Creating a Therapeutic Community in a Psychiatric Ward

Clark, David H.; Hooper, Derek; Oram, E. G.

doi:10.1177/001872676201500203

Cited by 19 publications

(6 citation statements)

References 8 publications

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“…He argued the need for the social structure itself to become a therapeutic instrument, emphasising the desirability of an emergent form rather than a medically dictated one. During the 1950s and 1960s, further attempts were made to develop therapeutic communities in mental hospitals both in Britain and the USA (Clark et al , 1962; Laswell and Rubenstein, 1966; Schoenberg, 1972; Wilmer, 1958; Wolff, 1964).…”

Section: The Therapeutic Communitymentioning

confidence: 99%

“…In this case the investigating committee attributed the incident to the insistent and inflexible manner in which the methods had been carried out, and to a “blind spot” exhibited by the team in question to the intensity of the unhappiness and anxiety that their methods aroused in others. Looked at in isolation the explanation appears plausible, but as Clark et al (1962) have pointed out, it is not at all uncommon for social experiments carried out within mental hospitals to fail. Either the unit is closed down completely following protests or else it flourishes while the initiator is there but founders after he leaves.…”

Section: Introductionmentioning

confidence: 99%

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Therapeutic communities in mental hospitals

Wilson¹

2012

Therapeutic Communities

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PurposeDuring the latter part of the twentieth century, mental hospitals, originally built to provide asylum from the excesses of “community care” in the 1800s, began to be perceived as themselves damaging. Therapeutic communities within traditional hospitals offered a hopeful alternative. This paper aims to provide a succinct historical critique of the developments.Design/methodology/approachNarrative and historical review.FindingsAttempts at reform met with varying degrees of success. Some communities closed down in the wake of public scandals while others were eminently successful. Organisational change presented social and psychological threats which were difficult to overcome. Leadership was an important factor in determining the outcome.Originality/valueThis paper gives an insight into the social‐psychiatric approaches and organisational theories of the time. It is published in the belief that many of the themes remain relevant today.

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Section: The Therapeutic Communitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Therapeutic communities in mental hospitals

Wilson¹

2012

Therapeutic Communities

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“…Wing and Brown (63) have reported opposite findingsthey noted a diminishment in underlying pathology secondary to environmental alterations. Clark (7,8) has pointed to the significant reductions in the length of hospitalisation that milieu therapy can produce when combined with drug and psychotherapy. However, as the sole treatment modality for Schizophrenia, milieu therapy has been shown to be the least effective of all therapies (versus drug, ECT, and psychotherapy).…”

Section: Relationship Between and Within Occupational Groupsmentioning

confidence: 99%

Prospects for Change in Public Mental Institutions

Cohen

1978

Int J Soc Psychiatry

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“…Promising results have been obtained, in particular through therapeutic interventions encompassing the patient's immediate human environment (22,23). Treatment in a therapeutic community has also been considered to have a favourable effect on the patients' functioning (24)(25)(26). Research findings concerning psychotherapy, however, have been contradictory (27,28).…”

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confidence: 99%

Psychosocial outcome in schizophrenia and psychotherapeutic orientation

Salokangas¹

1986

Acta Psychiatr Scand

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The purpose was to compare the psychosocial outcome in two groups of schizophrenic patients who were treated by different methods but were in other respects unselected, and to consider factors predictive of the outcome. The first sample, consisting of a total of 100 patients, had received hospital and outpatient care, here called traditional; only 12 of them had received sustained psychotherapy. Of the second sample, comprising 75 patients, 66 were treated in a psychotherapeutic community and 25 also received sustained psychotherapy. All patients were interviewed by the author on an average of 8 years after the first hospitalization. The patients treated in the psychotherapeutic community had remained longer under hospital care, particularly at first, and at the end of follow-up their functional capacity was lower, but they were more satisfied with the treatment received compared with the patients treated traditionally. The samples did not differ in terms of clinical status. The severity of the schizophrenic disorder, including diagnostic category, and a tendency toward grandiose thinking emerged as the most important factors predictive of psychosocial outcome. Premorbid psychosocial development and social support were also relevant to the outcome. After taking the predictor variables into account, extensive hospital care was still associated with a poor outcome. This may in part explain why, despite the greater amount of psychotherapy provided, the functional capacity of the patients who received psychotherapeutic community treatment had poorer outcome than those treated traditionally.

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Creating a Therapeutic Community in a Psychiatric Ward

Cited by 19 publications

References 8 publications

Therapeutic communities in mental hospitals

Therapeutic communities in mental hospitals

Prospects for Change in Public Mental Institutions

Psychosocial outcome in schizophrenia and psychotherapeutic orientation

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