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Appel, K.E. (1949). Failures in Psychiatric Treatment.. Psychoanal Q., 18:372-375.

(1949). Psychoanalytic Quarterly, 18:372-375

Failures in Psychiatric Treatment.

Review by:
Kenneth E. Appel

Edited by Paul H. Hoch, M.D. New York: Grune and Stratton, 1948. 241 pp.

This symposium, presented by the American Psychopathological Association, essays an evaluation of failures in psychiatric treatment, psychoanalytic, Meyerian, and group therapy, child therapy, psychotherapy of criminals, 'psychosomatic therapy', insulin and electric shock, prefrontal lobotomy, social casework, and the treatment of epilepsy and neurosyphilis. The limitations of this first comprehensive attempt are dwarfed by its epochal importance as a contribution to psychiatry.

Much consideration had to be given in each of these articles adequately to define terminology and, particularly, the criteria of successful therapy. Therapeutic goals vary because each patient's psychopathology determines in part the potential for cure, and because the doctor's skill and his therapeutic orientation also participate in determining therapeutic objectives. All the contributors agree to the need for critical appraisal of therapeutic results to determine the influence of 1, the type of therapy used; 2, the specific life problem to be solved at the time therapy is initiated; 3, the biologic and psychologic organization of the individual; 4, the setting in which therapy occurs, which includes not only the environmental factors outside therapy but also the therapeutic milieu.

There is close agreement that the main causes of failure are: 1,

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