Institutional psychotherapy: a conceptual review and clinical toolbox

Category	Detail
Condition	Institutional Psychotherapy
Key Mechanisms	Collective, transference-based therapeutic milieu; integration of psychoanalysis, libertarian Marxism, and phenomenology.
Target Population	Individuals with severe and disabling mental disorders, particularly psychotic conditions.
Care Setting	Psychiatric institutions and collective care environments.

Institutional Psychotherapy emerged as a response to prevent psychiatric institutions from becoming alienating asylums.
It emphasizes the importance of social alienation and the therapeutic milieu in the treatment of psychosis.
The approach is characterized by its critical stance towards totalizing tendencies in psychiatric institutions.
IP integrates psychoanalytic ethics within institutional practices, extending beyond individual therapy.
It is structured by interdisciplinary influences, particularly from psychoanalysis, phenomenology, and Marxism.

Recognize the impact of social and environmental factors on psychotic conditions.

Utilize a collective approach to treatment that engages with the relational and material milieu.

Continuously assess the dynamics of power relationships and institutional practices.

Be aware of the potential for routine and habits to lead to stagnation in therapeutic practices.

Patients experiencing psychosis within institutional settings.

Treatment should be viewed as a political act that requires constant renewal to avoid alienation.

Incorporate psychoanalytic principles into collective care settings.
Foster an environment that encourages critical reflection on institutional practices.
Engage patients in the therapeutic process by considering their social and economic contexts.