Christie,
A.C.J.T.C.:—These
appeals
were
heard
on
common
evidence.
The
issue
in
each
case
is
whether,
in
computing
his
or
her
taxable
income
for
the
year
or
years
under
review,
the
appellant
is
entitled
to
deduct
amounts
expended
for
the
care
and
training
at
a
school
of
a
dependent
child.
The
taxation
year
or
years
and
the
amounts
involved
in
respect
of
each
appellant
are:
Kushnir
1980
—
$6,175*;
MacLean
1980
—
$6,175,
1981
—
$7,700;
Hartman
1981
—
$6,250
and
Bauer
1979
—
$5,800,
1980
—
$6,325.
The
date
of
mailing
the
notices
of
reassessment
to
the
appellants
is:
Kushnir
—
November
8,
1982,
MacLean
—
August
25,
1983
(both
years),
Hartman
—
August
11,
1983
and
Bauer
—
August
25,
1983
(both
years).
The
legislation
of
primary
relevance
to
these
appeals
is
subparagraph
110(1)(c)(vi)
of
the
Income
Tax
Act
("the
Act’).
It
provides:
110(1)
For
the
purpose
of
computing
the
taxable
income
of
a
taxpayer
for
a
taxation
year,
there
may
be
deducted
from
his
income
for
the
year
such
of
the
following
amounts
as
are
applicable:
(c)
an
amount
equal
to
that
portion
of
medical
expenses
in
excess
of
3%
of
the
taxpayer’s
income
for
the
year
paid
either
by
the
taxpayer
or
his
legal
representatives
if
.
.
.
payment
was
made
(vi)
for
the
care,
or
the
care
and
training,
at
a
school,
institution
or
other
place
of
the
taxpayer,
his
spouse
or
any
such
dependant,
who
has
been
certified
by
an
appropriately
qualified
person
to
be
an
individual
who,
by
reason
of
a
physical
or
mental
handicap,
requires
the
equipment,
facilities
or
personnel
specially
provided
by
that
school,
institution
or
other
place
for
the
care,
or
the
care
and
training,
of
individuals
suffering
from
the
handicap
suffered
by
that
individual.
It
is
undisputed
that
the
amounts
sought
to
be
deducted
were
paid
in
respect
of
children
who
were
dependent
on
the
appellants.
There
is
however
a
serious
question
regarding
whether
the
amounts
sought
to
be
deducted
were
paid
in
respect
of
persons
who
were
certified
as
required
under
subparagraph
110(1)(c)(vi)
of
the
Act.
The
school
involved
in
these
appeals
is
Robert
Land
Academy.
It
is
located
near
the
Village
of
Wellandport
on
the
Niagara
Peninsula,
Ontario.
One
of
its
founders
and
headmaster
since
its
creation
is
Major
Scott
Bowman.
The
background
to
the
establishment
of
the
school
is
that
by
Letters
Patent
dated
February
23,
1973,
a
charter
was
issued
under
the
Business
Corporations
Act
of
Ontario
to
Bowman
and
others
constituting
them
as
a
non-profit
corporation
without
share
capital
under
the
name
of
THE
CREATIVE
CENTRE
FOR
LEARNING
DISABILTIES
(“the
Corporation’’)
for
these
objects:
a)
to
implement
specialized
programmes
to
assist
young
people
with
learning
handicaps
and
their
families;
b)
to
help
individuals
and
families
make
socially-satisfying
and
constructive
adjustments
within
the
community
setting
which
will
help
them
work
through
their
problems,
whether
material,
psychological
or
spiritual;
c)
to
stimulate,
to
help
promote
and
to
participate
in
desirable
and
constructive
community
programmes
which
have
as
an
objective
the
welfare
of
the
individual
and
the
family;
d)
to
encourage
and
promote
education
and
training
in
these
fields
and
to
develop
opportunities
for
service
by
volunteers;
and
e)
subject
to
the
Mortmain
and
Charitable
Uses
Act
and
the
Charitable
Gifts
Act,
to
receive,
acquire
and
hold
gifts,
donations,
legacies
and
devises.
Initially
the
Corporation
founded
a
summer
camp,
Camp
Keywaatan,
which
the
Major
said
“had
a
very
strong
remedial
educational
component,
as
well
as
a
behaviour
modification
component.”
Youths
were
referred
to
the
camp
from
such
sources
as
psychiatrists,
psychologists
and
school
boards.
Soon
after,
a
children’s
mental
health
centre
called
Horizon’s
was
established
as
a
division
of
the
Corporation.
It
was
described
as
“a
residential
therapeutic
mental
health
centre
licensed
under
the
Ministry
of
Health
at
that
time
as
a
children’s
mental
health
centre
and
later
under
the
Ministry
of
Community
and
Social
Services
as
a
very
highly
specialized
therapeutic
residence
for
boys
only,
who
had
encountered
tremendous
difficulties,
not
only
in
the
schools,
but
also
in
the
community.”
The
foundation
of
Robert
Land
Academy
followed
in
1977
as
a
further
division
of
the
Corporation.
The
land
on
which
it
is
located
was
sold
to
the
Corporation
by
another
corporation,
the
shareholders
of
which
included
Bowman.
It
is
based
on
“a
military
theme.”
The
campus
is
modelled
on
a
British
fort
of
the
early
19th
century.
A
parade
square
is
the
centrepiece
of
the
campus.
Military
terminology
and
trappings
abound.
