A systemic-developmental model of day treatment for young adult chronic patients.

The young adult chronic patient is a recently designated dysfunctional group which is growing significantly in numbers. These patients' multiple deficits in independent functioning and their extreme dependence-independence conflict make them difficult to engage and help in traditional forms of outpatient therapy. A day-treatment program which systematically and flexibily intervenes over many levels would seem to increase the likelihood of successful treatment. F. S. DuBois Day Treatment Center, Stamford, Connecticut, has established such a program based on an integration of general systems theory and separation-individuation theory. This systemic-developmental model of day treatment involves both systems-oriented multimodality therapy and developmentally phased expectations for gradually increasing independent functioning. This paper presents theory and applications of the systemic-developmental day-treatment model and a 2-year pilot program evaluation demonstrating its effectiveness.