The therapeutic relationship in neighborhood psychiatry: impact of clinical setting on clinical practice.

The relationship between psychotherapist and patient in neighborhood mental health practice differs in important ways from the therapeutic relationship established in other clinical settings. Obviously, no matter where therapist and patient meet, their personality characteristics and the clinical methodology will shape the relationship between them. Most clinical approaches emphasize personality and technique--therapists of all schools are trained to scrutinize these aspects of psychotherapy.

Integrating community psychiatry into residency training.

Beginning in 1969 a training program in community psychiatry was developed in a psychiatric hospital that had become a community mental health center with responsibility for a catchment area. Initially the program focused on individual supervision of psychiatric residents in their work with inpatients from the catchment area. The inadequacies of that approach led to assigning residents to spend four hours each week in a comprehensive neighborhood health center.