Difficulties in the integration of psychological and medical practices

The authors, who support in principle the important goal of integrated psychological and physical care, discuss five sources of difficulty in the practical application of such integration: 1) differences in values and, consequently, in systems of practice, 2) training influences, 3) differences in dealing with emotions, 4) conflicting patient expectations, and 5) limitations on the degree of intimacy tolerable in professional relationships. They suggest that practitioners and educators take these difficulties into account without abandoning a holistic perspective.