Advisory and Coercive Functions in Psychiatry

Two questions about professional practice rarely arise: the use of control in expert-client relations and the effect of different settings on the styles of practice. This paper presents the historical development of the mandates, for both control and advice, which pervade psychiatric practice. Though the presence of expertise always implies an element of control, usage varies according to opportunities and constraints provided by each setting. An analysis of control functions exercised by psychiatrists in coercive settings-institutions-leads to recognition of the application of control elements in the supposedly advisory setting of private practice. Patients meeting psychiatrists in different settings require differing kinds of protection against misuse of professional expertise.