title: Mania and milieu: treatment of manics in a therapeutic community.
abstract: The authors observed the management of 35 manic patients admitted to a 32-bed general hospital unit that emphasized milieu treatment. They concluded that the principles of treatment derived from the therapeutic community model--democratization and permissiveness--are generally incompatible with the effective treatment of manic patients, who can be a strong disruptive force on the patient and staff community. The authors describe approaches to managing manic patients in four phases--preadmission evaluation, and the postadmission, middle, and termination phases of inpatient treatment. They stress that milieu modifications are necessary to meet individual treatment needs.
mesh_terms: D001714:Bipolar Disorder / Q000188:drug therapy / Q000628:therapy*; D006760:Hospitalization; D006769:Hospitals, General; D006801:Humans; D009519:New York City; D010347:Patient Care Planning; D010348:Patient Care Team; D011567:Psychiatric Department, Hospital; D013808:Therapeutic Community