Det terapeutiske samfunn, universalmiddel eller spesifikk behandlingsmetode?

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Abstract
The development of some therapeutic communities and the concept of milieu therapy in Norway is summarized. In spite of strong resistances some pioneer institutions gradually developed a therapeutic community proper, and the concept of milieu therapy spread more rapidly as the new »mode« in institutional psychiatry in Norway. Much enthusiasm followed, reinforced by a general wave of reforms in Norwegian psychiatry, good economic conditions, and the social political climate fitting well to the values of the therapeutic community. In the seventies most psychiatric institutions met new challenges, in the reorganization of the psychiatric services, changes in pathology of the patient populations and shortening of in-patients' stay. Many psychiatric units got increasing problems, sometimes resulting in burn-out syndrome in the staff. These clinical experiences and research reports contributed to the need for re-evaluation of our milieu programs and treatment ideology, and to create more different milieus for different groups of patients. As an afterthought the concept of milieu therapy probably was a compromise between the different professional orientations among psychiatrists, which favoured a simplistic and superficial tendency in institutional treatment. We are convinced that the therapeutic community neither is a panacea, nor a specific treatment method. Its main principles are basic for all social life. What psychiatrists and other professionals, however, need to learn more about is group and organizational dynamics.

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