The therapeutic environment and team approach at the Menninger Hospital

Good treatment for difficult patients in contemporary psychiatric practice requires a collaborative approach by the mental health professionals responsible for that patient's care and treatment. This form of practice, defined as team treatment, uses the special strengths of team members from each mental health discipline. Properly focused, a treatment team can ensure a thorough diagnostic review of individual patient's problems and the development of a comprehensive treatment plan. A well-operating therapeutic tram, effectively managed by a team leader who understands group process, disciplinary strengths and differences, and the psychodynamic process, can provide a protective, analytic context in which the troubled behavior of the patient can be examined carefully and treated appropriately. Even as the treatment context shifts to an ambulatory setting, an effective tram can ensure competent, cost-effective, goal-focused treatment of high quality. This paper describes the history of team treatment at the Menninger Foundation, outlines the primary features of tram treatment, discusses the issues involved in this form of collaboration, and defines the benefits to treatment that this approach can bring.