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Avoiding Institutionalization of Psychotic Children

Richard M. Silberstein, MD; Wallace Mandell, PhD; John D. Dalack, PhD; Allen Cooper, PhD
Arch Gen Psychiatry. 1968;19(1):17-21. doi:10.1001/archpsyc.1968.01740070019003.
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TRADITIONALLY, the treatment of choice for severely disturbed and hard-to-manage psychotic children has involved institutional placement. Because such children exhibit behavior which is threatening to family, school, and community, in-hospital care has seemed most advisable from the community's point of view. However, clinical observation suggests that institutionalization frequently has a disruptive effect on children's emotional and intellectual development if they are not provided with an appropriate degree of specific professional attention, available only at specialized intensive residential treatment centers. Since the cost of such residential treatment is prohibitive for most parents, and since the number of such centers is extremely limited, alternative methods of treatment are urgently needed. Moreover, with the development of the community mental health movement, child psychiatrists and child development experts have become concerned about the implications of removing children from their homes. To this group it seems contrary


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