A. Y. Berkouwer: Symbiosis and fragmentation of psychiatric treatment teams and their impact on the patient group
In clinical psychiatric treatment there is an important development towards a more intensive treatment by multidisciplinary teams. It is most important to understand under which conditions a treatment team provides a facilitating environment, promoting growth and hope for change and under which conditions it has a disturbing and chronifying effect on the patients.
Two types of dysfunctioning are described: the symbiotic team, in which individuation of its members is lacking and in which there is a blurring of boundaries between the various disciplines and members of the team; and the fragmented team, in which each person and discipline works on its own, without cohesion and integration. Examples of patient-staff meetings are given to illustrate the disturbances in communication between staff and patient group: the symbiotic team hindering attempts for individuation and initiatives for new and multiple ways of relating, and the fragmented team hindering attemps of patients towards 'rapprochement', contact and integration. In respect to individuation and integration of the patient, teams can only help if they have worked through these problems themselves within their team.