Deborah Blythe Doroshow is a historian of medicine, mental health, and childhood. She received her PhD in history from Yale University and her MD from Harvard Medical School. Previous work has focused on insulin coma therapy in American psychiatry, the bedwetting alarm and its role in the history of child rearing, and state laws mandating premarital syphilis testing.
In a meticulously researched and well-written book, Doroshow (Yale Univ. School of Medicine) traces the rise and fall of residential treatment centers (RTCs) for children classified as emotionally disturbed. The classification was created during the first half of the 20th century, after a progressive period in American psychiatry, to describe hard-to-manage children who should not be in state mental hospitals or training schools for juvenile delinquents. RTCs sought to provide a therapeutic milieu from which the child could return to society, enroll in public school, obtain a job, and lead an otherwise normal life. The centers used a home model, reflecting the middle-class concerns of Cold War America. By the late 1960s, RTCs began to decline in favor of community-based treatments, due in part to weak evidence of the efficacy of RTCs and unresolved problems related to insurance coverage. Finally, reclassification of this group of children as handicapped or autistic left a gap in appropriate treatment options, particularly for disadvantaged children. Doroshow reminds readers that “by the 1980s and 1990s, child mental illness, race, and poverty had become inextricably intertwined” (p. 219). A welcome contribution to the history of medicine.
“Emotionally Disturbed is a clearly written and meticulously researched account of residential treatment centers, a largely forgotten strategy for addressing the needs of children with mental illness. This book will remind those who work with, live with, and love such children how a combination of ingenuity, resources, and focused care greatly improved the lives of those whom society had left behind.”
“Doroshow’s work exemplifies a new generation of historians bent on reinterpreting the history of American psychiatry from a fresh, twenty-first-century perspective. Artfully researched and beautifully written, Emotionally Disturbed explores a little-known aspect of twentieth-century mental health care: the efforts to devise new therapeutic options for ‘leftover’ children, that is, children and youth so troubled that neither their families nor existing institutions would care for them. Doroshow’s work deepens our understanding of the past and present challenges of caring for this very important, very vulnerable group of Americans.”