The
dining
hall
is
the
mess.
There
are
7
a.m.
inspections
of
the
cadets
by
the
sergeant-major.
Civilian
clothing
is
dispensed
with
and
uniforms
designed
along
Canadian
military
lines
are
worn.
Military
ranks
are
assigned.
There
is
a
precision
drill
team.
People
stand
at
attention
and
salute,
etc.
All
of
the
teaching
staff
are
graduates
from
Canadian
universities
with
Bachelor
or
Masters
degrees.
They
are
chosen
for
what
is
regarded
as
their
adaptability
to
the
environment
of
the
academy.
The
students
are
all
in
residence.
All
are
male
and
range
in
age
from
10
to
19
years.
Bowman
said
that
the
student
body
is
composed
of
persons
"'who
have
had
a
history
of
specific
learning
and/or
behavioural
and/or
sensorial
or
neurological
problems.”
He
added
later
that
it
is
the
policy
of
the
school
to
restrict
admission
to
boys
afflicted
by
learning,
behavioural
or
neurological
problems.
A
brochure
prepared
under
the
direction
of
the
Corporation’s
management
and
distributed
by
it
was
entered
in
evidence.
Inter
alia,
it
conveys
these
messages:
Robert
Land
Academy
is
part
of
a
registered,
non-profit
orgnaization
authorized
to
issue
tax
deductible
receipts.
Further
tax
deductible
benefits
can
be
obtained
because
of
the
developmental
learning
program
provided
by
the
Academy.
The
annual
fee
comprises
a
tuition
and
room
and
board
expense.
The
next
witness
to
testify
on
behalf
of
the
appellants
was
Dr.
Murray
McGovern.
In
1957
he
became
a
Fellow
of
the
Royal
College
of
Physicians
(Canada)
specializing
in
pediatrics.
In
1971
he
became
a
Fellow
of
the
same
institution
specializing
in
psychiatry.
The
answer
to
the
preliminary
question
of
whether
he
qualified
as
an
expert
witness
was
yes.
He
played
a
role
in
founding
the
Academy
and
was
at
all
times
relevant
to
these
appeals
a
consulting
psychiatrist
to
it.
He
also
served
in
that
capacity
for
Camp
Key-
waatan
and
Horizon’s.
A
number
of
documents
were
entered
in
evidence
on
behalf
of
the
appellants
of
which
McGovern
was
the,author
and
relate
to
children
of
the
appellants
in
respect
of
whom
deductions
in
computing
taxable
income
are
sought.
With
respect
to
Frederick
Dean
Herriot,
the
dependant
of
the
appellant
Kushnir,
they
consist
of:*
(i)
A
letter
dated
December
12,
1980,
from
McGovern
to
Kushnir
which
reads:
Please
let
this
letter
act
as
evidence
that
I
have
prescribed
placement
in
a
private
residential
school
for
your
son
Fred,
for
the
September
to
December,
1980
school
term.
On
the
basis
of
psychological
data
and
our
assessment
of
Fred,
I
regard
him
as
psychologically
immature
and
academically
underachieving.
I
prescribed
Robert
Land
Academy
as
a
school
specifically
designed
to
deal
with
his
difficulties.
I
would
be
willing
to
provide
specific
data
to
substantiate
the
diagnosis,
should
the
income
tax
department
request
it.
(ii)
A
letter
dated
March
13,
1981,
from
McGovern
to
Kushnir.
It
relates
to
a
“lengthy
final
reassessment
session
(with
Fred)
at
Robert
Land
Academy
on
March
5,
1981.”
(iii)
A
four-page
letter
from
McGovern
to
Kushnir
dated
December
2,
1981.
This
arose
out
of
a
request
dated
November
13,
1981,
received
by
McGovern
from
Revenue
Canada
requesting
substantiation
of
Kushnir’s
entitlement
to
deduct
payments
made
by
her
to
the
Academy.
(iv)
A
letter
dated
April
12,
1983,
from
McGovern
to
Kushnir
regarding
“a
lengthy
interview
(with
Fred)
on
April
7,
1983.”
(v)
An
undated
letter
from
McGovern
addressed
to
Kushnir
which
reads:
The
undersigned,
being
a
duly
qualified
person,
hereby
certifies
that
Frederick
Herriot
was,
in
respect
of
the
taxation
years,
1980-81
a
person,
who
by
reason
of
a
mental
handicap,
namely,
Conduct
Disorder
undersocialized,
nonaggres-
sive
Personality
Disorder
had
need
of
the
facilities,
personnel
and
equipment
specially
provided
by
the
Robert
Land
Academy
for
the
care
and
training
of
persons
suffering
from
such
handicap.
McGovern
said
he
had
signed
this
last
document
very
recently.
Counsel
for
the
appellants
suggested
that
it
be
taken
as
dated
November
18,
1985,
which
was
the
first
day
of
the
hearing
of
these
appeals.
No
objection
was
raised
in
this
regard.
In
what
follows
it
will
be
referred
to
as
the
certificate
of
November
18,
1985.
Nothing
turns
on
whether
it
was
actually
signed
on
November
18,
1985,
or
one
or
two
days
previously.
The
emphasized
words
are
in
the
handwriting
of
McGovern.
The
rest
of
the
certificate
was
prepared
by
counsel
for
the
appellants.
It
was
signed
in
the
presence
of
appellants'
counsel.
The
pattern
regarding
the
other
appellants
is
basically
the
same.
