Johansen K H
Hosp Community Psychiatry. 1983 Sep;34(9):842-6. doi: 10.1176/ps.34.9.842.
Inpatient psychiatric facilities are admitting an increasing number of young patients with chronic character pathology. Hospitals must explore the impact these patients have on the treatment facility and the risks inherent in their treatment, including the possibility of decreased milieu specificity, increased staff regression, and loss of cost-effectiveness. These risks are system responses that go beyond individual staff countertransferences. Possible remedies include refined indications for inpatient psychiatric treatment, tailoring of milieu functions to fit individual patient needs, explicit accountability of administrative and supervisory structures, and involvement of families in the formation of the initial treatment alliance.
住院精神科机构收治的患有慢性性格障碍的年轻患者数量日益增加。医院必须探究这些患者对治疗机构的影响以及其治疗中固有的风险，包括环境特殊性降低、工作人员退行增加以及成本效益丧失的可能性。这些风险是超出个别工作人员反移情的系统反应。可能的补救措施包括完善住院精神科治疗的指征、调整环境功能以适应个体患者需求、明确行政和监督结构的问责制，以及让家庭参与初始治疗联盟的形成。
