Establishing Psychiatric Consultation for Agency Program

Abstract

This complete clarification of details with the staff, board, and consultant is a cardinal factor in the development of an integrated consultation service. Only when these details are definitely outlined and accepted can the service be used efficaciously by both disciplines as a means of obtaining a competent “diagnostic synthesis”¹³ and a form of treatment in which each has contributed his respective skill and ability.

These are the elements on which a smoothly functioning consultation service rests: (1) The community must have knowledge about the service and support it. To achieve this, it needs to understand its meaning; this suggests a strong educative endeavor by the agency through various methods of effective and continuous interpretation. (2) In the worker-consultant relationship there must be an acceptance by the psychiatrist and caseworker of each other's differentiated roles, and an adherence to agency function and scope of work. Recognizing that their diagnostic and treatment procedures, albeit derived from the same stem (concern for the individual's total adaptive function), have taken the form of different offshoots, the worker will be less apt to feel in a threatened or, perhaps, competitive position.¹⁴ (3) Understanding of their respective roles determines the procedures through which their duties can be effectively discharged in service to the client, safeguards their professional identities, and adds to further differentiation. This means that the psychiatrist will not assume supervisory or agency-representative duties, nor will the worker assume obligations ancillary to the psychiatrist. Their complementary activities and the administration of them will be structuralized within the agency in such a way that consistency, radier than diffusion, of agency definition and function is steadfastly maintained. (4) Particularly important are the complete understanding and acceptance among the board, staff, executive, and psychiatrist of the meanings of the consultation service, their responsibilities in this team relationship, and the agency policies through which such service will be discharged. The element of consonance in this is the basis for integration which, in turn, becomes the keystone for an efficient consultation service.