Included
in
what
the
appellant
MacLean
received
from
McGovern
was
a
letter
dated
February
24,
1981,
which
is
nearly
the
same
as
the
letter
dated
December
12,
1980,
received
by
Kushnir.
It
reads:
Please
let
this
letter
act
as
evidence
that
I
have
prescribed
placement
in
a
private
residential
school
for
your
son
David.
On
the
basis
of
psychological
data
and
our
assessment
of
David,
I
regard
him
as
psychologically
immature
and
academically
underachieving.
I
prescribed
Robert
Land
Academy
as
a
school
specifically
designed
to
deal
with
his
psychological
and
psychoeducational
difficulties.
I
would
be
willing
to
provide
specific
data
to
substantiate
the
diagnosis,
should
the
income
tax
department
request
it.
The
appellant
Hartman
received
a
letter
from
McGovern
dated
April
1,
1982,
which
reads:
Please
let
this
letter
act
as
evidence
that
I
have
prescribed
placement
in
a
private
residential
school
for
your
son
Paul.
On
the
basis
of
physical,
psychological
and
social
data
and
our
systematic
assessment
of
Paul,
we
have
prescribed
placement
in
Robert
Land
Academy.
With
appropriate
authorization,
I
would
be
willing
to
provide
specific
data
to
substantiate
the
diagnosis,
should
the
income
tax
department
request
it.
The
appellant
Bauer
received
an
undated
letter
from
McGovern.
It
reads:
Please
let
this
letter
act
as
evidence
that
I
have
prescribed
placement
in
Robert
Land
Academy
in
Wellandport,
for
your
son,
Jerry.
Since
his
registration
there
in
September
of
1979,
he
has
made
remarkable
strides
physically,
psychologically,
socially
and
academically.
He
has
obtained
a
70%
average
in
Grade
9
despite
poor
academic
progress
immediately
prior
to
his
placement
in
this
residential
school
setting.
He
has
expressed
pleasure
about
his
physical,
psychological,
social
and
academic
performance
and
is
optimistic
about
his
future.
I’m
grateful
for
a
chance
to
have
helped
here.
McGovern
speculated
that
this
letter
was
sent
in
1981.
Also
addressed
to
the
appellants,
MacLean,
Hartman
and
Bauer
are
certificates
similar
in
form
to
that
of
the
certificate
of
November
18,
1985,
addressed
to
Kushnir.
They
were
prepared
and
signed
under
the
same
circumstances.
They
are
also
undated,
but
it
was
agreed
that
the
date
of
November
18,
1985,
would
likewise
be
assigned
to
them.
The
psychiatric
terminology
in
each
of
these
four
certificates
varies.
In
preparing
them
McGovern
had
recourse
to
the
11th
printing,
which
was
in
March
1984,
of
DSM-III
Diagnostic
and
Statistical
Manual
of
Mental
Disorders,
3rd
(1980)
edition
prepared
under
the
auspices
of
the
American
Psychiatric
Association.
The
certificates
of
November
18,
1985,
were
produced
because
of
concern
on
the
part
of
counsel
for
the
appellants
that
prior
documentation
prepared
by
McGovern
might
not
be
regarded
as
establishing
that
the
dependants
of
the
appellants
had
been
“certified”
within
the
meaning
of
subparagraph
110(1)(c)(vi)
of
the
Act.
I
fully
appreciate
counsel's
apprehension
in
this
regard.
In
the
last
analysis
the
appellants
relied
on
the
certificates
of
November
18,
1985,
and
to
what
was
described
in
relation
thereto
by
their
counsel
as
the
“earlier
certificates”.
These
earlier
certificates
were
precisely
identified
by
him
as
correspondence
previously
referred
to,
namely:
letter
from
McGovern
to
Kushnir
dated
December
12,
1980;
letter
from
McGovern
to
Hartman
dated
April
1,
1982,
and
the
undated
letter
from
McGovern
to
Bauer
which
the
former
thought
was
sent
some
time
in
1981.
I
will
deal
first
with
the
certificates
of
November
18,
1985.
The
combined
effect
of
section
169,
subsection
171(1)
and
the
definition
of
“assessment”
in
subsection
248(1)
of
the
Act
is
to
give
the
appellants
a
right
to
appeal
to
this
Court
to
have
the
reassessments
made*
on
the
mailing
dates
previously
mentioned
vacated,
varied
or
referred
back
to
the
respondent
for
reconsideration
and
reassessment.
Those
reassessments
were
made
on
the
basis
that
the
dependants
had
not
been
certified
as
required
under
subparagraph
110(1)(c)(vi).
I
cannot
appreciate
how
they
can
be
successfully
attacked
by
resorting
to
certificates
which
were
not
in
being
until
years
after
the
reassessments
were
made.
The
reassessments
could
be
in
error
only
if,
at
the
time
they
were
made,
there
was
lawful
authority
for
the
deductions
claimed
and
indispensable
to
such
authority
was
the
existence
of
certification
under
the
legislation.
Furthermore,
it
strikes
me
that
if
what
is
described
in
Maxwell
on
Interpretation
of
Statutes,
12th
(1969)
edition
at
page
28
as
the
first
and
second
most
elementary
rules
of
construction
are
applied
to
subparagraph
110(1)(c)(vi)
and
the
relevant
words
therein
are
given
their
ordinary
meaning
and
they
are
construed
according
to
the
rules
of
grammar,
this
leads
to
the
conclusion
that
in
order
for
the
deductions
to
be
allowable,
the
dependants
must
have
been
certified
at
the
time
the
amounts
were
paid
on
their
behalf.
