STUDY GUIDE
TREATMENT
SETTINGS AND
THERAPEUTIC
PROGRAMS
CHAPTER 4 LATEST
UPDATE 2026/2027
MULTIPLE CHOICE
QUESTIONS AT THE
END FOR BETTER
UNDERSTADING
RATED A+
,Treatment Settings and Therapeutic
Programs
KEY TERMS
assertive community treatment (ACT)
clubhouse model
criminalization of mental illness
day treatment
interdisciplinary (multidisciplinary) team
partial hospitalization programs (PHPs)
recovery
residential treatment settings
stigma
telepsychiatry
LEARNING OBJECTIVES
After reading this chapter, you should be able to:
1. Discuss traditional treatment settings.
2. Describe different types of residential treatment
settings and the services they provide.
3. Describe community treatment programs that provide
services to people with mental illness.
4. Identify the factors that distinguish recovery
programs from traditional treatment.
, 5. Identify barriers to effective treatment for people
with mental illness who are homeless.
6. Discuss the issues related to people with mental
illness in the criminal justice system.
7. Discuss the difficulties faced by military veterans both
during and following service.
8. Describe the roles of different members of a
multidisciplinary mental health care team.
9. Identify the different roles of the nurse in varied
treatment settings and programs.
NURSING CONCEPTS
Collaboration
Community-Based Practice
Health Care Disparities
Health Care Systems
Managing Care
Therapeutic Communication
INTRODUCTION
Mental health care has undergone profound changes in the past 50 years.
Before the 1950s, humane treatment in large state facilities was the best
available strategy for people with chronic and persistent mental illness,
many of whom stayed in such facilities for months or years. The
introduction of psychotropic medications in the 1950s offered the first hope
of successfully treating the symptoms of mental illness in a meaningful
way. By the 1970s, focus on client rights and changes in commitment laws
led to deinstitutionalization and a new era of treatment. Institutions could
no longer hold clients with mental illness indefinitely, and treatment in the
, “least restrictive environment” became a guiding principle and right. Large
state hospitals emptied. Treatment in the community was intended to
replace much of state hospital inpatient care. Adequate funding, however,
has not kept pace with the need for community programs and treatment (see
Chapter 1).
Today, people with mental illness receive treatment in a variety of
settings. This chapter describes the range of treatment settings available for
those with mental illness and the psychiatric rehabilitation programs that
have been developed to meet their needs. Both of these sections discuss the
challenges of integrating people with mental illness into the community.
The chapter also addresses two populations who are receiving inadequate
treatment because they are not connected with needed services: clients who
are homeless and clients who are in jail. In addition, the special challenges
facing military veterans are presented. The chapter also describes the
multidisciplinary team, including the role of the nurse as a member. Finally,
it briefly discusses psychosocial nursing in public health and home care.
TREATMENT SETTINGS
Inpatient Hospital Treatment
In the 1980s, inpatient psychiatric care was still a primary mode of
treatment for people with mental illness. A typical psychiatric unit
emphasized talk therapy, or one-on-one interactions between residents and
staff, and milieu therapy, meaning the total environment and its effect on
the client’s treatment. Individual and group interactions focused on trust,
self-disclosure by clients to staff and one another, and active participation
in groups. Effective milieu therapy required long lengths of stay because
clients with more stable conditions helped provide structure and support for
newly admitted clients with more acute conditions.
By the 1990s, the economics of health care began to change
dramatically, and the lengths of stay in hospitals decreased to just a few
days. Today, most insured Americans are under some form of managed
care. Managed care exerts cost–control measures such as recertification of
admissions, utilization review, and case management—all of which have
altered inpatient treatment significantly. The growth of managed care has
TREATMENT
SETTINGS AND
THERAPEUTIC
PROGRAMS
CHAPTER 4 LATEST
UPDATE 2026/2027
MULTIPLE CHOICE
QUESTIONS AT THE
END FOR BETTER
UNDERSTADING
RATED A+
,Treatment Settings and Therapeutic
Programs
KEY TERMS
assertive community treatment (ACT)
clubhouse model
criminalization of mental illness
day treatment
interdisciplinary (multidisciplinary) team
partial hospitalization programs (PHPs)
recovery
residential treatment settings
stigma
telepsychiatry
LEARNING OBJECTIVES
After reading this chapter, you should be able to:
1. Discuss traditional treatment settings.
2. Describe different types of residential treatment
settings and the services they provide.
3. Describe community treatment programs that provide
services to people with mental illness.
4. Identify the factors that distinguish recovery
programs from traditional treatment.
, 5. Identify barriers to effective treatment for people
with mental illness who are homeless.
6. Discuss the issues related to people with mental
illness in the criminal justice system.
7. Discuss the difficulties faced by military veterans both
during and following service.
8. Describe the roles of different members of a
multidisciplinary mental health care team.
9. Identify the different roles of the nurse in varied
treatment settings and programs.
NURSING CONCEPTS
Collaboration
Community-Based Practice
Health Care Disparities
Health Care Systems
Managing Care
Therapeutic Communication
INTRODUCTION
Mental health care has undergone profound changes in the past 50 years.
Before the 1950s, humane treatment in large state facilities was the best
available strategy for people with chronic and persistent mental illness,
many of whom stayed in such facilities for months or years. The
introduction of psychotropic medications in the 1950s offered the first hope
of successfully treating the symptoms of mental illness in a meaningful
way. By the 1970s, focus on client rights and changes in commitment laws
led to deinstitutionalization and a new era of treatment. Institutions could
no longer hold clients with mental illness indefinitely, and treatment in the
, “least restrictive environment” became a guiding principle and right. Large
state hospitals emptied. Treatment in the community was intended to
replace much of state hospital inpatient care. Adequate funding, however,
has not kept pace with the need for community programs and treatment (see
Chapter 1).
Today, people with mental illness receive treatment in a variety of
settings. This chapter describes the range of treatment settings available for
those with mental illness and the psychiatric rehabilitation programs that
have been developed to meet their needs. Both of these sections discuss the
challenges of integrating people with mental illness into the community.
The chapter also addresses two populations who are receiving inadequate
treatment because they are not connected with needed services: clients who
are homeless and clients who are in jail. In addition, the special challenges
facing military veterans are presented. The chapter also describes the
multidisciplinary team, including the role of the nurse as a member. Finally,
it briefly discusses psychosocial nursing in public health and home care.
TREATMENT SETTINGS
Inpatient Hospital Treatment
In the 1980s, inpatient psychiatric care was still a primary mode of
treatment for people with mental illness. A typical psychiatric unit
emphasized talk therapy, or one-on-one interactions between residents and
staff, and milieu therapy, meaning the total environment and its effect on
the client’s treatment. Individual and group interactions focused on trust,
self-disclosure by clients to staff and one another, and active participation
in groups. Effective milieu therapy required long lengths of stay because
clients with more stable conditions helped provide structure and support for
newly admitted clients with more acute conditions.
By the 1990s, the economics of health care began to change
dramatically, and the lengths of stay in hospitals decreased to just a few
days. Today, most insured Americans are under some form of managed
care. Managed care exerts cost–control measures such as recertification of
admissions, utilization review, and case management—all of which have
altered inpatient treatment significantly. The growth of managed care has
