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vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Main_ideas"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Main ideas</span> </div> </a> <ul id="toc-Main_ideas-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Effectiveness" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Effectiveness"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Effectiveness</span> </div> </a> <ul id="toc-Effectiveness-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-In_popular_culture" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#In_popular_culture"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>In popular culture</span> </div> </a> <ul id="toc-In_popular_culture-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" 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aria-label="Page tools"> <div id="vector-page-tools-pinned-container" class="vector-pinned-container"> </div> </nav> <nav class="vector-appearance-landmark" aria-label="Appearance"> <div id="vector-appearance-pinned-container" class="vector-pinned-container"> <div id="vector-appearance" class="vector-appearance vector-pinnable-element"> <div class="vector-pinnable-header vector-appearance-pinnable-header vector-pinnable-header-pinned" data-feature-name="appearance-pinned" data-pinnable-element-id="vector-appearance" data-pinned-container-id="vector-appearance-pinned-container" data-unpinned-container-id="vector-appearance-unpinned-container" > <div class="vector-pinnable-header-label">Appearance</div> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-pin-button" data-event-name="pinnable-header.vector-appearance.pin">move to sidebar</button> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-unpin-button" data-event-name="pinnable-header.vector-appearance.unpin">hide</button> </div> </div> </div> </nav> </div> </div> <div id="bodyContent" class="vector-body" aria-labelledby="firstHeading" data-mw-ve-target-container> <div class="vector-body-before-content"> <div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Group-based approach to therapy</div> <p><b>Therapeutic community</b> is a participative, group-based approach to long-term <a href="/wiki/Mental_illness" class="mw-redirect" title="Mental illness">mental illness</a>, <a href="/wiki/Personality_disorders" class="mw-redirect" title="Personality disorders">personality disorders</a> and <a href="/wiki/Drug_addiction" class="mw-redirect" title="Drug addiction">drug addiction</a>. The approach was usually residential, with the clients and therapists living together, but increasingly residential units have been superseded by day units. It is based on <a href="/wiki/Milieu_therapy" title="Milieu therapy">milieu therapy</a> principles, and includes <a href="/wiki/Group_therapy" class="mw-redirect" title="Group therapy">group psychotherapy</a> as well as practical activities. </p><p>Therapeutic communities have gained some reputation for success in rehabilitation and patient satisfaction in <a href="/wiki/UK" class="mw-redirect" title="UK">Britain</a> and abroad. In Britain, 'democratic analytic' therapeutic communities have tended to specialise in the treatment of moderate to severe personality disorders and complex emotional and interpersonal problems. The evolution of therapeutic communities in the United States has followed a different path with hierarchically arranged communities (or concept houses) specialising in the treatment of drug and <a href="/wiki/Alcohol_dependence" title="Alcohol dependence">alcohol dependence</a>.<sup id="cite_ref-:2_1-0" class="reference"><a href="#cite_note-:2-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Therapeutic_community&action=edit&section=1" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Antecedents">Antecedents</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Therapeutic_community&action=edit&section=2" title="Edit section: Antecedents"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There are several antecedents to the therapeutic community movement. One of the earliest is the change in treatment of institutionalised patients in the late 18th century, continuing throughout the 19th century.<sup id="cite_ref-:0_2-0" class="reference"><a href="#cite_note-:0-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> A major contributor to this change is <a href="/wiki/Philippe_Pinel" title="Philippe Pinel">Philippe Pinel</a>, a French physician who advocated for a more humane treatment of psychiatric patients.<sup id="cite_ref-:0_2-1" class="reference"><a href="#cite_note-:0-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> In Britain <a href="/wiki/William_Tuke" title="William Tuke">William Tuke</a> founded <a href="/wiki/The_Retreat" title="The Retreat">the Retreat</a> where patients were treated according to humanitarian principles, called <a href="/wiki/Moral_treatment" title="Moral treatment">moral treatment</a>.<sup id="cite_ref-:0_2-2" class="reference"><a href="#cite_note-:0-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> Tuke based the treatment of mentally ill people partly on the <a href="/wiki/Quakers" title="Quakers">Quaker</a> ideology. The influence of Quaker principles continues throughout the development of the therapeutic community.