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Milieu Therapy in Schizophrenia:  A Negative Result

Alex J. Spadoni, MD; Jackson A. Smith, MD
Arch Gen Psychiatry. 1969;20(5):547-551. doi:10.1001/archpsyc.1969.01740170051007.
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THE LAST decade has witnessed a rapid increase in interest and use of milieu therapy with hospitalized patients. E. Simmel's1 work at the Tegel Sanitorium and H. S. Sullivan's program2 at Sheppard and Enoch Pratt Hospital stimulated interest in the use of social environment as a therapeutic tool. The experience of psychiatrists in World War II provided impetus towards the use of group and social forces in the handling of combat casualties. Then, in the 1950's and early 1960's, a number of books appeared which gave a theoretical foundation and methodology for using these forces to promote patient recovery. The most influential of these were publications by M. Jones,3 A. Stanton and M. Schwartz,4 H. Wilmer,5 E. Goffman,6 W. Caudill,7 the Cummings,8 K. Artiss,9 and M. Edelson.10

While psychiatrists had generally accepted the importance of social and cultural factors in

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