Am J Psychiatry 1977; 134:267-272
Copyright © 1977 by American Psychiatric Association
Moral therapy and the problem of morale
L Sederer
The author reviews the history of moral therapy and the lessons and
warnings it holds for modern psychiatry. Custodial management replaced
moral therapy in this country in the late 1800s because of inadequate
manpower and fiscal resources, a lack of charismatic leaders, the
increasing lack of control over admissions and discharge, and other
factors. One "solution" to the unacceptable conditions of custodial care
was an increased faith in science and technology; humanistic medical
science became scientism, and patients suffered. Morale is essential to the
provision of moral therapy, and the increasing emphasis on somatic
therapies has strained the union of morale and moral treatment. The author
believes that the profession can reaffirm its identity and distinguish
itself through the appropriate provision of humane, psychosocial care--the
essence of moral therapy.