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p>Moral treatment focused on a more humane treatment of patients and a stimulating environment that engages them in healthy behaviour.<sup id="cite_ref-:3_4-0" class="reference"><a href="#cite_note-:3-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> An important distinction between the later therapeutic community is the strong hierarchy in moral treatment facilities. The superintendent had authority over and responsibility of the patients. The patients followed a strict schedule to promote obedience and self-control.<sup id="cite_ref-:3_4-1" class="reference"><a href="#cite_note-:3-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>After the First World War, multiple varieties of living-and-learning communities for young adults were established. Examples are the <a href="/wiki/Little_Commonwealth" title="Little Commonwealth">Little Commonwealth</a> school run by <a href="/wiki/Homer_Lane" title="Homer Lane">Homer Lane</a>, the <a href="/wiki/Q_Camp" title="Q Camp">Q camps</a> initiated by <a href="/wiki/Marjorie_Franklin_(psychoanalyst)" title="Marjorie Franklin (psychoanalyst)">Marjorie Franklin</a>, and Finchden Manor, founded by <a href="/wiki/George_Lyward" title="George Lyward">George Lyward</a>.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:0_2-3" class="reference"><a href="#cite_note-:0-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The Q camps were based on Planned Environmental Therapy, which focused on normally functioning parts of a patient's personality and use them to deal with difficult social situations.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Lyward’s work at Finchden Manor and its predecessor, provided from 1930 to 1973 what he called a ‘type of hospitality’<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> for emotionally troubled boys and young men of high intelligence.  Finchden Manor operated without rules and sanctions, but there were traditions and expectations, backed up by what Lyward called ‘stern love’.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> These projects all emphasized shared responsibility and decision-making and participation in the community.<sup id="cite_ref-:0_2-4" class="reference"><a href="#cite_note-:0-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> What influenced the establishment of these projects were, among others, the developments in psychoanalytic theory in Great-Britain.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="United_Kingdom">United Kingdom</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Therapeutic_community&action=edit&section=3" title="Edit section: United Kingdom"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The work conducted by pioneering NZ plastic surgeon <a href="/wiki/Archibald_McIndoe" title="Archibald McIndoe">Arcihibald McIndoe</a> at <a href="/wiki/Queen_Victoria_Hospital" title="Queen Victoria Hospital">Queen Victoria Hospital</a> and others at <a href="/wiki/Northfield_Hospital" class="mw-redirect" title="Northfield Hospital">Northfield Military Hospital</a> during <a href="/wiki/World_War_II" title="World War II">World War II</a> is considered by many psychiatrists to have been the first example of an intentional therapeutic community.<sup id="cite_ref-Harrison_10-0" class="reference"><a href="#cite_note-Harrison-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> But this story is prone to adopt a origin myth approach.<sup id="cite_ref-:0_2-5" class="reference"><a href="#cite_note-:0-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> The principles developed at Northfield were also developed and adapted at <a href="/wiki/Civil_Resettlement_Units" title="Civil Resettlement Units">Civil Resettlement Units</a> established at the end of the war to help returning <a href="/wiki/Prisoner_of_war" title="Prisoner of war">prisoners of war</a> to adapt back to civilian society and for civilians to adapt to having these men back amongst them.<sup id="cite_ref-Harrison_10-1" class="reference"><a href="#cite_note-Harrison-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-Thesis_11-0" class="reference"><a href="#cite_note-Thesis-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p><p>The term was coined by <a href="/wiki/Thomas_Main" title="Thomas Main">Thomas Main</a> in his 1946 paper, "The hospital as a therapeutic institution",<sup id="cite_ref-Main_12-0" class="reference"><a href="#cite_note-Main-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup> and subsequently developed by others including <a href="/w/index.php?title=Maxwell_Jones&action=edit&redlink=1" class="new" title="Maxwell Jones (page does not exist)">Maxwell Jones</a>, <a href="/wiki/R._D._Laing" title="R. D. Laing">R. D. Laing</a> at the <a href="/wiki/Philadelphia_Association" title="Philadelphia Association">Philadelphia Association</a>, <a href="/wiki/David_Cooper_(psychiatrist)" title="David Cooper (psychiatrist)">David Cooper</a> at Villa 21, and Joshua Bierer. </p><p>Under the influence of Maxwell Jones, Main, Wilmer and others (Caudill 1958; Rapoport 1960), combined with the publications of critiques of the existing mental health system (Greenblatt et al. 1957, Stanton and Schwartz 1954) and the sociopolitical influences that permeated the psychiatric world towards the end of and following the <a href="/wiki/World_War_II" title="World War II">Second World War</a>, the concept of the therapeutic community and its attenuated form – the therapeutic milieu – caught on and dominated the field of inpatient psychiatry throughout the 1960s. </p><p>The first development of therapeutic community in a large institution took place at <a href="/wiki/Claybury_Hospital" title="Claybury Hospital">Claybury Hospital</a> under the guidance of Denis Martin and John Pippard. Beginning in 1955 it involved over 2,000 patients and hundreds of staff.