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March 1979

The Therapeutic Community as a Research WardMyths and Facts

Author Affiliations

From the Langley Porter Neuropsychiatric Institute, University of California, San Francisco. Dr Braff is now with the Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla. Dr Glick is now with the Department of Psychiatry, Cornell University School of Medicine, Payne Whitney Psychiatric Clinic, New York.

Arch Gen Psychiatry. 1979;36(3):355-360. doi:10.1001/archpsyc.1979.01780030121012

• The clinical research ward run as a therapeutic community has been criticized as inefficient and scientifically unsound. This article discusses the therapeutic community as a research ward and identifies certain misconceptions which underlie many criticisms. The following myths are discussed and refuted: (1) There is an insurmountable community-research chasm. (2) The therapeutic community induces stress that interferes with research. (3) Patient passivity is engendered by research and this is destructive to the therapeutic community. (4) Symptoms are exacerbated by a research ward that is disruptive to the community. (5) Normal research subjects cannot live in a therapeutic community without pathologic psychic changes. These inaccurate myths are seen as a reflection of attempts to oversimplify very complex clinical and research issues. The use of mythology to simplify experiments, to artificially "clarify" complex issues, or to "protect" patients is seen as a disservice. The therapeutic community and research are syntonic when both receive appropriate support.