This paper describes the early phase of development of a therapeutic community and teaching unit on one ward of a large mental hospital. Some of the changes accomplished in the ward and some of the difficulties experienced are analysed in sociological terms in order to comprehend the reaction which occurred in the hospital ‘employee culture’. Some factors in the success of the program are discussed. Generally, the problems which arose were similar to those mentioned by other investigators of institutional change, and they may be considered to be predictable, comprehensible and usually soluble.
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