Psychotherapist, Psychiatrist, and Patient

A Triadic Relationship

¹ Kennedy Krieger Family Center, Kennedy Krieger Institute, Baltimore, Maryland, and the Department of Psychology, City University of New York.

Dr. Pilowsky, Kennedy Krieger Family Center, Kennedy Krieger Institute, 2901 East Biddle Street, Baltimore, MD 21213.

An increasing number of psychiatrists consult to nonmedical psychotherapists and treat their patients with medication. This dual treatment arrangement is known as "split treatment." Split treatment arrangements generate a triangular relationship among the three parties—patient, psychotherapist, and psychiatrist. Both the transferential aspects of the triangular relationship among the two therapists and a patient and the overt interpersonal conflicts that may arise—such as ideological and interdisciplinary conflicts—are discussed. Enhanced awareness of both sets of factors may facilitate the cooperation between psychiatrists and psychotherapists.