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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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