Milieu characteristics of successful psychiatric treatment programs.

Ellsworth, Robert B.; Maroney, Robert; Klett, William G.; Gordon, Hiram L.; Gunn, Robert C.

doi:10.1111/j.1939-0025.1971.tb01129.x

Cited by 91 publications

(40 citation statements)

References 12 publications

(3 reference statements)

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“…In contrast to these findings, Ellsworth et al (1971), Holland (1973Holland ( , 1981, Cummings and Berger (1976), Martin and Segal (1977), Prager and Schnit (1985/86), and Whiddon and Martin (1987) have found that services are improved under conditions of decentralized decision-making in which the staff of the service is actively involved. A more recent study (Sherman, 1988) found that centralization of authority in voluntary organizations has negative effects on organizational effectiveness, and that structural decentralization enhances participation and involvement.…”

Section: Introductionmentioning

confidence: 81%

Relationships Between Decentralized Authority and Other Structural Properties in Human Service Organizations:

Schmid

1992

Administration in Social Work

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Section: Introductionmentioning

confidence: 81%

Relationships Between Decentralized Authority and Other Structural Properties in Human Service Organizations:

Schmid

1992

Administration in Social Work

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“…He later modified the subscales after factor analysis to include five dimensions: Active Treatment, Socioemotional Activity, Patient Self-management, Behavior Modification, and Instrumental Activity (Jackson, 1969). Ellsworth, Maroney, Klett, Gordon, and Gunn (1971) Moos (1968) revised this questionnaire for correctional settings, naming it the Social Climate Scale (SCS), with the same dimensions. Further revisions led to the Correctional Institutions Environment Scale (CIES), with the Affiliation, Aggression, Variety, and Halo subscales eliminated (Wenk & Moos, 1972).…”

mentioning

confidence: 99%

An assessment of the dimensionality of moos' social climate scale

Wilkinson

1973

American J of Comm Psychol

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A revised form of the Social Climate Scale (SCS) containing nine of the 14 subscales was given to 145 staff and 143 boys at a state training school for delinquents. A first principal factor was extracted from the item-correlation matrices for staff and boys, respectively. This factor was named Value, because of its representation of an evaluative item dimension. A factor model was used to test whether this Value factor might account for the significant subscale intercorrelations found in these samples. Maximum likelihood factor analysis of the subscale correlation matrices for both groups provided the test for this model. Through a least-squares rotation procedure on the maximum likelihood factor loadings, the Value factor was identified as the source of most of the subscale dependence. Implications for validation of the SCS and other related questionnaires by Moos are discussed.The emergence of social climate (atmosphere) 4 as a psychological construct has been accompanied by the development of a number of questionnaires for its measurement. One setting where research in this area has been especially active is the treatment milieu. Psychiatric wards of general hospitals (Moos & Houts, 1968), state mental hospitals (Gripp & Magaro, 1971), and correctional schools (Moos, 1968;Wenk & Moos, 1972) 4Social climate and social atmosphere are used synonymously to refer to the set of attributes of a social setting (institution, society, association, group) that directly affect individual behavior within that setting. 342

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“…The stage 1 treatment contract begins with three goals: (1) to clarify the diagnosis and learn basic information about risk factors and course; (2) to describe the chain of events leading to admission, and (3) to learn basic coping strategies for depression and anxiety. Psychoeducation addresses the first goal.…”

Section: Interpersonal Connectionsmentioning

confidence: 99%

“…Structure is central to milieu treatment [1][2][3]5,7,18,45,46,51,74,83,84 since it is the framework within which treatment occurs, and serves as the foundation for containment and coherence of treatment. The structure is also resilient: mechanisms are in place to anticipate and implement changes through a predictable process.…”

Section: Program Structurementioning

confidence: 99%

Fixed Values and a Flexible Partial Hospital Program Model

Neuhaus¹

2006

Harvard Review of Psychiatry

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Since the 1990s, societal and economic factors have constrained mental health care service delivery in the United States. Partial hospital (PH) programs have been presented with the challenge of using limited resources to treat complex patients in very short time frames; yet predominant psychosocial models and evidence-based treatment approaches have not adjusted sufficiently to the combined demands of patient care and the new health care environment. An updated PH model can advance existing psychosocial theory and practice. The basic assumption of the model is that both clinical and organizational aspects of a PH program must be inherently adaptable to maintain consistent effectiveness. The set of fixed values described here are instrumental in establishing priorities, guiding decision making, and creating a proactive, flexible organization. These values are drawn from the history of psychosocial and milieu treatments from the 1930s to the present and from assumptions and practices of cognitive-behavioral therapy, and are augmented by insights from psychodynamic psychiatry, business management, and leadership. The PH treatment approach aims to translate evidence-based cognitive-behavioral treatments into pragmatic interventions with emphases on psychoeducation and skills training. The context is brief treatment (i.e., one to two weeks) for mood, anxiety, and personality disordered patients in a private sector, managed care environment. Elements of this model may be generalized to inpatient, residential, and intensive outpatient programs, as well as to those that are starting up or being reorganized.

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Milieu characteristics of successful psychiatric treatment programs.

Cited by 91 publications

References 12 publications

Relationships Between Decentralized Authority and Other Structural Properties in Human Service Organizations:

Relationships Between Decentralized Authority and Other Structural Properties in Human Service Organizations:

An assessment of the dimensionality of moos' social climate scale

Fixed Values and a Flexible Partial Hospital Program Model

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