The complexity of the therapeutic experience within the therapeutic community based on an ex-patient’s account

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Daniela Ivanova ◽  
Andrew John Howe ◽  
Patricia Burns ◽  
Merryn Jones
Keyword(s):  
Design Methodology ◽  
Therapeutic Community ◽  
Support Network ◽  
Therapeutic Communities ◽  
Community Based ◽  
Content Type ◽  
Therapeutic Experience ◽  
Key Factor ◽  
The Impact ◽  
E Mail

Purpose The purpose of this paper is to explore the effectiveness of the therapeutic community and to look at the potential changes that some patients may experience following treatment at the therapeutic communities (TC). Design/methodology/approach A thematic analysis was conducted on an e-mail sent by an ex-patient of the TC. The text was reviewed multiple times and codes were generated. Based on the data found, three themes were identified. The e-mail was sent to the patient’s primary therapist, who was asked to provide an account of the e-mail. The therapist was sent six questions created by the authors of the paper; the responses were used to compare the two perspectives. Findings The main findings entailed the changes the patient went through after her treatment at the TC. The patient’s account described her inability to process the adversities she had been through at the time and therefore her inability to communicate them. However, the impact the service had on the patient, according to the e-mail was evident years later. The lack of a support network during treatment at the TC and evidence of one following treatment seemed to be the key factor in the patient’s improvement. Originality/value The authors confirm that the research presented in this paper is their original work. The authors hereby acknowledge that all material included in this piece of work, that has been published or written by another person has been referenced accordingly.

The rise and fall and rise again of the therapeutic community

2017 ◽  
Vol 38 (2) ◽  
pp. 57-59
Author(s):  
Rowdy Yates
Keyword(s):  
Design Methodology ◽  
Social Issues ◽  
Therapeutic Community ◽  
Learning Difficulties ◽  
Therapeutic Communities ◽  
Health Issues ◽  
Community Based ◽  
Content Type ◽  
Low Profile ◽  
Personal Contribution

Purpose Therapeutic communities (and many other residential services) have been effectively marginalised in recent years with the increasing popularity of community-based outpatient responses to a variety of social issues including addiction, learning difficulties, mental health issues, etc. The paper aims to discuss this issue. Design/methodology/approach This has inevitably led to a low profile and has resulted in a lack of knowledge about therapeutic communities and how the methodology differs significantly from other approaches. Findings This situation is beginning to change in a number of fields and it is important that the therapeutic community movement adapts its methodology to the needs of their respective client groups and clarifies its approach (and the efficacy of that approach) to funders and service commissioners. Originality/value This paper is a personal contribution.

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.

In-prison therapeutic communities in California

2019 ◽  
Vol 40 (3/4) ◽  
pp. 142-158
Author(s):  
Rod Mullen ◽  
Naya Arbiter ◽  
Claudia Rosenthal Plepler ◽  
Douglas James Bond
Keyword(s):  
Personal Experience ◽  
Design Methodology ◽  
Research Literature ◽  
Therapeutic Communities ◽  
Community Based ◽  
Content Type ◽  
Research Findings ◽  
The Government ◽  
Reducing Recidivism ◽  
Practical Implications

Purpose Over nearly six decades in prison, therapeutic communities (TCs) have waxed and waned in California. While there have been dramatic and demonstrable sucess with some of the most intractable populations in California prisons, the TC model has met substantial challenges, both bureaucratic and political. The paper aims to discuss this issue. Design/methodology/approach This is a six-decade review of in-prison TCs in California based both on the research literature and from personal experience over 30 years providing both in-prison and community based TCs in California. Findings Despite well-documented success reducing the recidivism of violent offenders in California prisons (which is now the bulk of the population), the government has ignored the success of well implemented in-prison TCs, and has implemented a CBT model which has recently been documented to have been ineffective in reducing recidivism. The State is now at a crossroads. Research limitations/implications Documented research findings of success do not necessarily result in the implementation of the model. Practical implications There is evidence that violent felons are amenable to treatment. Social implications Public concern over the return of violent felons from prison can be ameliorated by the evidence of the effectiveness of TC treatment in prison. Originality/value There is no other publication which captures the narrative of the TC in California prisons over six decades.

The Daytop crisis and its impact on the global Therapeutic Community movement

2020 ◽  
Vol 41 (1) ◽  
pp. 25-35
Author(s):  
Phoebus Zafiridis
Keyword(s):  
Design Methodology ◽  
Status Quo ◽  
Best Interests ◽  
Therapeutic Communities ◽  
Sociological Analysis ◽  
Content Type ◽  
Professional Career ◽  
Constructive Dialogue ◽  
Scientific Status ◽  
The Impact

Purpose The Therapeutic Communities (TCs) movement tends to become from a revolutionary answer to the problem of addiction to another mainstream therapeutic proposal. The author considers that the crisis in 1968 in the seminal TC of Daytop was a pivotal event of this transition. This study aims to evaluate the impact of this historical crisis on the course of the TCs movement, assuming that, to enter into a constructive dialogue that can lead to the overcoming of today’s deadlocks of the movement, an awareness of the history is needed. Design/methodology/approach The present paper is a perspective/opinion paper and starts with a brief review of the origins of the first TCs for addicts. Emphasis is placed on their inevitable, according to the author, confrontation with the political and scientific status quo of that time. Then, it focuses on the period of the crisis in Daytop TC. The author interprets the events under a whole new scope, based on conversations he personally had with pioneers of that time, on his longstanding experience on the field, and the available literature. Findings The author attempts a historical and sociological analysis of the course of TCs and the Daytop TC. He concludes with a dispute of the prevailing idea that the Daytop crisis was a product of the confrontation between personal ambitions. He maintains that the collision that took place in Daytop TC was a confrontation between two antipodal perspectives over the notion of therapy. In any case, the subsequent estrangement of the movement from the groundbreaking attributes of the first TCs did not prove to be in the best interests of addicts; it was rather dictated by the need of the leaders of TCs to rescue their professional career. Originality/value The present paper attempts to offer a different view from the conventional reading of TCs’ history and their present situation for today’s predicaments of this proposal to be understood and possibly overcome.

