Therapeutic communities

Abstract

Two of the best-known pioneers of therapeutic communities, Tom Main and Maxwell Jones, defined them as follows: An attempt to use a hospital not as an organization run by doctors in the interests of their own greater technical efficiency, but as a community with the immediate aim of full participation of all its members in its daily life and the eventual aim of the resocialization of the neurotic individual for life in ordinary society. What distinguishes a therapeutic community from other comparable treatment centres is the way in which the institution's total resources, staff, patients, and their relatives, are self-consciously pooled in furthering treatment. That implies, above all, a change in the usual status of patients. Today therapeutic communities can be defined by a number of common features, but a word of warning. For reasons of historical coincidence, the term is used in the fields of mental health and addictions to refer to two somewhat different treatment models. In the addiction field they are also known as hierarchical, drug-free or concept-based therapeutic communities, or simply addiction therapeutic communities, in contrast to the more democratized programmes in mental health. The two models have similar goals but their methods differ, although there are signs of increasing rapprochement between them. This chapter deals mainly with therapeutic communities in mental health, but reference will also be made to addiction therapeutic communities and those in long-term care settings. It is worth noting that those admitted to a therapeutic community for treatment are usually referred to as residents, clients, or members, rather than as patients.

Assessing the Social Climate of Prisons

“…This can be seen, for example, in the opening in 1796 of The Retreat, a therapeutic program based on Quaker philosophies (Kennard 1983) which signalled the introduction of co-operative (rather than prescriptive) models of treatment. The origins of modern day therapeutic units can be found in the UK in the 1940s at the Northfield Military Hospital and Maxwell Jones" Mill Hill Neurosis Unit (Roberts 1997;Vandevelde et al 2004;Whiteley 2004).…”

Before Prison, Instead of Prison, Better Than Prison: Therapeutic Communities as an Abolitionist Real Utopia?

“…An individual's needs were met through total participation in Synanon, and individual roles and responsibilities evolved to serve the maintenance of the Synanon community. Clients were required to conform to rules, norms and expectations that detailed how to behave, and to uphold pre-determined values that applied to everyday life, from getting up in the morning to relaxing in the evening (Kennard 1998).…”

Outcomes of therapeutic community treatment for personality disorder

“…A DTC is most usefully defined as a treatment modality (i.e. integrating a range of psychological and/or pharmacological approaches) as opposed to a specific treatment method itself (Kennard, 1998).…”