.  Nature teaches us how perfectly woven together all of life really is and interdependent upon all life.  There is a web of the invisible breath of love energy which gives life to all, and in that “still” place the illusion of separation dissolves.  Good health is something that is invaluable.  Integrated Health observes the “whole” patient and develops healing interventions which help to educate the patient.  A patient-centered model will help to develop a reasonable and doable care plan to bring about “holistic” healing.

When it comes to the well-being of the trauma-exposed patient, this is especially true, by examining the impact which trauma caused to the physical body, mental health, emotional health, and spiritual belief system.  In fact, research has revealed that traumatic exposure and PTSD are linked to poor physical health with greater utilization of medical care, i.e., primary care, and overall higher morbidity (Taft et al., 1999).  Several investigations and ongoing research have revealed connections with lifetime trauma history or complex trauma, and specific medical diagnoses, even years after trauma occurred.  

Integrated healthcare programs are designed to increase the availability of behavioral health services within primary care settings.  Research shows us that the number of medical visits significantly decreased when they received behavioral health consultation services  (McFeature & Pierce, 2011).  The trauma-exposed patient many times will present with acute and chronic problems, such as depression, anxiety, obesity, gastrointestinal, chronic pain, diabetes, cardiovascular problems, and asthma/COPD.  These serious conditions require medical intervention and behavioral healthcare that, in this setting, becomes disease management, and a search for patterns and causes of symptoms.  

The patient in many cases will be working with various community organizations that all have one thing in common – they are touching the lives of the same patient/client.  Integrated health speaks to important macro and micro viewpoints.  It speaks to the importance of addressing the “whole” person from a patient-centered approach; along with the need for collaboration between community services that have incorporated trauma-informed care approaches.

Here are some principal elements of this new paradigm for improved health care and patient-centered practices:

  1. Integrated health practices are  concerned about the assessment and interventions for the “whole” patient.
  2. Integrated healthcare providers emphasis on human values (meeting the patient where they are.
  3. Healthcare providers are compassionate and focussed on the well- being of the patient., which is also a component of the patient’s healing.
  4. Pain and disease are often information about underlying conflict and disharmony and in most cases are attached to a life of complex trauma.
  5. Integrated health care providers consider the patient’s overall functionality with psychotherapies, diet, exercise, and preventive healthcare.
  6. The patient feels empowered and should be autonomous and feel supported by the primary care team.
  7. The professionals involved in the continuum of care become a therapeutic partner and collaborate in the patient’s best interest.
  8. A patient-centered practice has a body-mind perspective psychosomatic illness which is considered a province of all health-care professionals in truly integrated healthcare.
  9. When utilizing the narrative approach, this allows a primary reliance on qualitative information from the patient’s subjective reports and combined with the professional’s intuition, quantitative data, and adjunct.
  10. Prevention becomes synonymous with “whole-person health” a “Holistic” approach and begins by working with the patient to help them set personal health goals, consider relationships, and understand the mind-body-spirit connection (McFeature, B. & Herron-McFeature, C., 2017)

Trauma Theory should be a focus of interventions, from a perspective of integration.  It needs to be considered as a “whole” experience, requiring a “holistic” healing approach.  It is an opportunity for humanity to integrate large bodies of knowledge in a process known as “consilience,”  previously human services have been divided in silos placing the trauma-exposed patient to a great loss and disadvantage.  When we can integrate the framework and foundation of all human systems, the results shift from “treatment to healing.”  

Considering the additional social determinants to “health” within the multiple ways that class, race, and socioeconomic status interact with the trauma-exposed individual and social health, we understand the need for integration along with a true continuum of care.  We cannot go on just treating the resulting illnesses and behaviors presented by trauma-exposed patients, i.e., substance abuse, lack of attachment, and other medical and mental health issues, but we must pay attention to the underlying core cause of all of these.  When we address the core trauma and find consilience within all human services, private and public, then we will spend less money, help more people, and have better outcomes.

Cinthia McFeature, Ph.D.

Bill McFeature, Ph.D.

 

References

McFeature, B. & Herron-McFeature, C. (2017).  Integrated Health-HeartPath Practitioner Intervention and Assessment for the Trauma-Exposed Patient. Melbourne, Florida: Motivational Press, Inc.

McFeature, B. & Pierce T. (2011). Primary Care Behavioral Health Consultation Reduces Depression Levels Among Mood-Disordered Patients. Journal of Health Disparities Research and Practices, Volume 5, Issue 2, Summer 2012, pp. 36-44.

Taft C.T., Stern A.S., King L.A., King, D.W. Modeling physical health and functional health status: The role of combat exposure, posttraumatic stress disorder, and personal resource attributes. Journal of Traumatic Stress. 1999; 12:3–23.