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Functional Medicine (Holistic Care)

What is Functional medicine?

Functional medicine systematically addresses the unique physical, mental and emotional needs of all clients. By understanding each client’s current genetic, environmental/psychosocial, and lifestyle influences, your clinician is able to come up with a plan on how to move forward in providing you the best treatment, using a personalized holistic approach (incorporating the mind body and spirit connection).

  • Functional medicine seeks out the root causes of illnesses leading to imbalance and treats them (your presenting problem) with evidence-based and clinically verified methods.

 

  • Functional medicine delivers transformative holistic care with the purpose of promoting optimal health and wellbeing. During your intake session and follow up appointments, we will work together to develop a personalized care plan which address the 8 dimensions of health and wellness. In that process, I will partner with you in exploring and addressing modifiable lifestyle factors, including developing a thorough treatment plan. 

 

Our intake process will include 4 steps or phases. These four phases incorporated in treatment include the 4 pillars which aims to promote feeling centered and achieve overall total balance. Phases of treatment include:

 

  • Phase 1: Assessment phase (includes History taking and Treatment Planning). This usually last about 2-3 sessions and include collaborating with you in assessing your needs and developing a list of “target” sequence plan (with the goal of prioritizing your needs and determining what to work on first). 

  • Phase 2: Stabilization phase (this is where we will address the crisis or presenting problem that brought you into treatment (stabilize that), then move you forward to exploring and developing coping strategies or developing tools for coping.

  • Phase 3: Trauma Treatment (if appropriate, based on presenting symptoms) and finally,

  • Phase 4: Maintenance phase (prepare you for discharge by developing a wellness plan to keep you with maintaining your health and overall wellness after treatment is completed.)

 

  • If your needs are Stress related only (i.e.  life transition or work stress), we will work together utilizing Mindfulness Based Stress Reduction (MBSR) while teaching you tools to promote relaxation. This will include focusing on the four pillars of optimal health while working towards addressing modifiable lifestyle changes.

  • These include addressing exercise & movement, assessing nutritional needs, building relationships (establishing healthy boundaries in relationships as well as developing a healthy support system), while focusing on stress & Relaxation.

  • This Modifiable Lifestyle factors wellness plan will also involve partnering and collaborating together in developing an individualized interventions (primarily using Motivational Interviewing strategies to achieve goals and/or Acceptance and Commitment Therapy techniques).

  • All individualized treatment involves a comprehensive approach to health and wellbeing (utilizing a wholistic approach: which include completing a Biopsychosocial and exploring any social-cultural and spiritual factors and incorporating holistic practices that can contribute to overall, optimal wellbeing).

How is functional medicine different form conventional medicine?

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  • Functional medicine and conventional medicine both play important roles in client’s overall health and wellness.

    • Paired with conventional medical care, this results in improved overall health outcomes, reduced costs over time, and achieve a greater overall client experience (total healing).

 

What to expect in first visit?

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In addition to completing a thorough Biopsychosocial assessment, we will complete a: Functional Medicine Timeline including working through The Matrix in future sessions together. The timeline is designed to allow clinicians to visualize a client ‘s story chronologically by organizing important life events and health issues from pre-conception (antecedents) to the recent (triggers). We will work together identifying:

 

Antecedents: Factors that predispose a client to developing an acute or chronic illness. These often include family history, genetics, circumstances of birth and delivery, etc. For a person who is ill, antecedents form the illness diathesis.

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For prevention, antecedents are risk factors.

 

Examples of antecedents:

 

  • Family history (physical and mental state of mom during pregnancy)

  • Trauma (past or current)

  • Intrauterine/antenatal history (inadequate prenatal care including poor nutrition, maternal mental health or poor medical health)

  • Past or current Sexual abuse (Trauma)

  • Intestinal permeability/”leaky gut” (Exploring digestion and Absorption of foods and nutrients).

  • Dietary insufficiencies or excesses (food first or via supplementation if deficient.)

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Mediators/Perpetuators:

 

  • Represent biochemical or psychosocial factors that contribute to pathological changes.

  • These can include eating highly processed foods (Standard American Diet or SAD foods), isolation (loneliness), stress, chronic fatigue.

