ABSTRACT
This chapter examines four sets of factors that shape treatment environments: the institutional context, physical features, policies and services, and suprapersonal factors or the aggregate characteristics of residents and staff. Program reorganization sometimes provides a unique opportunity to examine the influence of size on treatment climate. When a psychiatric unit for schizophrenic patients was divided into smaller programs, organization increased and aggression declined. Higher staffing is used as an indicator of better quality care and might be expected to be associated with a more cohesive, self-directed, and well-organized social climate. Clearer policies may increase predictability for residents and staff and, consequently, their feeling of control; they may also contribute to more efficient program facility operation. In fact, in psychiatric and substance abuse programs, residents report more support and organization in programs with more formal avenues for communicating policies. As with the provision of resident control, residents may use formal mechanisms for relationship as well as for task functions.
