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February 1968

An Open-Ended Crisis-Oriented Group for the Poor who are Sick

Author Affiliations

From the Harvard Medical School, (Boston). Dr. Bloch is currently serving with the US Army Medical Corps in Vietnam.

Arch Gen Psychiatry. 1968;18(2):178-185. doi:10.1001/archpsyc.1968.01740020050006

THE RECENT interest in the mental health of the poor has been fraught with controversy about whether psychiatry can be helpful to the lower socioeconomic groups and, if so, how. Difficulties both on the part of lower-class patients and of the therapeutic personnel have been discussed.1-4 Yet, reports of new and imaginative approaches to the treatment of the poor have led to the dissolution of shibboleths such as the failure of the poor to persist in therapy or to utilize therapeutic relationships in other than supportive ways. Perhaps the most basic difficulty perceived in the treatment of the poor stems from particular characteristics of their behavior which are often exhibited in the clinical setting. These include a combination of the following: (1) more "oral demanding" attitudes than goal-oriented aspirations, coupled with (2) a low threshold of tolerance for frustration with relatively little ability to temporize gratification; (3) more action-oriented

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