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.

Containment: from cruelty to kindness

2015 ◽  
Vol 36 (1) ◽  
pp. 21-28 ◽  
Author(s):  
Penelope Campling
Keyword(s):  
Lived Experience ◽  
Design Methodology ◽  
Therapeutic Community ◽  
Modern Society ◽  
Modern World ◽  
Therapeutic Communities ◽  
Social Forces ◽  
Relational Dynamics ◽  
Content Type ◽  
Economic Philosophy

Purpose – This paper is about therapeutic containment. It makes links between what the author understands about containment in therapeutic communities and wider perspectives on containment in the context of organisational and social forces within which the author lives and works in modern society. The paper aims to discuss these issues. Design/methodology/approach – The author explores relational dynamics, focusing particularly on the English NHS, using evidence from a cross-section of disciplines including ethology, anthropology and economic philosophy. Findings – The author suggests that the crisis in healthcare culture reflects a wider crisis of containment in the modern world; and that the theoretical legacy from, and lived experience in, therapeutic communities offers a rich perspective on the issues and points to ways forward. Social implications – The paper suggests ways that therapeutic community thinking can be applied more widely to topical problems such as the undermining of healthcare culture. The paper argues that an explicit focus on values is important in order to mitigate the forces that distract from co-operative and therapeutic relationships. To illustrate this, the author describes a simple model for nurturing the conditions for intelligent kindness. Originality/value – The paper draws important parallels between therapeutic community philosophy and practice, and the culture at large.

If they will have me, I think I will stay a while: compassion and containment illustrated by the Ingrebourne Therapeutic Community

2020 ◽  
Vol 41 (2) ◽  
pp. 37-46
Author(s):  
Tom Harrison
Keyword(s):  
Design Methodology ◽  
Psychiatric Care ◽  
Therapeutic Community ◽  
Practical Implication ◽  
Therapeutic Communities ◽  
Content Type ◽  
Community Approach ◽  
Phd Thesis ◽  
Structured Approach

Purpose The purpose of this paper is to illustrate the evolution of discerning compassion and how it was used in the Ingrebourne Therapeutic Community. Design/methodology/approach This paper is derived from a PhD thesis which was researched through interviews and archival research. The fundamental finding was that the therapeutic community approach was almost unique in providing a structured approach to implementing discerning compassion. Practical implication The therapeutic community approach for discerning compassion, in which the response to distress aims to promote flourishing. Social implications This paper offers a model that has implications on how care is delivered in other settings. Originality/value There is little literature that explores the role of compassion in therapeutic communities or in care environments of any form. The approach taken here places compassion in a historical and philosophical setting and contrasts it with the kindness expressed in traditional psychiatric care that promoted “tranquility”.

Senior therapeutic community members show greater consistency when affirming peers: evidence of social learning

2020 ◽  
Vol 41 (1) ◽  
pp. 5-13
Author(s):  
Keith L. Warren
Keyword(s):  
Social Networks ◽  
Social Network ◽  
Social Learning ◽  
Prosocial Behavior ◽  
External Validity ◽  
Design Methodology ◽  
Therapeutic Community ◽  
Therapeutic Communities ◽  
Community Members ◽  
Content Type

Purpose Therapeutic communities (TCs) use social learning between peers in treating substance abuse. One mechanism for fostering social learning is peer affirmations for prosocial behavior. The purpose of this study is to use consistency of affirmations as a test of whether social learning does occur. Design/methodology/approach Using the results of a social network survey of 50 women in a corrections-based TC, the authors compared affirmations and nonprogrammatic compliments exchanged between residents as two directed social networks. The authors evaluated consistency of judgment using the hubs and authorities algorithm, and tested to see whether more senior residents are more likely to be hubs, thereby showing more consistent judgment. Findings More senior residents show greater consistency with peers in program affirmations but not in nonprogrammatic compliments. Hub status in the network of affirmations increases most rapidly in the first 200 days of residence, with slower increases thereafter. Research limitations/implications This study is limited to one survey of the women in one TC. The external validity of the findings is therefore unclear. The results suggest that social learning of TC principles and prosocial behavior does occur and that it is not simply a function of popularity among peers. This seems to happen most rapidly in the first 200 days, suggesting that programs much shorter than six months may limit this process. Originality/value This is the first use of the hubs and authorities algorithm with a social network drawn from a therapeutic community and the first attempt to verify social learning through a social network analysis.

Leading from below? Decisions, responsibility and creativity as a group dynamic

2020 ◽  
Vol 41 (2) ◽  
pp. 47-55
Author(s):  
Robert Douglas Hinshelwood
Keyword(s):  
Social Science ◽  
Design Methodology ◽  
Therapeutic Community ◽  
Therapeutic Communities ◽  
Community Practice ◽  
Group Dynamic ◽  
Content Type ◽  
The Past ◽  
Disadvantaged People

Purpose This paper aims to bring back into view some of the original ideas from which the Therapeutic Community (TC) developed today. If we forget the origins of therapeutic communities way back in the past, we cannot be in the best position to make decisions for the present. The underlying principles of the TC are a combination of social science ideas, psychotherapeutic practices and a political urgency to do something for disadvantaged people. There is a need to try to keep all branches of the past roots in play together. Design/methodology/approach Learning from the past. Findings The past has a relevance that must not be forgotten in present reflection. Originality/value This is a reflective exercise at the heart of the therapeutic community practice.

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