 

Triggers or Triggering events:

 

Triggers are discrete entities or events that provoke symptoms or disease. Each trigger is individual and specific to the client as the client’s health, reserve capacity, and resilience determine what causes the disease state. A trigger for one client may be an antecedent or a mediator for a different client. On a functional medicine timeline, triggers are listed chronologically. Examples of potential triggers include:

 

  • Physical trauma (past or present)

  • Stressful events (prolonged or cumulative stress exposure)

  • Surgery (past removal of an organ (i.e., gallbladder)

  • Infection (due to toxin exposure or inadequate sleep which can lead to decrease immune system.)

 

As an active client, we will:

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  • Complete Medical Symptoms Questionnaire (MSQ) (if deemed appropriate after intake session.)

  • Complete Diet, Nutrition & Lifestyle Journal -7 Day (if appropriate, based on needs).

  • Complete Self-care Questionnaire and developing a self-care plan, which focuses on evaluating: Stress, Sleep, Exercise, Nutrition,  Relationships and associated Behavior change (creating healthy habits).

 

In follow up sessions with you, your clinician will be:

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  • Using the Functional Medicine Matrix to help organize thoughts and observations about your health and decide how to focus therapeutic interventions.

  • Using The GOTOIT model: for clients with chronic illness (if medically appropriate or deemed necessary).

What is The GOTOIT model include:

 

Gather (oneself and information):

  • Gather information through intake forms, questionnaires, the initial consultation, physical exam, and objective data. Listening to the Client’s story by gathering a detailed Functional medicine history should be taken appropriate to age, gender, and nature of presenting problems.

Organize (on the matrix):

  • Organize the subjective and objective details from the Client’s story within the functional medicine paradigm. Position the Client’s presenting signs, symptoms, and ATMs, along with the details of the case history, on the Timeline and functional medicine Matrix.

  • Identifying Triggers or Triggering events

Tell (listen to your story):

  • Tell (relating the story back to the you in your own words) to ensure accuracy and understanding. The re-telling of the client’s story is a dialogue between the client and clinician, while highlighting the Antecedents, Triggers, and Mediators identified in the history, correlating them to the Timeline and the Matrix.

  • Acknowledge your goals while asking you to join in correcting and amplifying the story, with the aim to create the context of true partnership.

 

Order of your priorities (Prioritizing clinical imbalances):

  • Order and prioritization emerge from the dialogue between the clinician and client’s process during the initial assessment appointment. Your story (the presenting problem) along with further assessment of your mental, emotional, and spiritual needs will be considered in assessing the primary importance for prioritizing the next steps in your treatment.

 

  Treatment Plan Review:

 

    As part of your treatment process (usually around 6 weeks), we will continuously work on tracking your progress for the purpose        of:

  • Identifying clinical outcomes at each visit and

  • Noting the effectiveness of the therapeutic approach (current treatment plan), while revising, if needed (in partnership with you). With the overall purpose of: Noting the effectiveness of your treatment plan and tailoring it based on your current needs.

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  Initiate further Functional Assessment and Care (if medically indicated). This includes:

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  • Initiate further functional assessments and interventions based upon previous work and

 

  • Continue to perform further assessments as needed to provide optimal treatment.

 

  • (Example: If appropriate or as needed, Complete health assessments including reviewing Key Functional Roles & Aspects of the Gut such as:

 D: Digestion/Absorption

 I:  Intestinal Permeability

G: Gut Microbiota

I: Immune Modulation and Inflammation

N: Nervous System

  • Lastly, incorporating education and referrals with the goal of:

 

  • Initiate client education and therapeutic interventions and assisting with referrals for the treatment of modifiable lifestyle factors.

  • Modifying lifestyle factors. Refer client to adjunctive care, if needed:

    • Nutrition professional (referring to a dietician if needed.)

    • Lifestyle educator (Health coach if needed.)

    • Primary Care Healthcare providers: (Primary Care Physician, Nurse Practitioner or Physician Assistant)

    • Specialist (examples: Endocrinologist, Cardiologist, Pulmonary, ENT, ARNP, etc)

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