Rational hospital psychiatry: the reactive environment

Abstract

This volume provides mental health professionals with an integrated theoretical and practical framework to be used in the treatment of hospitalized patients. The 'reactive environment,' as the authors term their conceptualization, is applicable to many types of psychiatric hospitals, regardless of treatment orientation, patient population, or average length of stay. Part I presents a brief history of American psychiatric hospitals and a typology of contemporary inpatient facilities. The principles of a reactive environment are then discussed. In part II the authors demonstrate how these principles are applied within three different programs: a crisis intervention unit, a therapeutic community, and a token economy. Part III considers specific procedures in a reactive environment, focusing on the admissions process, the hospital system, individual psychotherapy, behavior modification, use of medication, activities therapy, group techniques, family involvement, and aftercare planning. The final part examines the role of teaching research, evaluation and record keeping in the psychiatric hospital.