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 ISSN 0964-1886
VOLUME 24 NUMBER 4
Winter 2003
CONTENTS
243
Editorial
Adrian Ward
Research
245 Setting up new services: How
service users were involved in planning therapeutic community day
programmes
Barbara Rawlings
Abstract: This paper describes
how service users with personality disorders helped to plan
therapeutic community day programmes in Leeds, Liverpool and
Manchester The planning for the three programmes was initiated and
led by Webb House, a residential therapeutic community, and carried
out in partnership with local statutory and voluntary groups. The
paper describes how, in each location, service users had diferent
degrees of participation in planning, and describes how this
participation worked. It goes on to look at three problems which
arose in the course of this planning method: finding appropriate
service users to recruit, assessing and managing the emotional risk
for service users who became involved in the planning enterprise,
and creating a ‘quasi-staff’ role for ex-therapeutic community
members who joined the planning groups and the programmes. The paper
concludes that even though the problems described were largely
anticipated, it was only when they occurred that their distinct
character and significance became apparent.
259 A
pilot evaluation of a therapeutic community for adolescent male sexual
abusers
Gwyneth Boswell and Peter Wedge
Abstract: McGregor Hall (a pseudonym) is a
Voluntary Children’s Home registered with the Department of Health.
It was founded nearly forty years ago and has operated as a
therapeutic community for over thirty of those years. Having always
catered for particularly damaged and challenging young men, the
majority of whom had failed in previous care or custodial settings,
the staff and trustees took the decision, in the early 1990s, to
specialise exclusively in known male perpetrators of sexual abuse in
late adolescence - the group that no-one else wanted. They believed
that their work was effective but, in 1998, decided to seek hard
evidence of this belief by commissioning a pilot research
investigation.
This paper outlines the content and outcome of the research into
McGregor Hal Vs programme of work and focuses, in particular; on the
views of ex-residents whose growth and relapse prevention it
promotes. Set against a comparison group of those who were referred,
but did not become resident, re-conviction rates of both sexual and
non-sexual offending had been considerably reduced. The ex-residents
were almost unanimously positive about their time at McGregor Hall
and the coping techniques with which it had furnished them.
Windsor 2002
277
Decision making in therapeutic communities
Enrico Pedriali and Edoardo Razzini
Abstract: Decision-making is a
very critical aspect of the community app roach under most
circumstances. Factors influencing decision-making can be quite
different; sometimes they can be easily detected, sometimes they are
more difficult to recognise due to their connection with unconscious
conflicting aspects, individually or within the group or the
organisation.
Decision-making means selecting, establishing, leading to, defining
or solving problems. Each of these actions includes one acting part
and another part that receives, shares, undergoes, or opposes
decisions, or is merely present.
The different ways of decision-making in institutions are, however,
a direct and visible expression of the working style, which creates
important dynamics among the structure members.
There is a variety of possibilities ranging from lack of
decision-making ability to the anarchy where nobody (or everybody)
takes a decision, to assembly-oriented decision-making, to
authoritative behaviour and many other intermediate variants.
Whatever the theoretical reference model may be, decision-making can
be considered, both for operators and for patients, as a gradual
passage leading from a dependence status to an autonomy position.
Under this aspect, the structure aiming at being called a
‘therapeutic community" represents a reality where both operators
and patients are stimulated to develop and improve their individual
decision-making abilities.
289
Enjoying myths in psychotherapy
Natassa Karapostoli, Eleftheria Assimina, Diamando Dogramatzi,
Christina Terlidou and Eleni Morarou
Abstract: Several kinds of art have been used
as therapeutic means in different settings and especially within
therapeutic communities. The Mythology Group is, as far as we know,
an original group which started in January 1985, in the context of
the Daily Psychotherapeutic Community of the OPC. In this specific
group we approach mythology not through reason nor interpretations,
but through pure enjoyment, following the belief that every myth has
a basic element of poetry and creative fantasy Myth is by nature
something pleasant, fascinating and hilarious, even when it is
tragic. It has converted into speech the unexpressed emotions of the
individual, the group and the people. Myths can serve as a basis or
connecting link to group procedure and offer an additional means of
communication, especially for patients who have difficulty in
expressing directly their deepest emotions, fears and thoughts to
others. Narrating myths is by nature a communicative procedure which
offers a link between reason and fantasy and reconciles the
contradictions of human nature.
