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

Department of Psychiatry, North Devon District Hospital, Barnstaple, Devon EX31 4JB

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.