Mania and Milieu: Treatment of Manics in a Therapeutic Community
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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