By John M. Oldham, L. Mark Russakoff, Otto F. Kernberg
In an unique integration of the medical model and healing group ways to clinic milieu remedy, Oldham and Russakoff current either a scientific conception for acute medical care and its functional program, spelled out in nice element with no reducing the excessive point in their narrative to a cookbook method of treatment.
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Additional resources for Dynamic Therapy in Brief Hospitalization
We are learning more and more about neurochemical alterations in schizophrenics, and we are continuing to raise questions about cortical atrophy, ventricular enlargement, inequalities in lateralization, and memory, perceptual, and cognitive deficits in some subgroups of chronic schizophrenics. Organic factors may also play a role in some chronic character-disordered patients, either subtly, due to residual learning disabilities, or more obviously, due to chronic alcoholism or repeated toxic drug-induced organic states.
55). In his careful analysis of the therapeutic community originated by Jones, Rapoport (1960) emphasizes the following for an effective program: "Patients' administration of therapy to one another is fraught with hazards. " (p. 286). Zeitlyn (1967), in a more critical vein, says: The introduction of the therapeutic community appears, for example, to have led in some places to a new discrimination and selection of patients and to the fonnation of a new group of rejected ones, excluded on the grounds that their symptomatology renders them unsuitable for the pennissive milieu characteristic of this fonn of treatment [p.
Rappaport and co-authors (1978) found that patients did as well or better when treated with milieu therapy alone than with drugs. These results are in marked contrast with earlier reports; May (1968) concluded that "our statistics demonstrate beyond reasonable doubt that for the general run of schizophrenic patients, milieu therapy alone is both expensive and relatively ineffective" (p. 268). It has been argued that the types of milieu therapy studied by May were ill-defined and ineffectual (Gunderson 1983, Mosher and Gunderson 1979), accounting for his negative results.