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Mania and Milieu: Treatment of Manics in a Therapeutic Community
Darla Bjork; Maurice Steinberg; Jean-Pierre Lindenmayer; Herbert Pardes
Psychiatric Services 1977; doi:
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Downstate Medical Center State University of New York Brooklyn, New York

Department of Psychiatry University of Colorado Denver, Colorado

American Psychiatric Association

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Abstract

The authors observed the management of 35 manic patients admitted to a 32-bed general hospital unit that emphasized milieu treatment. They concluded that the principles of treatment derived from the therapeutic community model—democratization and permissiveness—are generally incompatible with the effective treatment of manic patients, who can be a strong disruptive force on the patient and staff community. The authors describe approaches to managing manic patients in four phases—preadmission evaluation, and the postadmission, middle, and termination phases of inpatient treatment. They stress that milieu modifications are necessary to meet individual treatment needs.

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