With a clinical description of the admission-process and treatment program of a married couple, the author gives an impression of the functioning of an uncommon psychiatric department of a general hospital. The ward is horizontal organized. There is a great emphasis on a client-system approach, the principles of the therapeutic community, interdisciplinar teamwork and a short- and intensive treatment program. The staff maintains in its treatment philosophy a difficult combination of the medical and social model of which is expected that it never will be a stabilized balante.
The role of the psychiatrist in a framework characterized by such different conceptions is discussed on the basis of themes as: treatment model, organisationmodel, power, responsibility, professional abilities and identity, and the conflicting languages of different disciplines. These various areas are illustrated by many, often personal coloured experiences of the psychiatrist. The presentation ends with a short summary of the most conflicting and friction causing characteristics of the described department. Nevertheless positive results can be mentioned.