The usual mistakes
Subject of the article: residential psychotherapy with male and female adolescents and youths who suffer from serious neurotic disturbance. The text is entirely conceived in terms of some rnistakes which staff may make.
In residential treatment, a staff group treats a patient group. Various mistakes demonstrate the desirable priority of attention to staff rather than to patients. A staff standing defensive towards parents or society stands defensive towards patients.
The author cannot conceive of treatment without a centre-person who shares the patient's responsibility, no sector of life excluded. Staff may expect a patient to enter upon intensive psychotherapy through regression (a) or through ego stress (b); or staff may concentrate upon agogics and education (c). These three ways may be either sound or neurotic staff response to a patient. Different modes of perceiving a patient are discussed. Perception may be in terms of: attractive/non-attractive; in terms of psychopathological description; in terms of what a patient has to do, considering his developmental profile; in terms of what a patient has to do in using treatment and staff; in terms of what a patient is to get. Again, the definition of some major staff mistakes presents the material.
Intensive psychotherapy of these patients is to be semi-directive, and the author advances three arguments for this view. In being semi-directive, we may make three types of mistake. 1) Do not invent reality requirements for each patient individually all the time; you are to have a basic package for everyone. 2) Do not concentrate upon parts of reality while comfortably forgetting about other parts (such as money). 3) Do not be dreamy about time; things have a talent for happening too late.
Staff mistakes fall under two headings: wrong response and initiative not taken. Multi-track treatment is essential.