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November 1969

Defining Milieu Therapy

Author Affiliations

Madison, Wis
From the Department of Psychiatry, University of Wisconsin Medical Center, Madison, Wis.

Arch Gen Psychiatry. 1969;21(5):553-560. doi:10.1001/archpsyc.1969.01740230041006

MOST discussions of milieu therapy begin and end with an account of its value system. The therapeutic community is typically described as a humanistic, permissive, realityoriented, democratic, living-learning situation.1-3 Edelson's statement is characteristic:

The "therapeutic community" . . . (is) . . . an exemplification of the values to which contemporary psychiatry gives increasing allegiance, that the in-patient care of the mentally ill should be humane: taking place in a setting that is continuous with the society from which the patient comes, open, antiregressive, eschewng a "total institution" organization in favor of decentralized and democratic processes.. . .4

But after agreeing with these values, one is left with many questions. Precisely what are the treatment goals of the therapeutic community? What are its specific methods? How does the realization of its values relate to these goals and methods and particularly, how does the lone, sick individual get better by becoming acculturated

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