The treatment and management of psychiatric inpatients has progressed over the last two centuries from an era of warehousing and poor treatment of "lunatics" through an era of moral management to the medical model of custodial care. Since mid-century three major approaches have been utilized: the medical model, the milieu therapy model, and the social learning model. This paper proposes a combined social learning/milieu therapy program of inpatient treatment and management. The program utilizes the team approach to inpatient treatment and incorporates four levels of status which incrementally allow the patient to become more independent and more responsible for her own treatment. The behaviors appropriate to each level of status are incorporated into checklists with which each patient monitors her own progress. The program focuses on increasing the patient's level of social skills while she is concurrently working both in group and individually on her own treatment plan and goals, aided by her physician and therapist.
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