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March 1957

Adjustment Patterns of Leadership and Defenses in a Disturbed Child Group

Author Affiliations


Formerly at Institute for Psychosomatic and Psychiatric Training and Research, Michael Reese Medical Center; now at Veterans Administration Hospital, Sepulveda, Calif. (Dr. Goldstein). Clinic Physician (Dr. Judas), Head Nurse, Child Care Unit (Miss Sutton), Attending Psychiatrist and Chief of Child Care (Dr. Falstein), Institute for Psychosomatic and Psychiatric Research and Training, Michael Reese Hospital.

AMA Arch NeurPsych. 1957;77(3):312-317. doi:10.1001/archneurpsyc.1957.02330330098015

When a child enters a clinic, hospital, or institution for treatment, it is usual to think that it is his problem to adapt to an environment that by sheer numbers, tradition, and authority sets the rules and limits of behavior and therapy. Despite the convenience of this assumption, our experiences and anxieties often indicate that it is the staff, patients, even the building and the grounds that must bend toward the newness, unpredictability, and lack of knowledge suddenly confronting the child. Whether the interactive result is integrative or disruptive, our anticipations (rarely disappointed) are toward the change of a new configuration. On the children's psychiatric unit at the Institute for Psychosomatic and Psychiatric Research and Training of the Michael Reese Medical Center we found over a period of time that the parsimonious but practical criteria of admission acceptance, such as age, size, pubescence, type and degree of psychiatric dysfunction, and