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Attempting to determine the best way to sequence psychopharmacology and psychotherapy in a split/collaborative treatment arrangement is a real and significant problem (Beitman et al. 2003). Although research has shown that the combination of both types of treatments is effective for patients with many kinds of psychiatric diagnoses (Guidi et al. 2011, 2016) and that the split/collaborative treatment model has become the default paradigm in most clinical organizations (Gitlin and Miklowitz 2016), the research to date has not provided us with a clear guideline for sequencing specific treatments and treatment modalities. Furthermore, the guidelines that do exist based on general considerations of evaluation or treatment of certain types of disorders are focused on integrated treatment, in which a psychiatrist provides both the psychotherapy and medication management (Silverman et al. 2015). Split/collaborative treatment adds other variables that make the logistics and understanding of the sequence more complicated.
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