Therapeutic pretense in reality orientation

Based on a three month period of intensive observation in a nursing home, this study examines several aspects of the staff's work in the application of reality orientation (RO) to patients who are confused or disoriented. It is argued that in the application of RO and similar behavioral therapies, a clear analytic separation between the problems of patients and the work of caregivers cannot be justified. Caregivers do more than provide care; they help to constitute problems.