Split treatment: Recommendations for optimal use in the care of psychiatric patients.

BACKGROUND: Split treatment refers to the involvement of 2 mental health professionals in the care of a psychiatric patient-one providing psychotherapy and the other psychopharmacologic management. Despite the widespread use of split treatment in outpatient psychiatric care, little data exist on its core features or cost-effectiveness compared with other models of treatment.

METHODS: We reviewed published studies on split treatment, summarized the research data on split treatment, and created principles to guide its use in practice.

RESULTS: Few data-based studies have examined the split treatment model. Both prescribing psychiatrists and psychotherapists have specific and unique concerns and sensitivities in the split model that are likely to affect the overall success of treatment. Among the concerns are respect for the other treating professional, staying within the appropriate boundaries of one's expertise, efficient communication with the co-treater, and parallel accessibility in emergency situations.

CONCLUSIONS: Proper application of split care principles is likely to result in a better-coordinated and more effective approach to treatment of psychiatric patients. Recommendations for future research are offered.