The Principle of Separate Responsibility and the Therapeutic Community

Abstract

Within a psychiatric hospital it has been attempted to realize a maximum number of the elements of the therapeutic community. Problems here are the short median stays of patients and the rapid turnover of both patients and staff. What is more, a basic problem of the therapeutic community was encountered, namely that the interests of the individual patient and of the patients as a group are considered as identical. Thus there came about the development of the principle of separate responsibility, whereby a division of responsibility is made between the individual patient and the unit. Work is carried out by multidisciplinary and largely democratized teams.

The Principle of Separate Responsibility in Clinical Psychiatric Practice

“…The idea was to promote two-way communication by dividing power between those responsible for individual patients and those responsible for the (small) group. It was described in 1974 in this journal by Silbermann et al [2] as the 'principle of separate responsibility'. They wrote: 'Towards the patients and among the staff themselves, the assumption and the philosophy used to be that interests of the individual patients and the interests of the patients-as-group are identi cal ...…”