<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> The aim of therapeutic communities was a more democratic, user-led form of therapeutic environment, avoiding the authoritarian and demeaning practices of many psychiatric establishments of the time. The central philosophy is that clients are active participants in their own and each other's mental health treatment and that responsibility for the daily running of the community is shared among the clients and the staff. One phrase commonly used to summarise this treatment philosophy is 'the Community as Doctor'. 'TC's have sometimes eschewed or limited <a href="/wiki/Psychiatric_drug" class="mw-redirect" title="Psychiatric drug">medication</a> in favor of group-based therapies. </p><p>The Henderson Hospital first established in 1947 by <a href="/w/index.php?title=Maxwell_Jones&action=edit&redlink=1" class="new" title="Maxwell Jones (page does not exist)">Maxwell Jones</a> and named after <a href="/wiki/David_Henderson_(psychiatrist)" title="David Henderson (psychiatrist)">David Henderson</a> evolved the specific concept of Democratic Therapeutic Community (DTC). Admission to and early discharge from the one year of residential treatment was by majority vote and residents of the DTC always held the majority in these votes. No psychotropic medication or one to one therapy sessions were available and so all the work of the DTC was pursued, on the one hand, in small or larger therapy groups or work groups and community meetings, which could be called (by the residents) day or night; and on the other hand, in the unstructured time in between these more formal spaces, in which belonging in and membership of a living community could become in itself a healing experience. The Henderson Hospital DTC became an international centre of excellence for the care of survivors of severe trauma who did not fall under conventional psychiatric classifications and towards the end of the twentieth century it was funded to replicate the treatment model in two other DTCs: Main House in Birmingham and Webb House in Crewe.<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup> </p><p>The availability of the treatment on the <a href="/wiki/National_Health_Service" title="National Health Service">National Health Service</a> in the <a href="/wiki/United_Kingdom" title="United Kingdom">United Kingdom</a> came under threat because of changes in funding systems. Researchers at the <a href="/wiki/University_of_Oxford" title="University of Oxford">University of Oxford</a> and <a href="/wiki/King%27s_College_London" title="King's College London">King's College London</a> studied one of these national Democratic Therapeutic Community services over four years and found external policy 'steering' by officials eroded the community's democratic model of care, which in turn destabilised its well established approach to clinical risk management (this had been jointly developed by clients and staff).<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup> Fischer (2012), who studied this community's development at first hand, described how an 'intractable conflict' between embedded and externally imposed management models led to escalating organizational 'turbulence', producing an interorganizational crisis which led to the unit's forced closure.<sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup> The three 'Henderson' DTCs had all closed their doors by 2008. </p><p>However, development of 'mini' therapeutic communities, meeting for three or fewer days each week and supported out of hours by various forms of 'service user led informal networks of care' (for example telephone, texting and physical support), now offers a more resource and cost effective alternative to traditional inpatient therapeutic communities. The most recent exponent, the North Cumbria model, uses a dedicated out of hours website moderated by service users according to therapeutic community principles. This extends the community beyond the face to face 'therapeutic days'. The website guarantees a safe group-based response not always possible with other systems. The use of 'starter' groups as a preparation for entry into therapeutic communities has lowered attrition rates and they now represent a cost-effective model still aimed at producing durable personal and intergenerational effects; this is at odds with the current trend towards the defensive needs of service providers, rather than service users, for less intensive treatments and management of pathways to control risk.