A view from Riggs: treatment resistance and patient authority -- V. Silencing the messenger: the social dynamics of treatment resistance.

Treatment resistance has emerged as a significant issue in our era emphasizing biological treatments for psychiatric disorders. Some treatment programs utilize milieu treatment to advance work with treatment resistant patients. This article (1) explores the social factors that contribute to and exacerbate treatment resistance (2) reviews the theoretical framework and rationale of a therapeutic community milieu treatment program, and (3) illustrates therapeutic community work with two treatment resistant patients.