Training for democratic therapeutic community staff: a description and evaluation of three experiential workshops

2017 ◽  
Vol 38 (1) ◽  
pp. 10-22 ◽  
Author(s):  
Barbara Rawlings
Keyword(s):  
Therapeutic Community ◽  
Participant Observation ◽  
Community Setting ◽  
Therapeutic Communities ◽  
Experiential Training ◽  
Content Type ◽  
Staff Members ◽  
Community Staff ◽  
Set Up ◽  
Published Research

Purpose The purpose of this paper is to compare and evaluate three experiential training workshops, each set up as three-day transient therapeutic communities, and established to train therapeutic community staff. Design/methodology/approach The author carried out participant observation of all courses and analysed these using thematic analysis. The description is provided in Part 1 of the paper. The evaluation, in Part 2 was based on written feedback from participants and from assessment against relevant audit criteria. Findings All three workshops achieved their aims of providing participants with an authentic TC resident’s experience. Additionally, each offered personal understandings of how participants felt and why they felt that way in the community setting. Research limitations/implications This was largely a piece of qualitative research, carried out in the field, to achieve depth of description and understanding rather than statistical outcomes. Some numerical scores were derived from feedback forms. Further analysis of feedback from future workshops will strengthen findings by increasing the numbers of respondents. Practical implications The workshops should continue largely as they are, although there may be some small changes to the designs. They achieve the aim of advancing the understanding of TC staff members. Originality/value The paper is based on three earlier unpublished reports and is new published research of interest to trainers in the fields of mental health and experiential learning.

Working in a therapeutic community: exploring the impact on staff

2017 ◽  
Vol 38 (1) ◽  
pp. 32-40 ◽  
Author(s):  
Anisha Vyas ◽  
Cathy Spain ◽  
David Rawlinson
Keyword(s):  
Personal Development ◽  
Therapeutic Community ◽  
Future Research ◽  
Therapeutic Communities ◽  
Structured Interviews ◽  
Emotional Instability ◽  
Policy Makers ◽  
Content Type ◽  
Staff Members ◽  
The Impact

Purpose The purpose of this paper is to explore the impact working in a therapeutic community (TC) has on staff practice and personal development. Design/methodology/approach Eight female members of staff who work in the TC participated in semi-structured interviews. Interviews were recorded and transcribed. Thematic analysis was used. Findings The findings of this paper show three superordinate themes: confidence gained within TC; the staff impact of the intensity of TC; and staff value for specific TC principles. Research limitations/implications Limitations include researcher bias as both authors work in the TC and/or in the service. Reasonable adjustments were made in order to account for this. Practical implications Implications for future research include understanding and supporting the needs of staff and further exploration of the impact of staff working within TCs for people diagnosable with emotionally unstable personality disorders. Originality/value The research was carried out at one of the longest running TCs for people with emotional instability in the country. It offers a unique opportunity to garner the views of staff members with up to 27 years of experience. Findings may be of value to practitioners, administrators, policy makers and researchers interested in therapeutic communities.

scholarly journals The case for “fluid” hierarchies in therapeutic communities

2017 ◽  
Vol 38 (4) ◽  
pp. 207-216 ◽  
Author(s):  
Jenelle Marie Clarke
Keyword(s):  
Participant Observation ◽  
Power Dynamics ◽  
Therapeutic Communities ◽  
Personal Agency ◽  
Structured Interviews ◽  
Content Type ◽  
Interaction Ritual ◽  
Staff Members ◽  
Narrative Ethnography ◽  
Client Group

