French psychiatrist Philippe Pinel (1745-1826). One of the founders of the moral management mental health method of treatment
What was Moral Management in Mental Health Treatment?
During the early part of this period of humanitarian reform, the use of moral management are wide-ranging method of treatment that focused on a patient's of social, individual, and occupational needs became relatively widespread. This approach, which stemmed largely from the work of Pinel and Tuke, began in Europe during the late eighteenth century and in America during the early nineteenth century. Rees (1957) described the approach this way:
The insane came to be regarded as normal people who had lost their reason as a result of having been exposed to severe psychological and social stress. These stresses were called the moral causes of insanity and moral treatment aimed at relieving the patient by friendly association, discussion of his difficulties and the daily pursuit of purposeful activity; in other words social therapy, individual therapy, and occupational therapy. (pp. 306-307).
Human Treatment of Those with Mental Illness
Changes at Williamsburg's Public Hospital reflected this change in attitude. First, the hospital was renamed the Williamsburg Lunatic Asylum to reflect "the view that the mentally ill were innocent victims who required protection from Society" (Zwelling, 1985, p. 30). Treatment regimes were also changed. There were fewer physical restraints, more open wards, and opportunities to practice positive activities such as farming and carpentry. Social activities, some involving members of the opposite sex, were incorporated into the daily activities of the patients.
Moral treatment in asylums was actually part of a broader movement in which more humane treatment of physical illness in hospitals was being provided for patients, usually people from the poorer classes (Luchins, 1991). A great deal more emphasis was placed in both the general hospitals and asylums on the patient's moral and spiritual development and on rehabilitation of their "character" than on their physical or mental disorders, perhaps because very little effective treatment was available for these conditions at the time. The treatment or rehabilitation of the physical or mental disorders was usually through manual labor and spiritual discussion along with humane treatment.
Effectiveness of Moral Management in the Treatment of Mental Health Disorders
Moral management achieved a high degree of effectiveness - all the more amazing because it was done without the benefit of the
antipsychotic drugs used today and because many of the patients were probably suffering from syphilis, the then-incurable disease of the central nervous system. In the 20-year period between 1833 and 1853, Worcester State Hospital's discharge rate of patients who had been ill less than one year before admission was 71%. Even for patients with a longer preadmission disorder, the discharge rate was 59 Percent. (Bockhoven, 1972).
Source for History of Moral Management: Carson, Robert. C., Butcher, James, N., Mineka, Susan, (2000).
Abnormal Psychology and Modern Life (11th Edition)
(off-site link) - Boston: Allyn & Bacon. pages 43-45.
Pages Related to Moral Management, Psychology History
Positive Psychology Movement - Penn State University
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