Selection of Admissions to a Therapeutic Community Using a Group Setting: Association with Degree and Type of Psychological Distress

Abstract

Henderson Hospital is a therapeutic community offering treatment for personality disordered young adults. The community operates a unique system of selection, whereby a group of residents and staff jointly decide upon offering admission to new referrals. This study is a preliminary investigation examining, in part, the basis upon which the selection group makes its decision. A measure of symptomatic psychological distress (SCL-90) was completed by 156 selection candidates. Comparison of those candidates selected with those who were rejected showed no difference between groups in number of symptoms reported nor the degree of distress attributable to those symptoms. However, analysis of symptom sub-scale scores revealed that those subjects not selected scored significantly higher on measures of somatisation, obsessive-compulsive features and phobic anxiety. It could be argued that these three symptoms are indicative of a tendency to deny or avoid feeling emotional distress. We propose that at one level, the selection group may operate by identifying those candidates who are more able to verbalise their distress, i.e. those presumed most likely to benefit from the Therapeutic Community's psychotherapeutic approach.

Personality disordered individuals: the Henderson Hospital model of treatment

“…Research into the selection process using SCL-90R (Derogatis, Lipman & Covi, 1973) has shown that those not selected (approximately one-third of candidates interviewed) tend to be more somatising, obsessive/compulsive and phobic in their symptomatology (Dolan, Morton & Wilson, 1990). It appears, therefore, that the selection group is picking, among other attributes, those who have a capacity to verbalise feelings and psychosocial difficulties and to function in a group setting.…”