8.1 Introduction
Multidisciplinary teams are groups of professionals from diverse disciplines who come together to provide comprehensive assessments of patients, establish and carry out interventions for them, and engage in regular consultations about patients’ progress. This chapter provides a brief outline of the roles and unique contributions of typical members of the treatment team. It also discusses professional relationships, and when to refer patients to other clinicians or specialists.
8.2 The Multidisciplinary Team
While the primary purpose of having a team of professionals caring for a person with a psychiatric illness is typically to bring the expertise of several disciplines to the plan of care, they have other roles. They can promote coordination between agencies. They also can identify gaps in service and breakdowns in coordination or communication between agencies or individuals. They also can enhance the professional skills and knowledge of individual team members by providing a forum for learning more about the strategies, resources, and approaches that different disciplines use.
Each discipline has its own perspective, jargon, mandates, and resources. When professionals fail to understand these differences, barriers, misunderstandings, or “turf” conflicts may develop. On the other hand, when professionals learn about the approaches, resources, and perspectives of colleagues from other disciplines, they can greatly expand their repertoire of skills, increase the resources they make available to patients, and enhance their understanding of various problems. Collaboration and interaction can facilitate interagency coordination, resulting in a more comprehensive range of services. As a result the likelihood decreases that patients will “fall between the cracks” of the service network, cutting down on wasteful overlap.
Professional disciplines typically represented in psychiatric–mental health settings include psychiatrists, psychologists, social workers, occupational therapists, professional dietitians, recreation therapists, substance abuse counselors, and nurses. Actual team compositions, however, are as diverse as the settings for patient care, and may include parole officers and other stakeholders from the corrections system, as well as professionals from other local and state agencies. It can also include members of the advocacy communities.
Teams of professionals are generally found in an organized way in inpatient and residential treatment settings, in outpatient intensive case management settings, and in systems of care.
Table 8.1 illustrates modalities and aspects of patient care and staff members responsible for those modalities. The medical record should clearly indicate the fulfillment of the activities commensurate with the responsibility of each treatment team member.
Table 8.1 Professional/staff member modalities and responsibilities.
| Staff | Responsibilities |
| Psychiatrist | Admission evaluation/orders |
| • Precautions | |
| • Diagnostic examination | |
| Relationship interventions | |
| • Individual meetings, daily rounds | |
| • Formal psychotherapy (individual and/or group) | |
| • Special therapies | |
| • Special procedures (e.g., orders seclusion and restraint) | |
| Therapeutic milieu | |
| • Team meetings | |
| • Patient staff meetings | |
| • Special inpatient meetings (e.g., eating-disorder groups) | |
| Somatic therapies | |
| • Pharmacotherapy | |
| • Other somatic therapies (e.g., ECT) | |
| Discharge planning and referrals | |
| Generalist nursing care staff | Nursing assessment and care plan |
| Relationship interventions |
