Adapting milieu approaches to acute inpatient care for schizophrenic patients.
Classic therapeutic community or milieu therapy techniques are not applicable in many contemporary acute-treatment settings, which emphasize crisis intervention, short stays, psychotropic medication, and cost containment. However, milieu techniques can be integrated with an understanding of biological and psychosocial factors to provide a framework for the acute, short-term treatment of schizophrenic patients. After reviewing recent biological and psychosocial research, the authors outline three principles for incorporating such research with milieu techniques: creating a holding environment, developing a graduated therapeutic program, and focusing on common patient needs. Application of these principles in a short-stay setting will provide an intensely supportive treatment environment that allows the use of many different therapies and modulates stresses on staff.
Kahn
E M
EM
Psychiatric Inpatient Unit, Nashua Memorial Hospital, Hampshire 03061.
White
E M
EM
D000208:Acute Disease; D006801:Humans; D007902:Length of Stay; D008884:Milieu Therapy / Q000379:methods*; D012559:Schizophrenia / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D012931:Social Environment; D012944:Social Support; D012951:Socialization; D013808:Therapeutic Community / Q000379:methods*