INTENSIVE PSYCHOTHERAPY IN A HOSPITAL CLINIC

Abstract

In April, 1930, the Institute of the Pennsylvania Hospital was opened for both resident and out patients. This step was an outgrowth of the Department for Mental Diseases. The psychiatric staff of the department, through years of constant clinical work with the psychoses, diagnostic work in the out-patient clinic, and in other phases of their psychiatric work, became increasingly aware of the need for a department where intensive psychotherapy could be adequately applied for patients before a frank mental or nervous illness occurred. The psychotic patient was not fully accessible for psychotherapeutic approach. The usual out-patient clinic schedule did not permit time, and was often filled with unsuitable cases. Following years of careful study, plans were gradually drawn up for the Institute which should make available, to a new kind of patient, psychiatric consultation and treatment. Resident patients as private cases were provided for also, to help finance the necessary departments of the Institute. No further discussion of the work for the private patients as such will be continued, as their treatment differs in no way from that of the patients of the Consultation Clinic, with which this paper is concerned. The Consultation Clinic, or out-patient pay clinic, comprises the main clinical and research work of the Institute. The new Institute building consists of the Consultation Clinic offices, private offices of the psychiatrists, rooms for resident patients, and all departments needed for the treatment of patients. These are the usual physiotherapy, hydro-therapy, arts and crafts departments, the roentgenological, clinical and psychological laboratories. The Consultation Clinic operates on an appointment system. A full hour is given for each appointment, regardless of the frequency of the appointments, or the financial rating of the pa-