Whatever the clinical rationale is for such extreme boundaries between staff and clients, they have a negative impact that should not be disregarded. In addition to making clients feel dehumanized, these boundaries hinder healthy role modeling. In fact, they contribute to clinical condescension, and I believe they are the reason so many people are stuck in day treatment for large portions of their lives. In his book The Theory and Practice of Group Psychotherapy, Irvin D. Yalom (with Molyn Leszcz) cites healthy interpersonal relationships as a principal “curative factor” in recovery from mental illness. In many day treatment programs there is a stilted version of normal relationships which therefore provide a limited, if any, degree of recovery. And just as patients aren't allowed to really know their clinicians, their clinicians don't really get to know them in their full humanity. Instead, clinicians view clients through a haze of jargon and labels. Even after being in a day treatment program for many years, it was my experience that the staff didn't really know me.