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October 1967

Ward Structure, Therapeutic Ideology, and Patterns of Patient Interaction

Author Affiliations

From the University of Illinois at the Medical Center, Chicago.

Arch Gen Psychiatry. 1967;17(4):407-415. doi:10.1001/archpsyc.1967.01730280023002

OVER three decades ago, Rowland was impressed by the discovery of social interaction and social system among hospitalized schizophrenics.1,2 The implications of his work were relatively neglected in the psychiatric community until Stanton and Schwartz's monumental monograph presented strong evidence of the responsiveness of hospitalized patients to their milieu.3 Since then, two parallel but loosely related movements have been gaining momentum. First, the concept of "therapeutic community" evolved from empirical experience and is being taken up with more or less expertise in more and more mental hospitals. Second, series of careful investigations have been undertaken, one group of studies focusing on the social structure of hospitals and the nature of patient groupings,4-8 and another group of studies concerned with testing, more closely delimiting the relationship between milieu and patient behavior.8 11 One paper severely criticizes the application of terms such as "community" and "society" to

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