I
focus
in
particular
on
these
words
in
the
Act:
“For
the
purpose
of
computing
the
taxable
income
of
a
taxpayer
there
may
be
deducted
an
amount
paid
by
the
taxpayer
if
payment
was
made
for
the
care,
or
the
care
and
training,
of
any
dependant,
who
has
been
certified
by
an
appropriately
qualified
person.”
In
accordance
with
the
general
rule,
the
onus
would
be
on
the
appellants
to
establish
this.
It
is,
however,
unnecessary
for
me
to
apply
this
interpretation
of
the
legislation
in
determining
these
appeals
for
the
reasons
that
follow.
For
explanations
already
given,
the
only
certificates
that
can
have
any
relevance
to
these
appeals
are
the
earlier
certificates.
I
shall
deal
with
each
of
them.
The
McGovern
letter
of
December
12,
1980,
to
Kushnir
is
the
early
certificate
regarding
the
latter’s
appeal.
It
will
be
noted
that
this
document
was
specifically
prepared
by
McGovern
with
the
intention
that
it
should
be
acted
upon
by
the
taxing
authorities.
It
states
that
he
prescribed
that
the
appellant's
dependant
be
placed
in
a
private
residential
school
and
that
he
prescribed
Robert
Land
Academy
in
this
regard.
Of
the
four
appellants
only
two,
Kushnir
and
Maclean,
testified.
Kushnir
was
referred
to
McGovern
with
respect
to
problems
she
was
having
with
her
son
Fred.
She
said
that
McGovern
never
spoke
to
her
about
placing
Fred
in
the
Robert
Land
Academy.
All
he
made
reference
to
was
“a
residential
school.”*
The
witness
knew
about
Ridley
College
and
Upper
Canada
College
and
obtained
brochures
regarding
these
schools.
She
did
the
sme
regarding
Appleby
College
and
private
schools
near
Trenton
and
Newmarket.
It
was
with
the
assistance
of
the
principal
of
the
school
where
she
worked
that
she
discovered
Robert
Land.
The
appellant
MacLean
told
of
the
difficulties
she
was
having
with
her
son
David
who
is
the
dependant
in
respect
of
her
appeal.
She
went
on
to
say
that
on
her
own
she
canvassed
the
school
system
including
private
schools
seeking
assistance
for
him.
Specific
mention
was
made
of
Ridley
College.
In
the
course
of
this
search
she
discovered
Robert
Land.
She
contacted
Bowman
by
telephone
and
arranged
to
meet
with
him.
David
was
present
at
the
meeting
and
he
was
submitted
to
some
unidentified
written
test,
the
results
of
which
were
disappointing.
Nevertheless:
“Mr.
Bowman
said
he
would
take
David
anyway
because
he
felt
that
he
could
help
him,
and
so
David
went
to
Robert
Land/'
No
mention
is
made
of
McGovern
in
MacLean’s
testimony.
McGovern
saw
David
after
he
was
admitted
to
the
academy.
This
was
at
Bowman’s
request
and
he
was
present
at
the
interview.
The
evidence
does
not
indicate
when
this
occurred,
but
there
is
a
document
filed
as
an
exhibit
dated
April
27,
1981,
which
mentions
a
final
assessment
session
on
April
2,
1981.
As
already
noted,
the
prior
certificate
in
this
appeal
is,
in
substance,
the
same
as
the
prior
certificate
in
the
Kushnir
appeal.
As
the
appellants
Hartman
and
Bauer
chose
not
to
testify,
I
believe
I
am
warranted
in
assuming
that
the
enrolment
of
their
dependants
in
Robert
Land
is
not
attributable
to
advice
on
the
part
of
McGovern.
The
evidence
of
Kushnir
and
MacLean
and
this
assumption
is
consistent
with
McGovern's
evidence.
He
said:
No,
counsellor,
I
never
refer
a
case
to
Robert
Land
Academy.
I
always
indicate
that
here’s
the
diagnosis,
and
there
are
—
the
present
treatment
modalities
are
obviously
not
working,
here
are
some
schools
that
might
indeed
accept
your
son,
and
I
know
that
Robert
Land
Academy
for
which
I
am
the
consultant
would
be
a
very
good
school.
I
interject
this
observation
at
this
point.
McGovern’s
reliability
as
a
witness
was
in
large
measure
devastated
in
the
course
of
his
being
cross-
examined
by
Mr.
Templeton.
This
is
well
underscored
by
what
follows.
Early
in
his
lengthy
testimony
McGovern
was
shown
a
report
dated
October
5,
1985
(a
few
weeks
before
the
commencement
of
the
hearing)
on
his
letterhead
and
bearing
his
signature.
It
is
addressed
to
counsel
for
the
appellants.
He
acknowledged
it
as
his
“report
about
Robert
Land
Academy
as
an
important
source
of
Milieu
Therapy".
It
was
entered
as
an
exhibit
and
McGovern
said
nothing
at
that
time
to
suggest
that
the
report
should
not
be
taken
at
face
value.
Counsel
for
the
respondent
raised
this
document
in
cross-
examination
and
drew
particular
attention
to
certain
passages.
He
also
entered
in
evidence
as
an
exhibit
an
extract
from
a
work
entitled
Basic
Handbook
of
Child
Psychiatry
volume
3.
