A Controlled Experimental Study of the Therapist-Administrator Split
JAMES C. BECK M.D., PH.D.1,
LEE B. MACHT M.D.2,
DANIEL J. LEVINSON PH.D.3, , and
MILTON STRAUSS M.A.4
1 Cheif, Program Analysis Section, Division of Mental Health Service Programs, National Institute of Mental Health, 5454 Wisconsin Avenue, Chevy Chase, Md. 20203
2 Deputy Medical Director and Principal Psychiatrist, Job Corps, Office of Economic Opportunity, Washington, D. C.
3 Professor of Social Psychology, Department of Psychiatry, Yale University, New Haven, Conn.
4 Graduate student in the Department of Social Relations, Harvard University, Cambridge, Mass
The effect of separating therapy and administrative responsibilities was evaluated in a controlled experimental study of 24 patients. The authors found that schizophrenics treated by two physicians (a t/a split) remained in the hospital an average of three times as long as schizophrenics treated by one physician, who served as both therapist and administrator. Although the t/a split arrangement appeared to have learning value for the residents who participated, and although there may be specific clinical indications for its use in some cases, the authors conclude that it has no routine place in the treatment of schizophrenic patients.
