Alcohol liaison in action. The Canterbury experience.

In the changing health service, cooperation between disciplines is essential and innovation important to improve the service for people whose health is at risk or damaged. We describe our response to the challenge of liaison between different disciplines when faced with a multifaceted problem that needs the contribution of medical and psychiatric teams and community workers. Although this method of work has been applied to alcohol misuse, it could also be applied to other clinical problems. Liaison can be successful if these is an identified need and the different groups share a desire to work together. To stimulate the liaison and maintain momentum there need to be driving forces, be they clinical, practical or economic, also a shared philosophy and language, a conceptual base in the care of that group of patients, mutual respect and agreed working arrangements. Psychiatry and medicine operating together can ensure that these patients are treated with fairness and respect. They can tap into resources not easily available to either discipline separately, and so create original and exciting services. They can discover other agencies and individuals in their communities who will cooperate with them in obtaining funds and in pressurising statutory bodies to develop much needed services.

The practical business of treatment--1. A multidisciplinary and team approach.

This paper outlines the context in which I work, and then expresses my beliefs about treatment. The value placed on day care and multi-disciplinary teamwork is stressed. My treatment philosophy is explained and reference made to the ways we control the therapeutic setting. I argue for some of the more controversial aspects of our therapeutic activities and describe the roles of psychiatrist and psychotherapists in our work. It is hoped that these opinions which are candidly expressed will provoke a constructive debate on how we can all best help these challenging people.