The term 'institutionalization' is relatively recent(35) but the damaging effects of mental hospitals on patients has been recognized for much longer, at least since the early years of this century.(36) In the period after the Second World War, hospitals were organized in a less hierarchical and dehumanized way to avoid or reverse these adverse effects.
There has been some confusion regarding the term 'therapeutic community'. In the formal usage the term describes an intensive form of treatment in which every aspect of the environment is part of a setting in which behaviour can be challenged and modified, essentially through the group pressure. This is very different from approaches which attempt to prevent the dehumanizing effects of mental hospitals by creating a general therapeutic and democratic atmosphere (37) (see Chapter 6.3.9)
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