Sloppiness refers to the indeterminate, untidy or approximate qualities of the exchange of meaning between patient and psychotherapeutics (Boston Change Process Study Group, 2005). In an institutional’good-enough’ Day-Hospital, patients move around psychiatry, physicians, phychotherapists, rehabilitation groups giving arise a relational field where something happens. Beyond known therapeutic factors,’something else’ arises from intrinsic indeterminancy of the relationship among minds.

Our work is an attempt to elaborate and explore the idea of sloppiness and co-creativity as a model of therapeutic teamwork organization in an institutional Day-Hospital.

The sloppiness as a model of teamwork organization may permit to individuate features relevant in a co-creation process among teamwork members and patient in severe psychiatric disorder.

We present four case reports belonging to different diagnostic classes: psychosis, affective disorder, personality disorder and anxiety disorder.

Long time clinical observation suggests that different features significantly affect clinical outcome in different patients. So, sloppiness has a pivotal role in the therapeutic process leading to a change because,’playing’ among teamwork in a unstructured relational space, patients drawn on what they authentically need.

Sloppiness and co-creativity might represent’something else’ which allow patient to create his personal therapeutic pathway, and teamwork to fine-tune dynamically therapeutic act on patient. So sloppiness, as a tool of encounter between patient and teamwork in an institutional Day- Hospital, might advance co-creativity process leading to an individual care pathway good-fitted on patient.