DEBATE: What is the Best Model for Consulting Services in Psychosomatic Medicine? Lessons From Germany

A G DIEFENBACHER and J J STRAIN

DEBATE As of now, Germany is the only country in world with two different physician specialities working with psychologically ill patients, one being "psychiatry and psychotherapy", the other "Psychotherapeutic medicine" with the former one being much larger in number with regard to acute inpatient care, while the latter is predominant in rehabilitation hospitals. Hence, in acute care hospitals consultation-service delivery mostly is run by psychiatry, as their are much more psychiatric departments than departments of psychotherapeutic medicine. This dichotomy is hardly understood outside Germany. our debate tries to clarify issues and attempts to put the German special way into a broader internatinal perspective. Participants are: Michael Linden (Berlin) as a "psychiatrist and psychotherapist" and behavioural therapist, running a psychosomatic rehabilitation hospital. Hans-Christian Deter (Berlin), representing the classical German psychosomatic approach. Albert Diefenbacher (Berlin), on c-l-psychiatry and psychosomatics. Ulrik Malt (Oslo), commenting the German dichotomy from an international (European) perspective. James J Strain (New York), "Consultation and Liaison - revisiting issues of an old debate", as, of note, the German twofold c-l-approach has some resemblance with the consultation vs. liaison issue, though it is not identical with it.