World Library  
Flag as Inappropriate
Email this Article

Therapeutic community

 

Therapeutic community

Therapeutic community is a participative, group-based approach to long-term mental illness, personality disorders and drug addiction. The approach was usually residential, with the clients and therapists living together, but increasingly residential units have been superseded by day units. It is based on milieu therapy principles, and includes group psychotherapy as well as practical activities.

Therapeutic communities have gained some reputation for success in rehabilitation and patient satisfaction in Britain and abroad. In Britain, 'democratic analytic' therapeutic communities have tended to specialise in the treatment of moderate to severe personality disorders and complex emotional and interpersonal problems. The evolution of therapeutic communities in the United States has followed a different path with hierarchically arranged communities (or concept houses) specialising in the treatment of drug and alcohol dependence.

In the US, therapeutic communities, such as Another Way Transitional Living Program in New Hampshire, provide supportive housing services utilizing peers and professionals to help individuals looking to transition from chemical dependency to improved health.

Contents

  • History 1
    • UK 1.1
    • USA 1.2
  • References 2
  • Further reading 3
  • External links 4

History

UK

The term was coined by Thomas Main in his 1946 paper, "The hospital as a therapeutic institution",[1][2] and subsequently developed by others including Maxwell Jones, R. D. Laing at the Philadelphia Association, David Cooper at Villa 21, and Joshua Bierer.

Under the influence of Maxwell Jones, Main, Wilmer and others (Caudill 1958; Rapoport 1960), combined with the publications of critiques of the existing mental health system (Greenblatt et al. 1957, Stanton and Schwartz 1954) and the sociopolitical influences that permeated the psychiatric world towards the end of and following the second World War, the concept of the therapeutic community and its attenuated form – the therapeutic milieu – caught on and dominated the field of inpatient psychiatry throughout the 1960s. The aim of therapeutic communities was a more democratic, user-led form of therapeutic environment, avoiding the authoritarian and demeaning practices of many psychiatric establishments of the time. The central philosophy is that clients are active participants in their own and each other's mental health treatment and that responsibility for the daily running of the community is shared among the clients and the staff. 'TC's have sometimes eschewed or limited medication in favor of group-based therapies.

The availability of the treatment on the

  • European Federation of Therapeutic Communities (EFTC)
  • World Federation of Therapeutic Communities (WFTC)
  • The association of therapeutic communities
  • The Planned Environment Therapy Trust, including the PETT Archive and Study Centre
  • Therapeutic Community Open Forum
  • Another Way TLP
  • CooperRiis Healing Community
  • American Residential Treatment Association
  • Fountain House
  • Clubhouse International

External links

  • Manning, Nick (1989). The therapeutic community movement: charisma and routinization. London: Routledge.  

Further reading

  1. ^ Main T. (1946). "The Hospital as a Therapeutic Institution". Bulletin of the Menninger Clinic 10: 66–70. 
  2. ^ Reproduced in Main, Tom (1989). The Ailment and other psychoanalytic essays. London:  
  3. ^ Fischer, Michael Daniel; Ferlie, Ewan (1 January 2013). "Resisting hybridisation between modes of clinical risk management: Contradiction, contest, and the production of intractable conflict". Accounting, Organizations and Society 38 (1): 30–49.  
  4. ^ Fischer, Michael Daniel (28 September 2012). "Organizational Turbulence, Trouble and Trauma: Theorizing the Collapse of a Mental Health Setting". Organization Studies 33 (9): 1153–1173.  
  5. ^ Pennsylvania Department of Corrections
  6. ^ Stout Street Foundation
  7. ^ Texas Department of Criminal Justice
  8. ^ Therapeutic Community In a Correctional Setting
  9. ^ Therapeutic Communities Association of New York State
  10. ^ Stay'n Out: In-prison Treatment Programs for Men & Women

References

Modified therapeutic communities are currently used for substance abuse treatment in correctional facilities of several U.S. states including Pennsylvania,[5] Colorado,[6] Texas,[7] Delaware,[8] and New York.[9] In New York City, a program for men is located in the Arthur Kill Correctional Facility on Staten Island and the women’s program is part of the Bayview Correctional Facility in Manhattan.[10]

In the late 1960s within the US correctional system, the Asklepion Foundation initiated therapeutic communities in the Marion Federal Penitentiary and other institutions that included clinical intervention based upon Transactional Analysis, the Synanon Game, internal twelve-step programs and other therapeutic modalities. Some of these programs lasted into the mid 1980s, such as the House of Thought in the Virginia Correctional system, and were able to demonstrate a reduction of 17% in recidivism in a matched-pair study of drug-abusing felons and sex offenders who participated in the program for one year or more.

USA

However, development of 'mini' therapeutic communities, meeting for three or fewer days each week and supported out of hours by various forms of 'service user led informal networks of care' (for example telephone, texting and physical support), now offers a more resource and cost effective alternative to traditional inpatient therapeutic communities. The most recent exponent, the North Cumbria model, uses a dedicated out of hours website moderated by service users according to therapeutic community principles. This extends the community beyond the face to face 'therapeutic days'. The website guarantees a safe group-based response not always possible with other systems. The use of 'starter' groups as a preparation for entry into therapeutic communities has lowered attrition rates and they now represent a cost-effective model still aimed at producing durable personal and intergenerational effects; this is at odds with the current trend towards the defensive needs of service providers, rather than service users, for less intensive treatments and management of pathways to control risk. [4]

This article was sourced from Creative Commons Attribution-ShareAlike License; additional terms may apply. World Heritage Encyclopedia content is assembled from numerous content providers, Open Access Publishing, and in compliance with The Fair Access to Science and Technology Research Act (FASTR), Wikimedia Foundation, Inc., Public Library of Science, The Encyclopedia of Life, Open Book Publishers (OBP), PubMed, U.S. National Library of Medicine, National Center for Biotechnology Information, U.S. National Library of Medicine, National Institutes of Health (NIH), U.S. Department of Health & Human Services, and USA.gov, which sources content from all federal, state, local, tribal, and territorial government publication portals (.gov, .mil, .edu). Funding for USA.gov and content contributors is made possible from the U.S. Congress, E-Government Act of 2002.
 
Crowd sourced content that is contributed to World Heritage Encyclopedia is peer reviewed and edited by our editorial staff to ensure quality scholarly research articles.
 
By using this site, you agree to the Terms of Use and Privacy Policy. World Heritage Encyclopedia™ is a registered trademark of the World Public Library Association, a non-profit organization.
 


Copyright © World Library Foundation. All rights reserved. eBooks from Project Gutenberg are sponsored by the World Library Foundation,
a 501c(4) Member's Support Non-Profit Organization, and is NOT affiliated with any governmental agency or department.