ABSTRACT
Physically disabled individuals are engaged in a fight to modify the public environment to allow access to buildings, recreational areas, transportation, jobs, and professions. Overemphasizing the benefits of deinstitutionalization or community-based services may have the effect of underemphasizing the healing effects of appropriate, flexible, self-contained residential settings. The Menningers in Topeka, although very psychoanalytically oriented, expanded several of the ideas of milieu therapy. Milieus can be set up following eclectic, psychoanalytic, behavioral, educational, social learning, or social-psychological principles. Authoritarianism, defensiveness, rejection, criticism, and judgmental behavior are characteristics which are probably antithetical to the therapeutic relationship. All therapeutic systems present some rationale to participants. The rationale covers two aspects: An explanation, diagnosis or description of the problem allows it to be named, categorized, or concretized in some way and some prescription is offered as to what types of things need to be done in order to change have surgery, get more training or education, or develop self-understanding.
