Adaptive psychotherapy: an approach toward greater precision in the treatment of the chronically disturbed

The continuing care clinic: outpatient treatment of the chronically ill

The need for continuing care of chronic psychiatric patients within the community is a pressing problem that calls for development and testing of new treatment methods. This paper describes one such method, the Continuing Care Clinic, an outpatient program for chronic patients who have not responded well to other outpatient treatment approaches. The clinic's structure, treatment rationale and procedures, and clinical results over a 31/2-year period are described. Among specific treatment features discussed are the use of multiple therapists, focus on available personality strengths and on reality issues, and patient-staff group interaction as an adjunct to individual psychotherapy.

Issues in developing quality aftercare clinics for the chronic mentally ill

Two large aftercare clinics were established to provide treatment and rehabilitative care for a chronic mentally ill population requiring neuroleptic drugs. The clinics have evolved rapidly and expanded their service over the past 3 years but have required constant monitoring and modification in order to provide quality as well as quantity care in the community setting. These modifications are described and the importance of further community-based investigation in the rehabilitation and treatment of the chronic mentally ill is stressed.