March 1969

Patient Value Change in Milieu Therapy

Author Affiliations

New Haven, Conn
From the Yale University School of Medicine, New Haven, Conn. (Dr. Almond is currently with the Adult Psychiatry Branch, National Institute of Mental Health, Bethesda, Md.)

Arch Gen Psychiatry. 1969;20(3):339-351. doi:10.1001/archpsyc.1969.01740150083012

OBSERVERS and practitioners of psychotherapy have frequently emphasized the role of patient values and value changes in the process of treatment. A series of descriptive and anthropological studies during the past two decades have demonstrated the existence of ward or hospital "cultures" in a variety of settings. These institutional value systems, it has been argued, strongly affect the attitudes of patients, and exert great power over patient behavior and prognosis.1-5 Recognition of such cultures has led both to a more sophisticated examination of the psychiatric hospital as a complex organization, and to a more self-conscious use of the hospital community as a major therapeutic instrument.

At the same time, a small number of investigators have begun to examine the specific effects of therapeutic values on the values and attitudes of patients. Most formal studies have examined value phenomena during individual

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