The
extract
is
Part
D
which
is
entitled
Environmental
Therapies,
with
the
subtitle
Milieu
Therapy:
The
Orthogenic
School
Model.
The
authors
of
Part
D
are
Bruno
Bettelheim
and
Jacquelyn
Sanders.
This
appears
at
page
7
and
8
of
the
report.
All
of
this
was
put
forward
as
McGovern’s
creation:
First,
a
child
was
much
more
vulnerable
to
the
impact
of
his
parents,
from
whom
he
may
have
to
be
separated,
and
secondly,
for
some
centuries
society
has
been
convinced
that
the
young,
for
their
own
good,
must
be
removed
for
considerable
periods
of
time
into
a
very
special
institution
supposedly
designed
to
meet
their
needs:
schools.
Schools
overtly
teach,
but
also
free
adult
society
from
the
burden
of
interfering
children.
For
many
years
it
was
a
canon
of
education
that
children
suffering
from
severe
physical
defects
should
be
placed
in
institutions
which
provided
classroom
teaching
and
other
guidance
geared
to
the
nature
of
their
deviation.
After
World
War
One,
psychiatrist
August
Aichhorn
treated
a
group
of
wayward
youngsters
in
an
institutional
setting,
utilizing
psychoanalytic
theory
as
the
basis
for
his
very
successful
“Milieu
Therapy”.
Years
later
psychiatrists
Slavson,
Redl,
and
others,
applied
Aichhorn's
principles
to
group
or
camp
settings,
and
out
of
their
efforts
grew
the
procedure
now
known
as
group
therapy.
Redl
pioneered
summer
camp
settings
for
delinquent
youngsters
in
which
camp
activities
and
group
life
were
designed
to
have
a
therapeutic
impact,
independent
from
or
in
addition
to
the
group
therapy
and
individual
therapy.
In
the
United
States
during
the
1940s,
a
large
number
and
great
variety
of
treatment
settings
were
offered
for
the
treatment
of
very
disturbed
children
within
residence.
Psychiatrist
Stanislaus
Szurek
at
Langley
Porter
Clinic
in
San
Francisco,
Fritz
Redl,
under
whom
I
worked
in
Detroit,
and
those
working
at
Southward
schools
in
Topica
and
with
the
Jewish
Board
of
Guardians
in
New
York,
are
among
the
most
noteworthy.
Under
the
stimulus
of
the
new
thinking,
residential
institutions
for
disturbed
children
proliferated
widely.
All
these
efforts
convinced
psychiatry
that
the
effect
of
the
environment
on
the
rehabilitation
of
children,
was
of
maximum
importance.
In
1944
the
University
of
Chicago
entrusted
Bruno
Bettelheim
with
the
task
of
re-organizing
its
Orthogenic
School,
in
line
with
the
most
advanced
ideas
of
the
treatment
of
severely
disturbed
children.
It
has
become
apparent
to
every
professional
involved
that
how
a
child
was
fed,
bathed,
toileted,
treated
on
getting
up
and
put
to
bed,
were
more
important
than
individual
and
group
psychotherapeutic
efforts.
It
soon
turned
out
that
such
events,
when
handled
with
understanding
and
skill,
were
even
more
important
than
the
presence
of
a
psychiatrist
in
the
residence
at
any
time.
Since
all
children
with
major
emotional
illness
suffer
from
severe
ego
disturbance,
they
need
to
have
practical
help
in
mastering
all
those
life
experiences
that
lead
to
ego
development.
Psychiatrists
Bettelheim
and
Sylvester
scrutinized
the
success
of
their
common
work,
and
coined
the
term
‘Milieu
Therapy’.
The
Oxford
Dictionary
defines
‘milieu’
as
a
"medium,
environment,
surrounding,"
and
this
was
exactly
what
Bettelheim
and
Sylvester
had
in
mind;
in
their
first
joint
publication,
Bettelheim
and
Sylvester
stressed
that
their's
was
not
a
new
technique.
Their
article
on
“Milieu
Therapy"
begins:
"Milieu
therapy
is
not
new
as
a
psychotherapeutic
technique.
It
is
no
more
than
the
application
of
psychoanalytic
concepts
to
the
specific
task
of
creating
a
setting
for
emotionally
disturbed
children
who
are
in
need
of
residential
treatment.
[Emphasis
supplied]
This
is
said
by
Bettelheim
and
Sanders
at
pages
218
and
219
in
Part
D:
First,
a
child
is
much
more
vulnerable
to
the
impact
of
his
parents
—
from
whom
he
may
have
to
be
protected,
as
exemplified
by
the
‘‘battered”
child
—
than
is
the
average
adult
to
the
influence
of
his
closest
relatives.
Second,
for
some
centuries,
society
has
been
convinced
that
the
young,
for
their
own
good,
must
be
removed
for
considerable
periods
of
time
into
a
very
special
institution,
supposedly
designed
to
meet
their
needs:
schools.
Overtly,
schools
are
designed
only
to
teach
what
children
need
to
learn;
covertly,
schools
also
serve
to
free
adult
society
for
a
time
of
the
burden
of
its
children
so
that
they
do
not
interfere
unduly
with
its
operations.
Since
all
children
attend
some
institution
especially
planned
for
them,
the
idea
that
special
children,
such
as
the
severely
disturbed,
need
institutions
especially
designed
for
their
needs
is
easier
to
accept.
