The Behaviour of Chronic Psychotic Patients During Three Types of Occupation

¹ Research Psychologist, The Park Hospital for Children, Headington, Oxford
² Principal Psychologist, St. John's Hospital, Stone, Aylesbury
³ Senior Psychiatric Registrar, St. John's Hospital, Stone, Aylesbury, Bucks

An experiment was carried out to assess the differential effect on the adjustment of chronic patients of the three types of occupation normally employed in mental hospitals, domestic work, industrial work and handicrafts. The investigation took place in a ward of 36 male patients, half of whom at the beginning were employed on domestic work, the other half in the industrial workshop. A control group continued in their original occupation throughout the 38 weeks of the experiment, while the remainder sampled, in different orders, both occupations which were new to them, ending with a period in the occupation of their own choice. Remuneration was kept constant for all patients throughout the experiment.

Adjustment at work was assessed by weekly ratings on the Fergus-Falls Scale. General adjustment was measured by weekly Fergus-Falls ratings by the Ward Charge Nurse, repeated psychiatric assessments and administrations of the Wechsler Intelligence Scales, and by Ward records of disturbed behaviour.

All the measures made outside the working situations showed virtually no differences between the various groups throughout the whole period, except that the control group showed less improvement on the Wechsler Scales than those who changed jobs. Two significant effects were found in work adjustment: (1) those who changed jobs tended to improve with time while the controls remained constant; (2) those who made their first change to handicrafts, a situation new and strange to patients of this type, showed an initial disturbance; but when the change to handicrafts was made after a previous change of occupation, disturbance was not shown. When these order effects were taken into account the nature of occupation did not affect adjustment.