Discussion

I would like to direct my remarks towards the broader framework of this symposium, treatment and management of schizophrenia, and to see how Dr. Symonds’ paper fits into this framework.

If we stay with the organically injured child, as Dr. Symonds so aptly described in his paper, then the problem of management of the child by the family is in the forefront. At the Ittleson Residential Treatment Center they found that the organic child showed no more progress there than the ones that remained at home. It was in the non-organic child that the most progress was made in the residential treatment center. However, it is my feeling that with the advent of family therapy, as will be described later today, some of these children do better in the family situation at home.

The family understanding of the nature of the problem is certainly central; this includes not only the mother and father, but any crucial adult who comes in contact with the child, i.e., grandparents, older siblings. Also to be considered are remedial education plans and drugs and I am sure, only the lack of time prevented their inclusion. Just as the children may come from confused homes, they also are confusing children to live with. Usually I tell the parents of such a child, special knowledge is needed to bring him up, and this relieves them of unnecessary guilt.

I am in hearty accord with the encouragement of a healthy, psychological environment for children. Referring to Dr. Martin's “F's” for parents, he also, includes faith in children to grow, and friction with his firmness, as nothing can be created without friction. In management we must take into account the hierarchies of authority, such as management-labor, enlisted men's and officers’ organizations, and parent-child associations, each with its specific contributions for the good of the total. What are we out for in management?—Enough nurturance and direction so that the child may integrate his potential assets for healthly growth. Management goes