The article introduces a concept of social uterus as an integrative model of family development. The concept has been gradually developed by two of the authors of the article through extensive clinical work with individuals and families during the last two decades. It has shown to have clinical validity, particularly in family therapy for psychosomatic disorders and various chronic somatic diseases. In the article, we first present a short description of our perspective on psychosomatic issues. We also give some information about the broader context of psychosomatic medicine and family therapy in our country. The main part of the article focuses on the concept of social uterus in detail. With regard to process of family therapy, both promising and controversial aspects of the concept are discussed. We conclude with some ideas concerning a need for collaborative health care in the treatment of psychosomatic disorders.It has been more than 40 years since the psychiatrist Engel (1977) called for a bio-psychosocial approach in medicine. In his opinion, a narrow biomedical perspective was insufficient for both the understanding and treatment of most diseases. He argued that
Political, economic and cultural transformations in the Czech Republic after 1989 were refl ected in a number of demographic indicators, including those that characterize family behaviour. The main features of these changes are declining birth and marriage rates, postponement of fi rst marriage and fi rst birth ages, and a growing proportion of children born outside of marriage. These changes are comparable to those that have taken place in western Europe since the 1960s; however, some of them are abrupt and cause rapid shift in the family structure. Over the last two decades, signifi cant changes have also occurred in the organization of family therapy. Earlier less coordinated activities underwent institutionalization, and guidelines for training and supervision were established. Family therapy in the Czech Republic is covered by a national organization, the Society of Family Therapy (SOFT). Standards of training and supervision correspond to European standards. The problem remains the lack of support for family therapy from state institutions, especially in the health service. There are only a few healthcare facilities providing family therapy for the treatment of psychiatric disorders or chronic somatic diseases. The capacity of these centres is substantially inadequate.
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