The patient-staff community meeting: old tools, new rules

1. Psychiatric inpatient units with rapid turnover and acutely ill clients are vulnerable to the development of antitherapeutic trends, including destructiveness, disorganization, dysphoria, deviance, and dependency. 2. Inpatient therapists can apply the principles and techniques of milieu therapy, with certain modifications, to establish a therapeutic environment. 3. The patient-staff community plays a central role in this transformation, if it is structured to promote experiences of safety, order, support, involvement, and validation. 4. To accomplish these goals, the leaders of the meeting should establish clear rules and healthy norms, energize and guide participation, and focus discussion on topics relevant to unit events and to the processes of treatment and recovery.