Purpose Democratic therapeutic communities (TCs), use a “flattened hierarchy” model whereby staff and clients are considered to have an equal voice, sharing administrative and some therapeutic responsibility. Using the sociological framework of interaction ritual chain theory, the purpose of this paper is to explain how TC client members negotiated and enforced community expectations through an analysis of power within everyday interactions outside of structured therapy. Design/methodology/approach The study used narrative ethnography, consisting of participant observation with two democratic communities, narrative interviews with 21 client members, and semi-structured interviews with seven staff members. Findings The findings indicate social interactions could empower clients to recognise their personal agency and to support one another. However, these dynamics could be destructive when members were excluded or marginalised. Some clients used their interactions at times to consolidate power amongst dominant members. Practical implications It is argued that the flattened hierarchy approach theoretically guiding TC principles does not operate as a flattened model in practice. Rather, a fluid hierarchy, whereby clients shift and change social positions, seems more suited to explaining how the power structure worked within the communities, including amongst the client group. Recognising the hierarchy as “fluid” may open dialogues within TCs as to whether, and how, members experience exclusion. Originality/value Explorations of power have not specifically focused on power dynamics between clients. Moreover, this is one of the first papers to look at power dynamics outside of structured therapy.

Participant Observation of a Therapeutic Community Model for Offenders in Drug Treatment

1997 ◽  
Vol 27 (2) ◽  
pp. 209-314 ◽  
Author(s):  
Cátia Olivier Mello ◽  
Flavio Pechansky ◽  
James A. Inciardi ◽  
Hilary L. Surratt
Keyword(s):  
Criminal Justice ◽  
Drug Treatment ◽  
Therapeutic Community ◽  
Participant Observation ◽  
Therapeutic Communities ◽  
Therapeutic Tool ◽  
Theoretical Understanding ◽  
Community Model ◽  
Therapeutic Procedures

This paper reports the participant observation of a Brazilian psychologist and a Brazilian psychiatrist during a 1-month period in two therapeutic communities (TCs) for drug-using offenders. A description of the activities undertaken by the prisoners who are serving their sentences at the Multi-Purpose Criminal Justice Facility in Wilmington, Del., is complemented with a theoretical understanding of the process. Clinical and developmental psychological approaches are used to explain the functioning of TCs when applied to a correctional environment. The theory of scripts and the use of metacommunication as a therapeutic tool are used in the explanation of these therapeutic procedures.

scholarly journals Madness and chaos in the culture of a therapeutic community

2019 ◽  
Vol 40 (1) ◽  
pp. 16-24
Author(s):  
Jonathan Stephen Roger Leach
Keyword(s):  
Mental Health ◽  
Qualitative Study ◽  
Oral History ◽  
Design Methodology ◽  
Therapeutic Community ◽  
Content Type ◽  
Staff Members

Purpose The purpose of this paper is to explore the perceptions of staff members working in a psychiatric therapeutic community in relation to ideas of “madness” and “chaos”. Design/methodology/approach The paper is a qualitative study based on oral history group witness seminars. Findings The findings indicate that many of the participants experienced working in a therapeutic community as both exciting and unsettling; some found themselves questioning their own mental health at the time. Despite a sense of “madness” and chaos in the life of the community, there was also a feeling that it provided a containing environment for some very disturbed patients. Originality/value This study is unusual in drawing upon staff member’s perceptions of their own relationship to “madness” in response to being involved in the life of a therapeutic community.

The work is never ending: uncovering teamwork sustainability using realistic evaluation

2017 ◽  
Vol 31 (1) ◽  
pp. 64-81 ◽  
Author(s):  
Mandus Frykman ◽  
Ulrica von Thiele Schwarz ◽  
Åsa Muntlin Athlin ◽  
Henna Hasson ◽  
Pamela Mazzocato
Keyword(s):  
Participant Observation ◽  
Behavior Changes ◽  
Management Support ◽  
Realistic Evaluation ◽  
Content Type ◽  
Staff Members ◽  
Initial Implementation ◽  
Behavior Change Interventions ◽  
Implementation Period ◽  
Behavioral Mechanisms

