Abstract
This paper describes a consultation project at Essex County Hospital Center, a 900 bed psychiatric hospital, which utilized the services of a clinical psychologist in private practice. The project was initiated by the medical director, who sought the services of a clinical psychologist as a consultant to work with the multidisciplinary treatment teams that had been organized to fulfill the requirements of federal and state accrediting agencies. The members of the multidisciplinary teams generally included a physician, nurse, social worker, psychologist and activity therapist, or at least members from several of these disciplines. The team psychologist (when there was one) contributed his or her findings on an equal basis with the other team members. The team members had very different backgrounds; their psychological sophistication and levels of training and experience varied widely. The treatment plans that emerged from this diverse group lacked a clear focus and did not have a well detailed, integrated action plan. Frequently, they contained treatment suggestions that were incompatible with the true clinical picture, or the method by which the treatment could be carried out was either unspecified or too ambiguously stated. Criticism from the accrediting agencies frequently focused on lack of specificity of treatment goals and lack of evidence that treatments had been implemented to remedy the problems identified on the treatment plan.