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Volume 29 Issue 4 (winter 2008)

‘FUSION TCs’: divergent histories, converging challenges

Rex Haigh and Jan Lees

ABSTRACT: This paper explores the different historical developments in the therapeutic community (TC) world, and the resulting differences in types of therapeutic community. The authors then look at more recent developments in the two main types of therapeutic community, and argue that there are increasingly more similarities than differences, often in response to external factors and constraints. They go on to suggest that there is a new model emerging, which combines aspects of the two main types of therapeutic community: the ‘fusion TC’; and they discuss this model, and its implications for the therapeutic community field. They also suggest ways of developing and extending joint working and cooperation across all types of therapeutic communities.

A ‘keen young doctor’: Hamish Anderson

David W. Millard

ABSTRACT: No abstract included.

Taking anarchy seriously: the fourth strain of organisational, therapeutic and psychic progress

Gary Winship

ABSTRACT: Anarchy here is shown to be a ‘fourth strain’ (after bureaucracy, hierarchy and democracy) that is instrumental in psychic, group and social change. The paper considers a history of the idea of anarchy in therapeutic community practice as it interleaves with democracy, hierarchy and bureaucracy. Far from being an architect of democracy, Maxwell Jones’s democratic pedigree is problematised. Michael Foulkes’s inclination towards a‘third way’ for democratic group therapy is found to lack the political follow-through of his Frankfurt associates. Wilfred Bion emerges finally as offering the theoretical footings for a theory of anarchic practice. Bion is the arch agitator, concerned mostly with the verticalities of Establishment (the big E he calls it) and unfettered with regard to democracy; ‘see these epaulettes; Major Bion, that’s me.’ Bion’s sources reveal his struggle to explain mental processes as they were tethered to mathematical developments in chaos theory. Bion’s contribution to a psychic chaos theory is considered in this paper with a view to vitalising the future arc of our understanding of individual, group and organisational psychology.

Moving into action: the use of psychodrama in the therapeutic community

Pen FitzGerald, Peter Haworth and Vanessa Queening

ABSTRACT: This paper will illustrate how psychodrama has a philosophical affinity with therapeutic communities. It will use clinically informed material to show how psychodrama can be used in therapeutic communities to link interpersonal conflict with its origin in childhood trauma and neglect. It will show how the four principles of democratisation, permissiveness, communalism and reality confrontation that characterise therapeutic communities, as described by Rapoport in ‘Community as Doctor’, also underpin psychodrama. It will also consider the connections between psychodrama and Rex Haigh’s essential ingredients of a therapeutic community.

Neville Yeomans (1928–2000): an Australian therapeutic community pioneer

Les Spencer

ABSTRACT: This paper provides a brief biography of Neville Yeomans’s (1928–2000) adapting of his father’s research in complex natural systems to the social lifeworld. There is an outline of his pioneering of therapeutic approaches as the founding director in 1959 of Australia’s first therapeutic community, Fraser House, located at North Ryde Hospital, Sydney. Yeomans’s evolving of social epidemiology, sociotherapy, clinical sociology, and community psychiatry in Australia, as well as using social forces in large group therapy, splitting into Small Groups based upon social categories, cultural localities, work as therapy, research as therapy, and the engagement of residents in domiciliary care and suicide/crisis support is briefly described. Also outlined is his adapting of Fraser House self-help ways from the late 1960s in civil society; creating therapeutic contexts and places, evolving multicultural wellbeing arts festivals, dispersed non-residential therapeutic communities, wellbeing networks, self-help groups, and his founding of community mental health in Australia.

Ideology and belief in the 21st century therapeutic community

Huw Green

ABSTRACT: It is here argued that the therapeutic community movement has been born out of a distinct ideological tradition in the history of mental health care, and retains much of this in its many current manifestations. However, in the broader climate of modern care in the community, such concerns can be neglected. In this paper I address these ideological foundations and argue that practitioners should not lose sight of them as they are a significant part of what defines the work; indeed they can be used as a source of strength. I highlight five dimensions of personal practice and illustrate how they link to the active practice of belief in the political aspects of work in a TC.

Cultural Reviews

Walsh, B. W. (2008) Treating Self-Injury: A Practical Guide. London: Guilford. Reviewed by Simon McArdle

Palmer, S. (2008) Suicide: Strategies & Interventions for Reduction & Prevention. London: Routledge. Reviewed by Simon McArdle

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