Critical evaluation of a total push program for regressed schizophrenics in a state hospital.

Abstract

Two groups of regressed schizophrenic patients, 85 in total, were placed on successive six-monthtotal push programs at Fergus Falls State Hospital, Fergus Falls, Minn. The treatment program utilized an integration of electric shock, recreational, occupational, social, and psychological therapies. An evaluation of the success of the treatment was made by observing the differences between pre- and post-behavioral levels, as measured by the L-M Fergus Falls Behavior Rating Scale, and as measured by qualitative changes. Both groups showed a statistically significant amount of improvement as measured by the scale as well as considerable qualitative change for the better. Three factors (better initial behavior, shorter length of hospitalization, and having a diagnosis other than hebephrenic schizophrenia) appeared to differentiate between those patients who improved and those who did not improve in the first group. These factors, however, were found lacking when they were tested as prognosticators for the second group. More research on prognosticators for the total push type of therapy seems indicated. A follow-up study indicated that the male patients held their improvement, while the women did not. The hypothesis was offered that the men held their improvement because they enjoyed better post-treatment placement than the women. It was further suggested that, for many individuals at least, total push may not result in long-term improvement and that careful post-treatment placement may be necessary in order to maintain gains made on the program.