Purpose The purpose of this paper is to uncover the mechanisms influencing the sustainability of behavior changes following the implementation of teamwork. Design/methodology/approach Realistic evaluation was combined with a framework (DCOM®) based on applied behavior analysis to study the sustainability of behavior changes two and a half years after the initial implementation of teamwork at an emergency department. The DCOM® framework was used to categorize the mechanisms of behavior change interventions (BCIs) into the four categories of direction, competence, opportunity, and motivation. Non-participant observation and interview data were used. Findings The teamwork behaviors were not sustained. A substantial fallback in managerial activities in combination with a complex context contributed to reduced direction, opportunity, and motivation. Reduced direction made staff members unclear about how and why they should work in teams. Deterioration of opportunity was evident from the lack of problem-solving resources resulting in accumulated barriers to teamwork. Motivation in terms of management support and feedback was reduced. Practical implications The implementation of complex organizational changes in complex healthcare contexts requires continuous adaption and managerial activities well beyond the initial implementation period. Originality/value By integrating the DCOM® framework with realistic evaluation, this study responds to the call for theoretically based research on behavioral mechanisms that can explain how BCIs interact with context and how this interaction influences sustainability.

Social plastic at work: structure for dialogues in a therapeutic community

2016 ◽  
Vol 37 (1) ◽  
pp. 3-11
Author(s):  
Zsolt Zalka
Keyword(s):  
Developmental Process ◽  
Therapeutic Community ◽  
Specific Effect ◽  
Therapeutic Communities ◽  
Content Type ◽  
Norms And Values ◽  
Normative Dimension ◽  
Collective Agent ◽  
Work Structure ◽  
Therapeutic Activities

Purpose – Reports about therapeutic communities usually focus on specific therapeutic activities: the various ways of the community functioning correctively, the communal-personal dynamics of the community, the dramaturgically graspable problems and the operating and integrative function of the staff. There is relatively little attention paid to the features of the structure composed of the systems of norms and values of these communities. The purpose of this paper is to focus on this normative dimension of the culture of a therapeutic community. Design/methodology/approach – The authors wish to show this focus with the developmental process of the system of values, rules and norms of the therapeutic community of Thalassa House in Budapest, thinking mainly in self-psychological and ethical paradigm. Findings – The way of operating values, norms and rules – the systems of metanorms – creates the cognitive matrix in which members of the community are both acting and perceiving parties, simultaneously suffering and interpreting the communal occurrence of self-pathologies. It develops the cooperative potential of the community along this “ethical” dimension. In the view, the structure of rules, norms and values operated in the culture of relationships of the community, as a consciously elaborated collective agent, has a specific effect in the healing of self-pathologies. Originality/value – In the view, the efficiency of the actuation of norms depends primarily on the emergence of metanorms, that is of the ”how” of the application of norms. The values of the metanorms can be found both in the circumstances of the birth of self-according to the attachment theory and in the world of dialogical ethics.

scholarly journals The development of the therapeutic community for addictions in Denmark. A short report based on an interview with Hanne Holm Hage-Ali

2015 ◽  
Vol 36 (2) ◽  
pp. 103-110
Author(s):  
Eric Broekaert ◽  
Caroline Elizabeth Berg-Sørensen ◽  
Wouter Vanderplasschen ◽  
Stijn Vandevelde
Keyword(s):  
Therapeutic Community ◽  
European Federation ◽  
Short Report ◽  
Therapeutic Communities ◽  
Social Experiment ◽  
Content Type ◽  
Human Value ◽  
The Common ◽  
Alternative Community ◽  
In The Beginning

Purpose – Even though there is much information available with regard to the development of the therapeutic community (TC) for addictions in Europe, little is known about the particular situation in Denmark.The paper aims to discuss this issue. Design/methodology/approach – In order to address this dearth, the methodology of the following historical account is largely based on an interview and personal contacts with Hanne Holm Hage-Ali, current director of TC Opbygningsgården and star witness of the development of TC in Denmark. Findings – In 1971, the Freetown “Christiania”, Copenhagen, where TC Opbygningsgården started up, was based on communal, anarchic and hippie ideas and values. In the beginning, TC Opbygningsgården was not well accepted by TC pioneers promoting the classic hierarchical TC, as it was seen as a social experiment with anti-authoritarian roots. Later, in its turn, it became influenced by TCs Veksthuset and Phoenix House Haga, Norway, which were part of the common European TC movement. At this moment, TC Opbygningsgården functions as a well-accepted member of the European Federation of Therapeutic Communities. Research limitations/implications – The interview revealed information that it is line with current trends in and challenges for TC throughout Europe, as outlined in a recent EMCDDA study: TC in Europe can be considered as “children of the late sixties”; TCs are embedded in the anti-psychiatric movement, existentialism and the promotion of alternative community living; European TC leaders had different origins and professional background; and the TC never belonged to one religion or ideology. The common human value system always transcended the different visions. Originality/value – This paper aims at addressing the dearth in knowledge on the development of TCs in Denmark.

