A social network approach and the revolving door patient.

Abstract

Traditional psychiatric treatment approaches have not been very successful with the "revolving door patient." A variety of findings suggest that the social network, as opposed to the individual patient, may be a more viable locus for intervention. A conceptual review and analysis of the literature reveals two constructs salient to understanding social networks: flexibility and stability. The networks of revolving door patients are frequently characterized as inflexible and/or unstable. Assessment methods as well as strategies for balancing flexibility and stability are described. Enlarging the network, increasing multiplexity, and/or reducing the negative effects of attitudinal inflexibility encompass the strategies for increasing flexibility, while developing connections between individuals, generating spans between clusters of people in the network, and increasing multiplexity are recommended for increasing stability. The assets and liabilities of each of these strategies are discussed.