Moral treatment: how a caring practice lost its rationale.

The 19th-century practices of moral treatment and phrenology serve as historical examples of a narrowing focus in health care and reveal the manner in which theories can shape practice. The story of moral treatment, as it is told in connection with phrenology, emphasizes the push for success and right solutions. The push followed several shifts in the conceptualization of mental illness, the last of which proved moral therapy unreasonable. If practitioners in this century hope to ensure that the heart of moral treatment will withstand the effects of ever-changing theories, they must hold caring attitudes, words, and actions at the center of their practice.