There is an increasing interest in scientific and practical aspects of C/L psychiatry in Germany. The every day C/L work in Germany still differs substantially from the American one. In contrast to Germany and other European countries, C/L psychiatry in the USA has developed into a subspecialty with multiple activities in research and patient care during the last 3 decades. This study was conducted in Germany and the USA in order to evaluate and compare the training and patient care in C/L psychiatry, as assessed by consultants doing the every day C/L work. 227 C/L psychiatrists participated in the study in both countries. There are significant differences in theoretical and practical C/L psychiatry is obviously more comprehensive. American C/L psychiatrists take more time for consultations, do more follow-ups, and more frequently organize psychiatric or psychotherapeutic outpatient after-care. These results are suited to support activities to improve quality in Germany C/L psychiatry.