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An Unintended Side Effect in a Community Psychiatric Program

William M. Bolman, MD; Seymour L. Halleck, MD; David G. Rice, PhD; M. Lynn Ryan, MD
Arch Gen Psychiatry. 1969;20(5):508-513. doi:10.1001/archpsyc.1969.01740170012002.
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MOST LOST community psychiatric programs involve efforts to bring about change in some type of social system. The system may range from one that is small and relatively well defined, such as an agency, to one that is as large and complex as a community. The desired changes are many, but in general they are directed at improving the system's competence with regard to psychosocial and mental health concerns. The conditions for success or failure of such efforts are not at all clear, but several themes recur, in particular those that stress the need for effective communication and for mutual congruence of values between the different levels of the system.

In this report we hope to show how an attempt to bring about change in the social system of a university dormitory mobilized counter forces that led to unintended side effects and failure because of unresolved problems in communication and

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