© 2009 The Royal College of Psychiatrists
Interpersonal dynamics and multidisciplinary teamwork
David Reiss is a consultant forensic psychiatrist and Director of Forensic Psychiatry Education for West London Mental Health NHS Trust, and an honorary clinical senior lecturer at Imperial College London. His research examines the interface between clinical forensic psychiatry and public policy, including work on personality disorder, recidivism, homicide inquiries and educational issues. His clinical and educational work focuses on enabling the multidisciplinary team to gain an enhanced understanding of patients, thereby improving care and reducing risk. Gabriel Kirtchuk is a consultant psychiatrist in psychotherapy and a psychoanalyst for West London Mental Health NHS Trust. He has worked in forensic settings for the past 15 years and established a forensic psychotherapy department at the Three Bridges Unit. He is the lead clinician of the National Forensic Psychotherapy Training and Development Strategy and an honorary clinical senior lecturer at Imperial College London. His interests include the development of psychotherapeutic approaches within forensic mental health, as well as training and educational programmes in this field.
Correspondence: Correspondence Dr David Reiss, West London Mental Health NHS Trust, Three Bridges Unit, Uxbridge Road, Southall, Middlesex UB1 3EU, UK. Email: david.reiss{at}wlmht.nhs.uk
Analysing interpersonal dynamics is an approach through which the multidisciplinary team can develop a shared understanding of their patients. This empirically based method provides an insight into repeated patterns of dysfunctional behaviour, which not only have been evident in the past, but are currently having an impact on the patient’s relationships with caring staff. The technique is accessible to any team member with only minimal training required. It provides the team with a coherent map of the patient’s relationship patterns that underpins the formulation of an effective strategy for care. The multidisciplinary team is then able to work towards shared goals, supporting all members in their provision of effective interventions within the full range of therapeutic modalities. The approach promotes positive staff–patient interactions and provides an additional dimension to the assessment and management of risk.