Alice in Wonderland: a clinical case history exemplifying extended team work between public mental health services and professionals in private practice

With the detailed description of a clinical case, the authors illustrate how they decided to provide dual assistance to a patient by integrating their interventions as a psychiatrist in a public mental health service on the one hand and as a psychotherapist in private practice on the other. This form of cooperation is difficult and often hindered but in fact, it might prove extremely useful as an alternative solution to the lack of resources institutions are suffering from. As members of the same scientific association sharing the same modes of thought and the same working model, the two authors easily found a way of coordinating and integrating their work. This case study refers to a young, multi-problematic borderline patient: pharmacological treatment alone, even though supported by hospital day-care and then also community care, had proven insufficient. Special reference is made to a meeting which was carried out according to the Open Dialogue Method by Jaakko Seikkula: it was a crucial occasion for integration between mental health professionals and the patient’s family, which paved the way to the possibility of combining private, individual treatment to already ongoing, institutional treatment. This method proved to be effective to reduce the patient’s psychopathological symptoms.

Keywords: Borderline, Extended team, "Open Dialogue", Integrated public and private mental health care, Psychodynamic treatment, Therapeutic alliance

Paola Cecchetti, La de-posizione della sovranità dell’Io dell’analista è la relazione sociale in "GRUPPI" 1/2016, pp 70-77, DOI: 10.3280/GRU2016-001006