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (August 2015)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading3"><h3 id="United_States">United States</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Therapeutic_community&action=edit&section=4" title="Edit section: United States"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In the late 1960s within the US correctional system, the Asklepion Foundation initiated therapeutic communities in the <a href="/wiki/United_States_Penitentiary,_Marion" title="United States Penitentiary, Marion">Marion Federal Penitentiary</a> and other institutions that included clinical intervention based upon <a href="/wiki/Transactional_Analysis" class="mw-redirect" title="Transactional Analysis">Transactional Analysis</a>, the <a href="/wiki/Synanon" title="Synanon">Synanon</a> Game, internal <a href="/wiki/Twelve-step_program" title="Twelve-step program">twelve-step programs</a> and other therapeutic modalities. Some of these programs lasted into the mid-1980s, such as the House of Thought in the <a href="/wiki/Virginia_Department_of_Corrections" title="Virginia Department of Corrections">Virginia Correctional system</a>, and were able to demonstrate a reduction of 17% in <a href="/wiki/Recidivism" title="Recidivism">recidivism</a> in a matched-pair study of drug-abusing <a href="/wiki/Felony" title="Felony">felons</a> and <a href="/wiki/Sex_offender" title="Sex offender">sex offenders</a> who participated in the program for one year or more.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (July 2023)">citation needed</span></a></i>]</sup> </p><p>Modified therapeutic communities are currently used for substance abuse treatment in correctional facilities of several <a href="/wiki/U.S._state" title="U.S. state">U.S. states</a> including <a href="/wiki/Pennsylvania" title="Pennsylvania">Pennsylvania</a>,<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Washington_(state)" title="Washington (state)">Washington</a>,<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Colorado" title="Colorado">Colorado</a>,<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Texas" title="Texas">Texas</a>,<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup> <a href="/wiki/Delaware" title="Delaware">Delaware</a>,<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup> and <a href="/wiki/New_York_(state)" title="New York (state)">New York</a>.<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup> In <a href="/wiki/New_York_City" title="New York City">New York City</a>, a program for men is located in the <a href="/wiki/Arthur_Kill_Correctional_Facility" title="Arthur Kill Correctional Facility">Arthur Kill Correctional Facility</a> on <a href="/wiki/Staten_Island" title="Staten Island">Staten Island</a> and the women's program is part of the <a href="/wiki/Bayview_Correctional_Facility" title="Bayview Correctional Facility">Bayview Correctional Facility</a> in <a href="/wiki/Manhattan" title="Manhattan">Manhattan</a>.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Main_ideas">Main ideas</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Therapeutic_community&action=edit&section=5" title="Edit section: Main ideas"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The therapeutic community approach aims to help patients deal with social situations and to change perceptions they have about themselves.<sup id="cite_ref-:1_26-0" class="reference"><a href="#cite_note-:1-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> Difficult situations are re-enacted and experienced and patients are encouraged to examine and try to learn from them with the help of group and individual therapy.<sup id="cite_ref-:1_26-1" class="reference"><a href="#cite_note-:1-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup> The communities function as a living-and-learning situations, where every interaction can serve as a learning moment. </p><p>There is no encompassing definition of what a therapeutic community should be. Some have therefore also argued that it follows a family resemblance.<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup> A common conception of therapeutic community is a group of people living together in a non-hierarchical, democratic way that brings psychological awareness of individual as well as group processes. Furthermore, the community has clear boundaries of place, time and roles of the participants.<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup> They are democratic because the patients are involved in decision-making to encourage a sense of responsibility. This is fostered by the non-hierarchical structure that tries to minimise dependency on the staff.<sup id="cite_ref-:2_1-1" class="reference"><a href="#cite_note-:2-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p><p>A key principle is the creation of a culture of enquiry.<sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> Everyone within the community is encouraged to reflect and ask question about themselves and others.<sup id="cite_ref-:2_1-2" class="reference"><a href="#cite_note-:2-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> In this way the participants are supported by continuous feedback to create better self-awareness.<sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup> </p><p>The therapeutic community approach is informed by <a href="/wiki/Systems_theory" title="Systems theory">systems theory</a>, <a href="/wiki/Organizational_theory" title="Organizational theory">organisation theory</a> and <a href="/wiki/Psychoanalysis" title="Psychoanalysis">psychoanalytic practice</a>.<sup id="cite_ref-:2_1-3" class="reference"><a href="#cite_note-:2-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Effectiveness">Effectiveness</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Therapeutic_community&action=edit&section=6" title="Edit section: Effectiveness"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>As an intervention model for drug-using offenders with co-occurring mental health disorders, therapeutic communities may help people reduce drug use and subsequent criminal activity.<sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup> Research evidence for the effectiveness of therapeutic community treatment is substantial<sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup> and a demonstration of the cost efficacy of a year of residential therapeutic community treatment was instrumental in funding being granted in the late 1990s for the replication of the Henderson Hospital DTC.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="In_popular_culture">In popular culture</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Therapeutic_community&action=edit&section=7" title="Edit section: In popular culture"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li>The <a href="/wiki/Alfred_Hitchcock" title="Alfred Hitchcock">Alfred Hitchcock</a> film <i><a href="/wiki/Spellbound_(1945_film)" title="Spellbound (1945 film)">Spellbound</a></i> takes place within a therapeutic community called Green Manors.</li> <li><a href="/wiki/Leonard_Cohen" title="Leonard Cohen">Leonard Cohen</a> and his touring band The Army gave an impromptu concert at the Henderson Hospital DTC in August 1970, just before the Isle of Wight Festival, after being invited by one of the residents.</li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Therapeutic_community&action=edit&section=8" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-:2-1"><span class="mw-cite-backlink">^ <a href="#cite_ref-:2_1-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:2_1-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-:2_1-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-:2_1-3"><sup><i><b>d</b></i></sup></a></span> <span class="reference-text">Campling, P. (2001). <a rel="nofollow" class="external text" href="https://www.cambridge.org/core/services/aop-cambridge-core/content/view/EC7E385EA13DE71921C71311DADB9490/S135551460001004Xa.pdf/therapeutic-communities.pdf">Therapeutic communities.</a> <i>Advances in Psychiatric Treatment,</i> <i>7</i>(5), 365-372.</span> </li> <li id="cite_note-:0-2"><span class="mw-cite-backlink">^ <a href="#cite_ref-:0_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:0_2-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-:0_2-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-:0_2-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-:0_2-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-:0_2-5"><sup><i><b>f</b></i></sup></a></span> <span class="reference-text">Whiteley, S. (2004). The evolution of the therapeutic community. <i>Psychiatric Quarterly</i>, <i>75</i>(3), 233–248. <a rel="nofollow" class="external free" href="https://doi.org/10.1023/B:PSAQ.0000031794.82674.e8">https://doi.org/10.1023/B:PSAQ.0000031794.82674.e8</a></span> </li> <li id="cite_note-3"><span class="mw-cite-backlink"><b><a href="#cite_ref-3">^</a></b></span> <span class="reference-text">Boyling, E. (2011). Being Able to Learn: Researching the History of a Therapeutic Community. <i>Social History of Medicine 24</i>(1), 151–158. <a rel="nofollow" class="external free" href="https://doi.org/10.1093/shm/hkq096">https://doi.org/10.1093/shm/hkq096</a></span> </li> <li id="cite_note-:3-4"><span class="mw-cite-backlink">^ <a href="#cite_ref-:3_4-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:3_4-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text">Hollander, R. (1981). Moral treatment and the therapeutic community. <i>Psychiatric Quarterly</i>, <i>53</i>(2), 132–138. <a rel="nofollow" class="external free" href="https://doi.org/10.1007/BF01064897">https://doi.org/10.1007/BF01064897</a></span> </li> <li id="cite_note-5"><span class="mw-cite-backlink"><b><a href="#cite_ref-5">^</a></b></span> <span class="reference-text">Chapman, C. (1914). The Little Commonwealth. <i>Charity Organisation Review</i>, <i>35</i>(207), 119–124. <a rel="nofollow" class="external free" href="http://www.jstor.org/stable/43789304">http://www.jstor.org/stable/43789304</a></span> </li> <li id="cite_note-6"><span class="mw-cite-backlink"><b><a href="#cite_ref-6">^</a></b></span> <span class="reference-text">Franklin, M. E. 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London and Philadelphia: Jessica Kingsley. p. 30. