Culture, Medicine, and Psychiatry

, Volume 38, Issue 4, pp 578–596 | Cite as

Practicing and Resisting Constraint: Ethnography of “Counter Response” in American Adolescent Psychiatric Custody

  • Katherine HejtmanekEmail author
Original Paper


Based on extensive ethnographic research in psychiatric custody for adolescents, this article uses the creation of, implementation of, and resistance to a treatment model to reveal issues of constraint in American psychiatric treatment. The treatment model is called Counter Response. As a model Counter Response shifts the treatment focus in a total institution for mentally ill youth from the youth themselves to the staff response to the youth. This article uses Counter Response as a case study to illustrate the close ties between constraint and autonomy in psychiatry. It also shows how models like Counter Response reflect the power of unregulated treatment paradigms in American adolescent institutional psychiatric intervention. Finally, the article demonstrates that resistance to Counter Response reveals a tension American practitioners have with psychiatry’s constraining power.


American psychiatric custody Constraint Resistance 


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Children and Youth Studies Program, Department of Anthropology and Archaeology, Brooklyn CollegeCUNYNew YorkUSA

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