Psychotherapy consultation in an inpatient setting.

Evaluation of an ongoing psychotherapy by a consultant is a demanding and important task. In many cases consultation is best carried out in a hospital setting; the patient benefits by the structured environment, and the therapist gains the support of the inpatient consultative team. Close cooperation between patient, therapist, and inpatient staff can help revitalize a psychotherapy by renewing the commitment of therapist and patient to work together again on an outpatient basis. Consultation can also lead to a decision to terminate therapy. Psychotherapy consultation should be viewed not as a failure of either therapist or patient, but as a commonly occurring need in some psychotherapies, especially with difficult patients. A consultative team sensitive to the nature of the patient-therapist relationship and careful to avoid devaluing the therapist can make a significant contribution to a psychotherapy.