Soul of an Agency: Psychodynamic Principles in Action in the World of Community Mental Health

Abstract

Community mental health has undergone a number of evolutions since Lyndon Johnson declared a War on Poverty and gave birth to the community mental health movement. This paper describes a philosophy of treatment involving long-term psychotherapy to resistant and multiple problem families in disadvantaged communities. The agency's primary philosophy is described as a psychoanalytic frame that guides treatment from a secure attachment site (clinic) in the community. The interventions use home and community based therapists with supports from psychiatry, psychology, and therapeutic mentoring. The focus of all treatment is for high-risk families to remain in the community and not burden corrections, courts, child welfare, or juvenile justice systems. Therapy forms the connection that can help families navigate schools, medical providers, courts, and social service systems. The agency forms the positive attachment site; clinicians come and go. The net effect is sustained connection to families that would have otherwise been broken apart by domestic violence, school crimes, addiction, gangs, poverty, homelessness, and community violence.