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But we should not just worry about old words and new challenges, we should also look at another danger and that is the problem of using new words for old challenges. A new kind of tomfoolery is going on in our institutions, characterized by such terms as remotivation, therapy, group therapy, adjunctive therapy. As a matter of fact, in some institutions you can't turn around without running into somebody who proclaims he is doing therapy for something or other. Yet, take a second look and you will find he is working at the old stand, doing what he has always done, in the same inadequate surroundings with the same inadequate tools.

I read a very interesting editorial the other day which comes from a different field, my former field of endeavor of criminology. Dr. Melitta Schmiedeberg, a very fine psychiatrist, had this to say in a recent editorial in the Journal of Offender Therapy:

"For a generation we have glamorized 'therapy' and 'research'. Today disillusionment in therapy is rampant and there is a danger that research will meet the same fate. Both have been expected to magically solve all of our problems without true thought, effort or sacrifice. To fit our day dreams, the concept of therapy has become increasingly so all-embracing that by now it is impossible to agree on the answers to such basic questions as -- Who is to practice therapy? What are the legitimate methods? What are its professional ethics? What are its desired clinical results?

The semantic value of 'therapy' seems miraculous: by naming a relationship therapy it becomes automatically effective and beneficial; by calling oneself a 'therapist' one's status, salary and self-esteem becomes enhanced; to be in therapy gives comfort and a sense of being progressive. It has been estimated that three million persons are in 'therapy'. We are however slowly beginning to realize the disastrous aspects of this Fata Morgana. The ever-increasing trend to replace love and service to one's neighbors, the only basis of any society, by paid and status-giving therapy is in the long run disintegrating, But though we feel uneasy about our 'achievements' we cannot undo the last 25 years; nor do we understand why, if every aspect seemed so right, the sum total should prove so wrong."

Apply this kind of sober thinking when next you visit your State institution and come face to face with all this adjunctive therapy and remotivation and group therapy. Whenever an attendant has 5 residents throw a ball around in a circle, this is now called "group therapy". That is, of course, a mockery of the concept of therapy and a dangerous mockery, because how will we ever introduce good therapy where it is needed if we now allow our State administrators to fool themselves and us by thinking we can achieve improvement just by giving things new names without changing basic qualifications, basic personnel standards, basic facilities in the institution. In most of our institutions it is utterly impossible to give therapy. How can you give therapy in a dormitory building crowded with 70 to 100 people?

Harold Peterson, the administrator of the Brainerd State School in Minnesota, recently felt impelled to take a second look at something which many superintendents are very proud of, his ever growing volunteer activities. As a result, he wrote an editorial in the Brainerd Newsletter and titled it "The Game of Activity Jackstraws". Listen and maybe you will write him for a copy and show it to your own superintendents or call your residential care committee's attention to it.

"Behind any program in an institution for the mentally retarded there must be, we think, a belief in the limitless value and a certain equality of every human being regardless of his or her degree of intelligence. There must be a belief that every human being has capabilities which may be developed and that every human being has a right to that educational training which is in harmony with his needs, be they however lowly or different.

It may be quite impossible to prove scientifically that the equality of human beings exists. Nevertheless, this is an idea which is deeply inherent in the Christian philosophy and is reflected in the Declaration of Independence which is a most basic document in the development of American democracy. At any rate, it would seem to be very difficult to create a therapeutic community without a deep regard for the innate worth of each human being in such a community.

We are in the business of creating treatment programs for institutionalized mentally retarded patients. On the basis of our fundamental philosophy mentioned above we suggest that our programs must contain the following elements. First, all programs should be based upon a very careful, highly individualized study of the patient by building and by ward. Secondly, all programs should be in harmony with the kind of attitudes which promote the greater self-discipline, freedom of the patient. Third, there should be a part in every broad program for every patient and this goes down to the severely retarded bed-fast patient. Fourth, it is obvious that for the operation of the necessary programs there must be the needed personnel. Fifth, we feel that every program developed here should have progression and promotion built into it. Sixth, there is a great necessity of setting up some system of measurement so that we may really know that the particular patient is being improved or not by any part of our program.