The Anticipation and Management of Crisis on an Open Psychiatric Ward

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Abstract
The present article deals with an attempt at integrating the therapeutic and management functions on an open psychiatric ward. The viewpoint is taken that the administrative policy and procedures of an open ward must be made consistent and congruent with the philosophy and therapeutic goals of the program. Failure to recognize this relationship frequently leads to the development of an overpermissive ward administration, a punitive antitherapeutic atmosphere, or a mechanical and sterile social milieu. The staff of psychiatric wards, by restricting and compartmentalizing their roles, often fail to see the extent to which administrative policies and practices influence their psychotherapeutic efforts. To explain our position, we shall first describe the Patients' Training Laboratory and outline several general therapeutic goals set for patients. Next, we shall discuss the development of management practices intended to implement objectives. Since the management of an actual crisis is a critical test of the validity of a ward staff's intentions for the patients, this section will describe procedures for coming to grips with such crises. The last section will illustrate our procedures for anticipating crises.

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