base and treatment strategies described; its practice observed, monitored, and replicated; and its future growth anchored in a research foundation. How many times it thundered before Franklin took the hint! How many apples fell on Newton's head before he took the hint! Nature is always hinting at us. It hints over and over again. And suddenly we take the hint.—Robert Frost The essential elements of a psychiatric rehabilitation approach have been hinted at for well over a century. Different elements of a psychiatric rehabilitation approach have periodically moved in and out of favor, highlighted almost serendipitously as the mental health field progressed through various developmental phases. Currently there is a consensus developing as to what constitutes the field of psychiatric rehabilitation. The overall goal of psychiatric rehabilitation is to assure that the person with a psychiatric disability can perform those physical, emotional, social, and intellectual skills needed to live, learn, and work in the community, with the least amount of support necessary from agents of the helping professions (Anthony 1979). The major methods by which this goal is accomplished involve either teaching persons the specific skills needed to function effectively or developing the community and environmental resources needed to support or strengthen their present levels of functioning (Anthony, Cohen, and Cohen 1983; Livneh 1984; Liberman and Evans 1985). The work of current researchers and practitioners will determine whether psychiatric rehabilitation becomes an evolving field of study and practice, or merely a historical footnote. At present it seems that many mental health professionals recognize the need for rehabilitation interventions to complement existing treatment approaches (Anthony 1977; Liberman and Foy 1983). However, this recognition of need does not mean that psychiatric rehabilitation is a well-understood field of study. Because all types of mental health disciplines practice psychiatric rehabilitation, and because relevant research and conceptual articles appear in a wide range of professional journals, psychiatric rehabilitation is a field that until recently has been difficult to define. Historical Context The origins of the psychiatric rehabilitation field are rooted in several historical developments: (1) the moral therapy era; (2) the inclusion of the psychiatrically disabled into Reprint requests should be sent to Dr VY.A Anthony, Center for Psychiatric Rehabilitation, Sargent College of Allied Health Professions, Boston University, Boston, MA 02215 Downloaded from https://academic.oup.com/schizophreniabulletin/article/12/4/542/1874999 by guest on 23 November 2021 VOL 12, NO. 4, 1986 543 public-supported vocational rehabilitation programs; (3) the development of community mental health ideology; (4) the psychosocial rehabilitation center movement; and (5) the development of skills training techniques as an effective mental health intervention. Moral Therapy Era. The 19th century reformists for more humane care of the mentally ill aimed "to treat the patients as far as their condition would possibly admit, as if they were still in the enjoyment of the healthy exercise of their mental faculties . . . and to make their condition as comfortable as possible" (Bockoven 1963, p. 26). Moral treatment stressed a comprehensive assessment of the psychiatrically disabled, examining the person's work, play, and social activities. For example, a chaplain at a British asylum recognized the importance of patients' reentry into social life "by obtaining for them a change of scene and air and assisting them to obtain suitable employment" (Hawkins 1871, p. 107). Consistent with present-day rehabilitation practice, moral treatment recognized that structured activity can have therapeutic value. Today the goal of psychiatric rehabilitation practice is to have the person do something differently. Vocational Rehabilitation Programs. While initial governmental programs for employment of the disabled, sparked by the end of World War I, focused on the physically handicapped, they did demonstrate that rehabilitation principles could be effectively implemented and won public support for