For
many
years,
it
was
a
canon
of
education
that
children
suffering
from
severe
physical
defects
should
be
placed
in
institutions
which
provided
classroom
teaching
and
other
guidance
geared
to
the
nature
of
their
deviation.
For
example,
it
was
accepted
that
blind
children
required
from
the
institution
not
only
methods
of
teaching
different
from
normal
children,
but
special
arrangement
of
all
other
life
activities.
This
was
true
long
before
the
need
for
the
special
institutions
for
mentally
disturbed
children
was
recognized.
After
World
War
I,
in
an
all
too
short-lived
experiment,
August
Aichhorn
treated
a
group
of
wayward
youngsters
in
an
institutional
setting.
While
this
in
itself
was
not
new,
Aichhorn’s
experiment
was
critical
in
the
history
of
the
development
of
milieu
therapy
for
children.
Here,
for
the
first
time,
was
a
deliberate
effort
to
apply
psychoanalytic
understanding
to
the
“life”
structure
of
his
own
transference
relationship
to
guide
the
lives
of
some
of
his
patients.
In
the
institution,
he,
the
doctor,
became
involved
in
the
life
of
the
group,
supporting
and
guiding
the
“child
care”
staff
to
make
use
of
the
living
situation
to
rehabilitate
the
youngsters.
For
instance,
a
group
of
boys
was
permitted
to
act
out
and
destroy
things
in
accordance
with
the
notion
that
this
would
have
a
cathartic
effect.
Then,
rather
than
being
punished,
they
were
given
new
quarters.
Thus,
psychoanalytic
theory
was
applied
not
only
in
the
traditional
analytic
sessions,
but
to
a
whole
life
situation*
Years
later,
Slavson,
Redl,
and
others
applied
Aichhorn's
principles
to
group
or
camp
settings,
and
out
of
their
efforts
grew
the
procedure
now
known
as
group
therapy
(see
chapter
10).
Red!
pioneered
summer
camp
settings
for
de-
lingent
youngsters
in
which
the
camp
activities
and
the
group
life
were
designed
to
nave
a
therapeutic
impact
independent
from,
or
in
addition
to,
individual
and
group
treatment.
Among
psychoanalytically
trained
therapists,
it
became
accepted
that
as
much
attention
must
be
paid
to
all
details
of
the
setting
in
group
psychotherapy
as
was
necessary
in
individual
therapy.
But
within
institutions,
except
for
Aichhorn’s
work,
the
prevalent
conviction
persisted
that
the
setting
need
only
be
humane
and
protective,
while
the
true
therapeutic
impact
would
come
from
individual
or
group
therapy
sessions,
or
from
a
combination
of
both.
In
the
United
States
during
the
1940s,
a
number
of
psychoanalytically
trained
people
began
to
apply
psychoanalytic
principles
to
the
treatment
of
very
disturbed
children
within
a
residence.
Stanislaus
Szurek
at
Langley
Porter
Clinic
in
San
Francisco,
Fritz
Redl
in
Detroit,
those
working
at
Southard
School
in
Topeka,
and
the
staffs
at
settings
associated
with
the
Jewish
Board
of
Guardiens
in
New
York
are
among
the
most
noteworthy.
Under
the
stimulus
of
the
new
thinking,
residential
institutions
for
disturbed
children
proliferated
widely
at
that
time.
All
these
efforts
contained
some
element
of
concern
for
the
effects
of
the
environment
on
the
rehabilitation
of
the
children.
It
was
during
this
same
period
that
Maxwell
Jones
began
working
on
the
development
of
a
therapeutic
community
for
adults
in
England.
In
1944,
the
University
of
Chicago
entrusted
Bruno
Bettelheim
with
the
task
of
reorganizing
its
Orthogenic
School
in
line
with
the
most
advanced
ideas
on
the
treatment
of
severely
disturbed
children.
He
was
able
to
secure
Emmy
Sylvester’s
help
in
that
work.
Bettelheim
and
Sylvester
undertook
to
formulate
a
more
comprehensive
approach:
What
would
the
setting
and
life
within
an
institution
for
children
suffering
from
severe
functional
disorders
be
like,
if
every
detail
was
in
line
with
psychoanalytic
thinking
on
child
development
and
child
psychotherapy?
lt
immediately
became
apparent
that
how
a
child
was
fed,
bathed,
toiletted,
treated
on
getting
up
and
being
put
to
bed
were
just
as
important
as
what
occurred
during
his
daily
psychotherapy.
In
fact,
it
soon
turned
out
that
such
events,
when
handled
with
understanding
and
skill,
were
even
more
important
than
what
could
be
achieved
for
the
child
in
his
individual
treatment
hour.
Since
all
children
with
major
emotional
illnesses
suffer
from
severe
ego
disturbance,
they
need
to
have
help
in
mastering
all
those
life
experiences
that
lead
to
ego
growth.
This
was
the
situation
which
led
not
only
to
much
of
the
thinking
that
went
into
the
creation
of
milieu
therapy,
but
also
prompted
the
selection
of
its
name.
When
Bettelheim
and
Sylvester
felt
ready
to
report
on
their
common
work,
they
were
hard-pressed
to
find
a
suitable
name
for
it.
The
term
“mileau
therapy”
finally
occurred
to
one
of
them,
and
a
consultation
of
the
Oxford
Dictionary
indicated
its
appropriateness.
"Milieu”
was
defined
as
"a
medium,
environment,
surrounding.