Memoirs
301
Summing up: A day with Maxwell Jones
Dennie Briggs
Abstract: Maxwell Jones was instrumental in
amplifying his practice of democratic therapeutic communities to
community mental health on a broad scale, beginning in the US in the
early 1960s and then applying it to a rural setting in Scotland.
Following his retirement he was offered an opportunity to widen his
ideas as an ecological approach to a relatively cloistered
environment. When he met the local opposition he wasn’t able to
implement his ideas since they could not be construed as within the
confines of the governmental funding agency. In this conversation he
looks back at his work in community mental health with its broader
social and political implications.
Book reviews
325
Journal of School violence. Vol.1
Edited by Edwin R Gerier, Jr
Reviewed by Lorraine O'Sullivan
326
The anthropology of Child and Youth Care work
By Rivika A Eisikovits
Reviewed by Barbara
Rawlings
327
Handbook of counseling (2nd Ed.)
By Stephen Palmer and Gladena McMahon
Reviewed by Sarah Birch
EDITORIAL
I write in the dark days of winter. North and east,
Norwich lies on flat land near a coast whose wind and waters come from
the great Arctic or across from white Russia through Scandinavia. At
this time of year nothing seems to grow and little seems to move, apart
from some frantic beating of empty branches as the wind catches and
batters them, and the scatterings and whirlings of fallen leaves. No
hills, few trees, wide waters in the slow rivers. This is a landscape
with which some identify passionately, but which others feel untouched
and even alienated by.
Sometimes the emptiness is indeed unbearable, and
sometimes it makes us huddle together for warmth at home; but it also
draws us into the city, where a thousand years ago the Norman invaders
made their mark on this scene by creating huge monuments to their power
and beliefs in a vast square castle keep and a beautiful tall cathedral
spire. Nothing daunted, these ‘incomers’ imposed all, and swept aside
much of what they found. Empowerment of the oppressed was not, perhaps,
their forte, but creating and enforcing a new and lasting culture was.
They knew what they wanted and they knew how to make it happen. We can
only imagine how the locals were at first cowed and beaten into
submission — and yet over the ensuing years the culture did take root,
and grow alongside the existing culture without obliterating it. The
city became rich and powerful - England’s second city for many years —
and things did grow and move. Now, although its power has declined
greatly, Norwich remains a lively mixture of many strands of historical
culture, with tiny medieval streets twisting around corners into wide
modern shopping malls, and ancient buildings shining in the endless
glare of all-night lighting.
Enough history, enough indulgence: an editorial needs to
be written, and the work of the year needs to be set to rest. The
journal has run its course again, and the range of papers over the year
has been remarkable. Especially successful was the special issue on
environment, which included some excellent papers from a wide span of
disciplines and perspectives. This was just what the journal should be:
wide-ranging but also focused; political but also intensely personal. In
the rest of the volume we have addressed some highly topical issues,
such as the involvement of service users in the planning and development
of new services, as well as staying in close touch with our roots
through the inclusion both of archive papers and of interviews with and
about historical figures in the TC movement. We have spanned many types
of TC, including those for substance misusers, for people with acute
mental illness and for children and adolescents. We have included a
number of papers on leadership and decision-making (mostly from Windsor
2002), which is especially valuable in a field where effective and
‘aware’ leadership is so central to the success of the enterprise.
The journal itself as an enterprise has also been the
subject of lively debate this year, with the odd pitched battle and
rearguard action adding to the drama. What is at stake turns out to be
not so much the future of the journal as the future direction of the ATC.
In other words, if the journal is to reflect the position. ethos and
energies of the TC movement it needs to be truly engaged with those
working in the field and thinking about it. Growth and change is
indicated, but in which direction and with what emphasis? Do we want
incremental growth which builds on existing trends, or sudden expansion
into new fields? If we are to be truly international, does that mean
identification with the North American market or with the European
traditions? This last one is a not-unfamiliar British dilemma, although,
of course, it does not really need to be a dilemma at all, since a truly
inclusive movement would readily embrace all traditions, and would be
secure enough to do so without either being swamped by them or
over-running them.
I commend the current issue to you — the papers
represent the usual mix of past, present and future, and of myth, method
and statistics. I am especially pleased that we have reinstated the Book
Reviews section, which will now be edited by Alan Worthington. This is a
bumper Winter Issue, so I hope it will warm you and inspire you, and
that the year ahead will see the journal and the ATC move into the New
Year with confidence and courage.
Adrian Ward
Editor
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