Families and hospitals: collusion or cooperation?

The author describes the therapeutic problems that can arise on a family-oriented psychiatric inpatient service. The stress emerging from the therapeutic demands on and changes in the internal structure of the family may cause the family to seek to reestablish its internal equilibrium by changing the hospital staff and structure at the ward level, department level, and the hospital administration level. These transactions between the hospital and families, which are complex, are extremely important to recognize because they can undermine the therapeutic process.