This
was
exactly
what
Bettelheim
and
Sylvester
had
in
mind,
for
what
they
had
tried
to
create
was
a
medium
—
an
enveloping
matrix
within
which
one
lives;
an
agency;
an
environment.
Within
the
framework
of
psychoanalytic
thinking,
they
strove
to
create
an
environment,
both
physical
and
human
that
would
in
itself
function
as
an
agency
for
therapy.
“A
therapeutic
Milieu”
was
the
title
for
their
first
publication
describing
the
work
of
the
Orthogenic
School,
shortly
followed
by
another,
“Milieu
Therapy
—
Indications
and
Illustrations.”
In
these
first
publications,
Bettelheim
and
Sylvester
stressed
that
theirs
was
not
a
new
technique.
Their
article
“Milieu
Therapy”
begins:
Milieu
Therapy
is
not
new
as
a
psychotherapeutic
technique.
It
is
no
more
than
the
application
of
psychoanalytic
concepts
to
the
specific
task
of
creating
a
setting
for
emotionally
disturbed
children
who
are
in
need
of
residential
treatment
....
[Emphasis
supplied.]
This
is
also
said
at
pages
8
and
9
of
McGovern
report:
Psychiatrists
Caudill,
Goffman
and
Henry,
after
successfully
utilizing
their
Milieu
Therapy
approaches
for
psychotic
and
delinquent
children
and
adolescents,
concluded,
“The
one
most
important,
single
factor
in
treating
the
psychotic
child
or
delinquent
child
is
this;
despite
the
complexities,
vagaries
and
crises
of
his
life,
the
child
or
adolescent
should
be
surrounded
at
all
times
by
the
reality
of
a
unified
setting.
And
this
setting
cannot
be
artificial
regarding
the
importance
of
relating
to
the
realities
of
adult
authority
and
peers,
and
the
responsibilities
of
day-to-
day
existence.
A
clement
philosophy
regarding
treatment
is
as
imperative
as
particular
scientific
tactics.
Since
solidarity
is
based
on
commitment
to
what
the
institution
stands
for,
it
must
stipulate
defense
against
those
who
seem,
rightly
or
wrongly,
to
act
out
of
line
with
its
ethos.”
[Emphasis
supplied]
The
language
of
the
sentences
in
quotation
marks
is
not
that
of
the
psychiatrists
named
or
any
one
or
more
of
them.
Bettelheim
and
Sanders
said
this
at
page
221
of
Part
D:
It
was
agreed
that
there
was
one
most
important
single
factor
in
treating
the
psychotic
child.
It
was
this:
that
despite
the
complexities,
vagaries,
and
crises
of
his
life,
the
child
should
be
surrounded
at
all
times
by
the
reality
of
a
unified
setting.
This
view
has
been
supported
by
the
findings
of
Caudill,
Goffman,
and
others
who
brought
this
concept
to
wider
attention,
and
Henry
who,
for
a
few
years,
joined
in
the
work
of
the
Orthogenic
School
and
published
his
findings.
[Emphasis
supplied]
At
page
9
of
his
report
McGovern
adds:
Recognizing
these
opinions
and
facts
concerning
Milieu
Therapy,
more
recently
psychiatrist
Sachehay
(sic)*
concluded,
“The
therapeutic
milieu
must
take
very
seriously
the
problem
of
how
to
convey
meaning,
not
only
through
rational
arrangements
but
also
through
the
attitudes
reflected
by
the
physical
setting.
This
is
the
carrier
of
symbolic
meaning.
How
the
institution
is
built
and
furnished,
down
to.the
last
detail
of
lighting
and
furniture,
must
all
be
designed
to
convince
the
patient
that
this
is
a
place
that
expects
order
and
harmony
and
appropriate
impulse
controls
and
introversion
in
some
settings,
while
in
others
that
are
part
of
the
same
Milieu
Therapy
setting,
one
can
become
more
extroverted
and
group
oriented
and
active,
safely
and
securely
.
.
."
[Emphasis
supplied]
The
quoted
words
are
not
those
of
Sechehaye.
Bettelheim
and
Sanders
said
this
at
page
225
of
Part
D:
Recognizing
these
facts,
the
therapeutic
milieu
must
take
very
seriously
the
problem
of
how
to
convey
meaning
not
only
through
rational
arrangements
but
also
through
the
attitudes
reflected
by
the
physical
setting.
This
is
the
carrier
of
symbolic
meaning.
How
the
institution
is
built
and
furnished,
down
to
the
last
detail
of
lighting
and
furniture,
must
all
be
designed
to
convince
the
patient
that
this
is
a
place
where
he
can
afford
to
let
down
his
defenses,
because
everything
is
here
to
satisfy
all
his
needs.
Further,
he
must
become
convinced
that
these
satisfactions
will
not
endanger
him,
and
that
he
will
not
be
destroyed,
even
if
he
relaxes
his
controls
over
his
anger
and
anxiety.
But
he
will
believe
this
only
if
even
inanimate
objects
tell
him
that
everything
is
here
for
him,
that
he
is
terribly
important
to
the
staff,
and
that
life
can
be
good
even
for
him.
Only
then
can
be
dare
to
begin
to
trust
the
institution's
intentions
and
begin
to
get
well.
[Emphasis
supplied]
The
justification
offered
by
McGovern
for
this
conduct,
which
was
undisclosed
except
under
cross-examination,
is
that
he
prepared
the
report
in
haste
and
under
pressure.
