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The psychotherapy department and the community mental health team: bridges and boundaries

  • Jeremy Holmes (a1)
Abstract
Aims and method

The aim of the study was to clarify the role of psychotherapy departments in relation to a general psychiatric service, and in particular community mental health teams (CMHTs). Literature reviews of therapeutic activities in CMHTs and of psychotherapy delivery methods were undertaken. The implications of the National Health Service Executive document on Psychotherapy Services in England was considered, based on experience of the psychotherapy-general psychiatry interfaces in North Devon and Bristol.

Results

Psychological therapies are an integral part of psychiatric treatment provided in CMHTs, but are often delivered without careful assessment training or supervision. Psychotherapy departments contain expertise in the range of psychological therapies, but are sometimes perceived as remote from everyday psychiatric practice. Ways in which the divide between general psychiatry and psychotherapy might be bridged are suggested. A multi-disciplinary psychological treatment unit can offer specialist resources for the assessment and treatment of complex cases, especially those with personality disorders; psychological interventions in psychosis; and brief focused therapies for neurotic disorders unresponsive to drugs.

Clinical Implications

Consultation and liaison with the CMHT should become a key element in the work of a psychological treatment unit, and structured therapies under supervision similarly central to the work of CMHTs.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Albeniz, A. & Holmes, J. (1995) Integration in psychotherapy: implications for psychiatry. British Journal of Psychiatry, 169, 563570.
Bateman, A. (1997) Borderline personality disorder and psychotherapeutic psychiatry. British Journal of Psychotherapy, 13, 489498.
Gabbard, C., Lazar, S., Horberger, P., et al (1997) The economic impact of psychotherapy: a review. American Journal of Psychiatry, 154, 147155.
Holmes, J. & Mitchison, S. (1995) A model for an integrated psychotherapy service. Psychiatric Bulletin, 19, 210213.
Holmes, J., Mitchison, S. & Lindley, R. (1998) The Values of Psychotherapy (2nd edn). London: Karnac.
National Health Service Executive (1994) Guidance on the Discharge of Mentally Disordered People and their Continuing Care in the Community. London: HMSO.
National Health Service Executive (1996) Psychotherapy Services in England. London: HMSO.
Roth, A. & Fonagy, P. (1996) What Works for Whom. New York: Guilford Press.
Royal College of Psychiatrists (1991) The future of psychotherapy services. Psychiatric Bulletin, 15, 174179.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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The psychotherapy department and the community mental health team: bridges and boundaries

  • Jeremy Holmes (a1)
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