The authors discuss the numerous incompatibilities between the clinical
research ward, with its emphasis on the collection of baseline and
treatment data, and the therapeutic milieu environment, with its emphasis
on an open door, team orientation, and nonauthoritarianism. They posit that
the two orientations may be mutually destructive and that the therapeutic
milieu may not be the best treatment setting for patients with
schizophrenic or certain affective disorders. Two case histories
illustrating these ideas are included.