Human Elements of the Therapeutic Community

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Abstract
The importance of the context in which psychotherapy takes place has been amply documented in recent years, most explicitly in the work of Caudill and associates1,2and Stanton and Schwartz.3It has become clear that the behavior of a hospitalized patient cannot be understood solely in terms of his past personal history, since it also reflects the nature of his participation in the social system of the hospital. Further, there is general agreement that the hospital social system can be so structured as to have a therapeutic impact upon the patient. While there is less agreement, and little systematic investigation, regarding the mechanisms which produce the therapeutic effect, the literature and personal experience suggest the following possible factors: (1) the availability of staff personnel and other patients as objects for identification, (2) the social reinforcement of newly learned defensive or need gratifying techniques, (3) the psychological desensitization

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