Problems to Anticipate in Treating Difficult Patients in a Long-Term Psychiatric Hospital

Data were collected on 127 patients in 5 treatment units. Examined association of 4 patient pathology dimensions, previously identified as related to treatment difficulty (suicide-depression, character pathology, withdrawn psychoticism & violence-agitation), with staff members’ dissatisfaction with 4 areas of treatment–interpersonal approaches, structure & control, quality of teamwork & medication. Treatment problems are proposed to be, in part, mediated by patterns of countertransference.