I
cannot
accept
it.
Reverting
to
the
earlier
certificates
in
the
Kushnir
and
MacLean
appeals,
each
contains
this
same
“diagnosis”
by
McGovern:
“I
regard
him
(the
dependant)
as
psychologically
immature
and
academically
underachieving/’
At
no
time
did
McGovern
suggest
that
these
words
are
identifying
the
existence
of
mental
handicap.
He
said
that
it
was
his
practise
in
dealing
with
parents
of
children
he
examined
to
mask
the
true
nature
of
the
problem
identified
because
of
what
he
considered
potential
harm.
This
modus
operand!
is
obvious
from
the
fact
that
while
the
diagnosis
in
each
of
the
earlier
certificates
in
the
Kushnir
and
MacLean
appeals
are
the
same,
the
diagnosis
in
the
certificates
of
November
18,
1985,
are
not
ony
different
from
what
was
diagnosed
earlier,
but
also
from
each
other.
Another
person
called
on
behalf
of
the
appellant
MacLean
as
an
expert
witness
is
Dr.
Charles
Cunningham,
a
clinical
psychologist.
He
had
examined
David
MacLean,
but
said
that
he
was
unfamiliar
with
Robert
Land.
In
the
circumstances
there
could
be
no
question
of
his
having
certified
David
within
the
meaning
of
the
legislation.
Cunningham
was,
however,
asked
this
question
and
gave
this
reply
which
is
relevant
to
McGovern’s
method
of
dealing
with
parents:
Q.
So
I
think
in
the
statement
you
are
indicating
that
it
is
very
important
that
exactly
what
the
child’s
difficulty
is
then
be
communicated
to
the
people
who
are
involved.
It
would
be
the
parents
—
it
would
be
very
important
that
the
parents
understand
what
the
difficulty
is?
A.
Yes.
It
strikes
me
that
this
answer
is
eminently
sensible.
Surely
in
the
absence
of
some
special
circumstance,
when
parents
retain
professionals
to
advise
them
about
their
children’s
mental
or
physical
health,
steps
should
be
taken
to
inform
them
with
whatever
exactness
is
reasonably
possible
of
the
child’s
true
condition
in
order
that
parents
may
make
informed
decisions
regarding
the
course
of
action
to
pursue.
The
language
most
akin
to
the
words
“academically
underachieving’’
which
appear
in
the
prior
certificates
in
the
Kushnir
and
MacLean
appeals
that
was
discussed
at
the
hearing
is
the
phrase
“learning
disability’’.
In
that
regard
McGovern
ventured
this
opinion:
The
average
child
that
is
labelled
a
learning
disability
is
unquestionably,
I
suppose,
a
child
like
Winston
Churchill
who
is
sanguine
in
temperament,
a
dominant
aggressive,
disorganized
person
basically,
and
is
very
much
at
risk
for
not
responding,
not
developing
a
conscience.
In
Winston
Churchill’s
case,
I’m
pointing
something
like
this
forward,
of
course,
he
had
the
best
teaching,
the
best
environmental
influences;
he
was
the
first
to
admit
that
without
these
he
may
have
been
a
misfit;
he
had
anti-authoritarian
attitudes.
With
respect
to
the
Bauer
appeal
the
transcript
shows
McGovern
giving
these
answers:
Q.
All
right,
thank
you.
And
so
than
Jerry
(Bauer)
went
to
see
Mrs.
Elgie,
and
it
was
basically
on
the
basis
of
Mrs.
Elgie’s
report
that
it
was
decided
whether
or
not
Robert
(sic)
would
come
into
Robert
Land
Academy
or
not,
along
with
the
other
criteria
that
—
A.
I
believe
so.
I
believe
so.
Q.
—
that
Mr.
Bowman
would
normally
use.
A.
Yes,
I
believe
so.
Nancy
Ann
Elgie
is
a
psychologist
and
testified
as
an
expert
witness
on
behalf
of
the
appellant
Bauer.
Through
her
a
report
was
filed
as
an
exhibit
which
is
dated
May
15,
1979.
She
prepared
it
in
relation
to
an
examination
of
Jerry
Bauer
conducted
by
her
on-April
18,
1979.
This
report
was
discussed
at
length
and
at
the
conclusion
of
her
cross-examination
this
exchange
took
place:
His
Honour:
If
somebody
asked
you
the
question,
is
your
assessment
of
Jerry
Bauer
or
was
your
assessent
of
Jerry
Bauer
on
April
18th,
1979,
that
he
was
a
mentally
handicapped
boy,
would
you
have
said
yes?
Witness:
No,
I
would
not
have
said
yes.
The
prior
certificate
in
the
Hartman
appeal
is
not
descriptive
of
the
dependant's
mental
condition
and
the
prior
certificate
in
the
Bauer
appeal
contains
nothing
that
can
be
construed
as
saying
that
the
dependant
was
a
mentally
handicapped
person.
These
certificates
also
state
that
McGovern
"prescribed
placement”
of
the
dependants
in
Robert
Land.
This
has
already
been
dealt
with.
When
regarded
in
its
totality
the
evidence
leads
me
to
the
conclusion
that
McGovern
never
certified
any
of
the
dependants
within
the
contemplation
of
subparagraph
110(1)(c)(vi)
of
the
Act.
It
follows
that
these
appeals
cannot
succeed.
The
appeals
are
dismissed.
Appeals
dismissed.