치료공동체로의 구성과 추적평가

Implementation and Follow-up Evaluation of a Therapeutic Community

We converted closed and custodial ward to therapeutic community ward at Bohoon Hospital during the past two years. We have investigated the effect of therapeutic milieu by comparing 3 periods ; the period prior to the institution of milieu therapy, slump period and reactivation period. The changes of severat dependent variables-maintenance level of antipsychotics, and the number of parenteral injections, taking hypnotics, acting-out, restraints and maximum security room (MRS) -were compared and the results were as follows : 1) While main tenance level of antipsychotics and the number of acting-out decreased in slump period of therapeutic community compared to the period prior to milieu therapy, the number of parenteral injections, restraints and MRS rather increased. Inactivation and confusion of therapeutic programs necessitated different methods of maintaining ward environment other than milieu therapy. 2) Especially during the reactivation period following institution of milieu therapy, pathological symptoms and acting-out decreased and therefore, the need for different methods other than milieu therapy to control them decreased. 3) Similar experimentations at other institutions will be needed to verify our experience with therapeutic community.