Patient treatment preferences and treatment orientation

The terms 'therapeutic community' and 'therapeutic milieu' have been used rather liberally to describe a variety of mental health treatment programs in many different settings. The use of either term has generally denoted a treatment approach which attempted to extend itself beyond the traditional medical disease model of diagnosis and treatment of emotional difficulties. The extension involved the use of the patient's environment as a tool in effecting his recovery. A program of this nature required that the patient enter into his treatment and the treatment of fellow patients through active participation in the therapy process and responsible participation in the decision making processes. The staff in a therapeutic community discarded its traditional roles and assumed a team posture. Within the team, the staff operated on the basis of delegated authority and responsibility. Staff roles were viewed as interchangeable with few exceptions. At times, these modifications involved an entire institution, but more likely only effected one or two treatment wards.