Abstract
1. In Japan, confusion is evident as to the role and position of the Clinical Psychologist (CP) and the Ps.ychiatric Social Worker (PSW) as their qualifications are not prescribed by the current Japanese laws governing medical services. The government-managed medical insurance system do not cover fees for the team treatment. These institutional inadequacies have caused various problems and difficulties for the content and the practice of psychodynamic treatment. The paper reviews the current situation and recommends solutions from the perspective of a psychiatrist. 2. It is often that the doctor in psychiatry or psychosomatics and the CP provide similar or overlapping services. Models of relationship between the two, both successful and conflicting, are described with suggestions for better understanding on the part of the doctor. 3. The doctor functions in several roles and positions as administrator of the clinic/hospital, planner of the medical examination and treatment. team leader, psychotherapist and others. He/she needs to establish a system to differentiate and integrate these multiple roles. Further development of the system will positively affect the treatment as it allows more effective introduction of transferences, counter-transferences, splittings and acting-outs into the therapeutic process. The paper discusses requirements for management by the doctor to facilitate team work with the CP.
