The ecology of child treatment. A developmental/educational approach to the therapeutic milieu

Many residential and day treatment programs for troubled children have experienced only limited success because of their inability to impact the child's total life sphere: family, peer group, school, and neighborhood. This has prompted the present move to deinstitutionalize children's mental health services--a movement which is sound in its underlying purpose, but which sometimes falls prey to the notion that merely altering the location of treatment from the ward or institution to the community setting will dramatically alter its results. It will not. This paper begins with the assumption that the focus of child treatment is as important as the locus and attempts to identify the critical elements in a therapeutic community-based program for the troubled child and his parents.