Volume 31, Issue 3 (autumn 2010)

MAXWELL JONES LECTURE

What Should Social Psychiatry Say to Neuroscience?

Chris Holman

ABSTRACT: No abstract.


Maxwell Jones Lecture: Response

Kath Lovell

ABSTRACT: No abstract.


WINDSOR PAPERS

Managing and Adapting to Increased Security and Audit Requirements Within a Prison-based Therapeutic Community: The Recent Experience of HMP Grendon

Michael Brookes and Patrick Mandikate

ABSTRACT: This paper describes ways in which HMP Grendon, a prison establishment in which there is a series of discrete therapeutic communities (TCs), has adapted to increased security and audit requirements. Set out are the reasons why those adjustments were important and necessary. Some were a function of revised Prison Service priorities alongside a changing management culture within the National Offender Management Service. Others were in response to specific establishment deficits or to enable the work undertaken within HMP Grendon to be better recognised and acknowledged as an effective intervention in reducing offending behaviour.
Explained will be the reaction to these developments, as accepted routines and assumptions were challenged and altered. This adaptation and change, although part of normal organisational life, especially within TCs, was met with doubt and suspicion. Fears and concerns were acted out. The introduction of a new senior management team added to these anxieties.
How these concerns were addressed, especially within the wing therapist team, is detailed. Identified are the important therapeutic principles that were maintained and developed as well as the nature of the relationship change between the old and new managers. The paper concludes with indicators of how successful these adaptations and corrections have been.


Compromise or Collaboration: How to Stay Focused on What Really Matters in a Chaotic Changing Environment

David Walker

ABSTRACT: Compromise or collaboration? Competition or cooperation? What is the difference?
How does one survive in today's public service arena, getting one's hands dirty, being pragmatic so money comes in, explaining and arguing for what we do? But perhaps more importantly how do we develop our services or the principles underlying them? When do we hold to tradition and established practice and when do we adapt and introduce novelty? In effect what do we let go of or hang on to? What are the ethical issues and moral dilemmas that face us daily in our work? What effect do these have on our staff, ourselves as leaders, and ultimately our patients?
This paper will explore the author's experience of his expanding leadership role in an attempt to protect one therapeutic community and transfer the principles into other clinical settings; in particular, the importance of relationship and understanding the real pain underlying many of our clients' difficulties. How do we develop services that stay with this pain rather than take part in the medicalisation of human suffering in a culture based on performance and deceit?
In particular, this paper will explore the professional and personal dilemmas confronted. Through taking this everyday experience seriously and drawing on complexity and group analytic theories of change and organisations, the author will explore ways to survive and develop services.


The Naked TC: Can a TC Prosper Without Finance, Buildings or Staff?

Peter R. Holmes and Susan B. Williams

ABSTRACT: Without funding, without its own building and without any paid therapeutic or medical staff, Christ Church Deal is a therapeutic community (TC) with a difference. For 12 years it has relied on its social and relational processes for the continuity of the therapeutic dynamic in the community. The authors, who were co-founders of the community, suggest that equipping members to carry personal and mutual responsibility has been a core element in the maintenance of the life of the community. They also highlight several other aspects of the TC that have contributed to its survival without the support of finance, buildings or staff.


OTHER PAPERS

An Informal Review of the Literature on Community Meetings and the Potential for their Application in a Secure Adolescent Service

Marilyn A. Sher

ABSTRACT: An informal review of the literature pertaining to Community Meetings (CMs) was undertaken. This involved defining CMs, exploring their purpose, process, structure and leadership. Therapeutic approaches and techniques relevant to CMs as well as the role of group processes were also examined. Brief reflections on the existing evaluations undertaken so far in the literature were considered. Finally, the application of such a meeting in a secure adolescent service was discussed. This discussion centres on some of the challenges secure adolescent services may face when implementing CMs, mainly due to the culture of forensic services focusing on risk management, lack of adequately trained staff and the initial expected ‘hostility’ both staff and patients perceive will occur. However, valuable contributions of CMs were evident in terms of developing social perspective-taking skills, self-awareness, use of support and empathy. This indicates the importance of implementing CMs in secure adolescent services to enhance client skills and complement the therapeutic approaches utilised with this client group.


Staff Perceptions About Stress and Staff Burnout in Drug Treatment Organisations: A Qualitative Comparative Study in Greece and the UK

Charalampos Poulopoulos and Kim Wolff

ABSTRACT: Burnout is a significant issue in drug treatment organisations and it can be linked with high turnover staff rates. However, not many studies have been carried out in this field, although burnout has received significant attention in education, health care and social welfare fields and an extensive literature has developed around the model, the theory and the process of burnout. The aim of the current study is to understand burnout in the drug treatment field. Using a focus group interview, the study tries to explore staff perceptions of burnout working in the drug treatment field in Greece and Britain in various organisations. The study reveals that there are many similarities in the way in which professionals from the two countries perceive the phenomenon. Both groups seem to agree that burnout is related with organisational function and policies. The paper concludes by suggesting organisational and personal measures in preventing burnout.


Review

C. Bollas (2009) The Evocative Object World. Published by Routledge
together with
C. Bollas (2009) The Infinite Question. Published by Routledge.
Reviewed by Simon McArdle.

 

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