Learning from action: a description and evaluation of an experiential learning programme

2016 ◽  
Vol 37 (1) ◽  
pp. 27-42 ◽  
Author(s):  
Barbara Rawlings
Keyword(s):  
Design Methodology ◽  
Participant Observation ◽  
Learning Experience ◽  
Mental Health Practitioners ◽  
Therapeutic Communities ◽  
Content Type ◽  
Effective Learning ◽  
Health Practitioners ◽  
Audit Standards

Purpose – The purpose of this paper is to describe the learning from action (LfA) workshop held in Italy in October 2014 and to evaluate how well the workshop achieved its aims. Design/methodology/approach – The researcher joined the workshop as a member, and data were collected through participant observation. Evaluation was carried out using relevant audit standards and a follow-up questionnaire. Findings – The evaluation found that an authentic transient therapeutic community was created, which provided an effective learning experience for participants. Research limitations/implications – The description is a single study based on the findings of a single researcher, as is usual with ethnographic work of this kind. Only a few participants completed the questionnaire. Originality/value – This is the first detailed research description of the LfA programme for training mental health practitioners who work in therapeutic communities. It provides a description of events, comments on how some of these impacted on the researcher-participant and an evaluation of the workshop.

Some impressions on taking on the leadership of a therapeutic community

2015 ◽  
Vol 36 (4) ◽  
pp. 219-228
Author(s):  
Martin K. Bhurruth
Keyword(s):  
Design Methodology ◽  
Therapeutic Community ◽  
Therapeutic Communities ◽  
Content Type ◽  
The Face ◽  
Selling Point ◽  
Participant Observer

Purpose – The purpose of this paper is to illustrate how psychoanalytic thinking can help therapeutic communities think about how the defence of psychic retreat can develop and take hold in the face of organisational transition and overwhelming loss. Design/methodology/approach – This paper draws upon the paradigm of psychoanalysis and is a case study orientated by a participant/observer stance. Findings – This paper posits that unless loss is worked through then perverse clinical cultures can develop including bullying and denial of reality. Originality/value – This paper illustrates the unique selling point of therapeutic communities incorporating justice into the treatment frame. It also identifies that unless loss is emotionally worked through then it can become the ground soil in which perverse cultures can develop.

The potential of prison-based democratic therapeutic communities

2017 ◽  
Vol 13 (1) ◽  
pp. 19-24 ◽  
Author(s):  
Jamie Bennett ◽  
Richard Shuker
Keyword(s):  
Literature Review ◽  
Design Methodology ◽  
Therapeutic Community ◽  
Well Being ◽  
Therapeutic Communities ◽  
Content Type ◽  
Wide Range ◽  
Sexually Violent ◽  
Self Harm ◽  
The Uk

Purpose The purpose of this paper is to describe the work of HMP Grendon, the only prison in the UK to operate entirely as a series of democratic therapeutic communities and to summarise the research of its effectiveness. Design/methodology/approach The paper is both descriptive, providing an overview of the work of a prison-based therapeutic community, and offers a literature review regarding evidence of effectiveness. Findings The work of HMP Grendon has a wide range of positive benefits including reduced levels of disruption in prison, reduced self-harm, improved well-being, an environment that is experienced as more humane and reduced levels of reoffending. Originality/value The work of HMP Grendon offers a well established and evidenced approach to managing men who have committed serious violent and sexually violent offences. It also promotes and embodies a progressive approach to managing prisons rooted in the welfare tradition.

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