Abstract

The Menninger Clinic This article is based on a patient education program the authors are conducting in the Professionals in Crisis program at The Menninger Clinic. This program is designed to foster a therapeutic alliance by helping patients understand a central aim of treatment, namely, fostering mentalizing, the awareness of mental states in self and others. The educational material is based on research in the Menninger Child and Family Program. The educational sessions are conducted like seminars in which the leaders and patients collaborate in understanding these concepts and their application to treatment. Patients in the program are provided with this article as background material for the seminar. Many persons with serious psychiatric disorders require intensive treatment. Medication or individual psychotherapy alone—or even their combination—won't always do. Patients who have not benefited sufficiently from less intensive outpatient treatment may require inpatient treatment that provides for comprehensive assessment and combines a wide range of interventions—not just medication and individual psychotherapy, but also group therapy, family work, educational groups, therapeutic activities and a specialized milieu. Crucial to such treatment is a social environment that provides support, a feeling of belonging and ample formal and informal opportunities to confide in peers and learn from them. Such a rich array of therapeutic interventions confronts us with a problem: How does it all work? It is no small challenge to understand how medications work or to understand how individual psychotherapy helps. Researchers have been studying these interventions for decades. When we combine these standard interventions with many other therapies, understanding the basis of our treatment's effectiveness becomes even more challenging. We all subscribe to the "bio-psycho-social" model of treatment, believing that we must integrate the biological, psychological and social domains, as well as the spiritual domain. But this is a vast territory to cover.