Integration of a behavior modification program into a traditionally oriented residential treatment center for children.

The historical background and early contributions of the Emma Pendleton Bradley Hospital, the first psychiatric hospital for children in the United States, are described. The focus of this report is on the incorporation of the treatment modality of behavior modification into this traditional psychoanalytically oriented program. Beginning with exploratory studies in the mid-1960s, in recent years within the residential center there has been a separate Autistic Unit, in which the major treatment strategy is consistent application of behavior modification principles and programs. Changes that have occurred in the course of developing the behavior modification program are discussed to show some of the positive and negative aspects of introducing such a radical change into a traditional setting. Case studies are included to reveal both the failures and the successes that have been encountered in treating psychotic children with either psychotherapy or behavior therapy. Description of the current status of the program shows that treatment is comprehensive, including psychodynamic and behavioral approaches, medication when warranted, and special education. The role of parents in the program is now very different from that ascribed to them in traditional psychoanalytically guided treatment.