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The psychiatric consultation reconsidered

Published online by Cambridge University Press:  02 January 2018

David Hartman*
Affiliation:
Department of Child and Adolescent Psychiatry, Lanesborough Wing, St George's Hospital, Blackshaw Road, Tooting, London SW17 ORE; e-mail dhartman sghms.ac.uk
Leon Rozewicz
Affiliation:
Park Royal Centre for Mental Health, Central Middlesex Hospital, Acton Lane, London NW10 7NS
*
Correspondence
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Abstract

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We have subjected the current structure of the psychiatric consultation to critical examination, and We propose that the concepts of ‘history’, ‘mental state’ and formulation’ should be abandoned. In their place we propose the more carefully defined concepts of ‘narrative’, ‘interaction’, ‘examination’ and ‘inferences'. The clinician should make a dear distinction between information that is reported, observed or inferred, as these sources of knowledge are qualitatively different, and subject to psychodynamic, systemic and cultural influences. We propose that this approach would facilitate a clearer and more comprehensive understanding of the patient, and lead to a more creative therapeutic relationship.

Type
Original Papers
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 1996 The Royal College of Psychiatrists

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