The treatment of psychiatric inpatients by milieutherapeutic principles requires a special type of management. The author describes a model of milieutherapeutic management. The importance of keeping congruent the surface structure and the depth structure of a work group _ the treatment team _ is emphasized. A relationship between group fragmentation and incongruency is described. Fragmentation in work groups probably leads to regression in primitive ways of interacting between group members. The task of the milieutherapeutic manager is to prevent fragmentation and regression and to keep the surface structure and the depth structure of the work group congruent.

Milieutherapeutic management is a way of handling a hospital organisation which has consequences for each and every worker. It requires a permanent reflection on the interactive aspects of working together and working with patients.