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/9781843100560" title="Special:BookSources/9781843100560"><bdi>9781843100560</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Valuing+and+Educating+Young+People%3A+Stern+Love+the+Lyward+Way&rft.place=London+and+Philadelphia&rft.pages=30&rft.pub=Jessica+Kingsley&rft.date=2006&rft.isbn=9781843100560&rft.aulast=Harvey&rft.aufirst=Jeremy&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATherapeutic+community" class="Z3988"></span></span> </li> <li id="cite_note-8"><span class="mw-cite-backlink"><b><a href="#cite_ref-8">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFBurn1956" class="citation book cs1">Burn, Michael (1956). <i>Mr Lyward's Answer</i>. 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Archived from <a rel="nofollow" class="external text" href="http://www.staynout.org/staynout.php">the original</a> on August 28, 2008.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=unknown&rft.btitle=Stay%27n+Out%3A+In-prison+Treatment+Programs+for+Men+%26+Women&rft_id=http%3A%2F%2Fwww.staynout.org%2Fstaynout.php&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATherapeutic+community" class="Z3988"></span></span> </li> <li id="cite_note-:1-26"><span class="mw-cite-backlink">^ <a href="#cite_ref-:1_26-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:1_26-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text">Kennard, D. (2004). The therapeutic community as an adaptable treatment modality across different settings. <i>Psychiatric Quarterly</i>, <i>75</i>(3), 295–307. <a rel="nofollow" class="external free" href="https://doi.org/10.1023/B:PSAQ.0000031798.95075.26">https://doi.org/10.1023/B:PSAQ.0000031798.95075.26</a></span> </li> <li id="cite_note-27"><span class="mw-cite-backlink"><b><a href="#cite_ref-27">^</a></b></span> <span class="reference-text">Dunstan, F. & Birch, S. (2004). What Makes a Therapeutic Community? A Comparative Study of Ideal Values. In N. Manning, D. Menzies, & J. Lees <i>A Culture of Enquiry : Research Evidence and the Therapeutic Community</i> (pp. 175-187). Jessica Kingsley Publishers.</span> </li> <li id="cite_note-28"><span class="mw-cite-backlink"><b><a href="#cite_ref-28">^</a></b></span> <span class="reference-text">Whitwell, J. (1998). <a rel="nofollow" class="external text" href="https://www.johnwhitwell.co.uk/about-the-cotswold-community/hello-world/">What is a therapeutic community?</a> <i>Emotional and Behavioural Difficulties</i>, <i>3</i>(1), 12–19.</span> </li> <li id="cite_note-29"><span class="mw-cite-backlink"><b><a href="#cite_ref-29">^</a></b></span> <span class="reference-text">Rex, H. S. P. (2017). <i>The theory and practice of democratic therapeutic community treatment</i>. Jessica Kingsley Publishers.</span> </li> <li id="cite_note-30"><span class="mw-cite-backlink"><b><a href="#cite_ref-30">^</a></b></span> <span class="reference-text">Lees, J. (2004). <i>A culture of enquiry: researching evidence and the therapeutic community</i> (Ser. Therapeutic communities, 6). Jessica Kingsley.</span> </li> <li id="cite_note-31"><span class="mw-cite-backlink"><b><a href="#cite_ref-31">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFPerryMartyn-St_JamesBurnsHewitt2019" class="citation journal cs1">Perry, Amanda E.; Martyn-St James, Marrissa; Burns, Lucy; Hewitt, Catherine; Glanville, Julie M.; Aboaja, Anne; Thakkar, Pratish; Santosh Kumar, Keshava Murthy; Pearson, Caroline; Wright, Kath; Swami, Shilpi (2019-10-07). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6778977">"Interventions for drug-using offenders with co-occurring mental health problems"</a>. <i>The Cochrane Database of Systematic Reviews</i>. <b>10</b> (10): CD010901. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.CD010901.pub3">10.1002/14651858.CD010901.pub3</a>. <a href="/wiki/ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1469-493X">1469-493X</a>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6778977">6778977</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/31588993">31588993</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=The+Cochrane+Database+of+Systematic+Reviews&rft.atitle=Interventions+for+drug-using+offenders+with+co-occurring+mental+health+problems&rft.volume=10&rft.issue=10&rft.pages=CD010901&rft.date=2019-10-07&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6778977%23id-name%3DPMC&rft.issn=1469-493X&rft_id=info%3Apmid%2F31588993&rft_id=info%3Adoi%2F10.1002%2F14651858.CD010901.pub3&rft.aulast=Perry&rft.aufirst=Amanda+E.&rft.au=Martyn-St+James%2C+Marrissa&rft.au=Burns%2C+Lucy&rft.au=Hewitt%2C+Catherine&rft.au=Glanville%2C+Julie+M.&rft.au=Aboaja%2C+Anne&rft.au=Thakkar%2C+Pratish&rft.au=Santosh+Kumar%2C+Keshava+Murthy&rft.au=Pearson%2C+Caroline&rft.au=Wright%2C+Kath&rft.au=Swami%2C+Shilpi&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC6778977&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATherapeutic+community" class="Z3988"></span></span> </li> <li id="cite_note-32"><span class="mw-cite-backlink"><b><a href="#cite_ref-32">^</a></b></span> <span class="reference-text">Lees, J., Manning, N., Menzies, D. & Morant, N. (2004). <a rel="nofollow" class="external text" href="https://play.google.com/store/books/details/A_Culture_of_Enquiry_Research_Evidence_and_the_The?id=A2BT9jb9hxQC&gl=US">A Culture of Enquiry: Research Evidence and the Therapeutic Community</a>. London: Jessica Kingsley Publishers.</span> </li> <li id="cite_note-33"><span class="mw-cite-backlink"><b><a href="#cite_ref-33">^</a></b></span> <span class="reference-text">Dolan, B., Warren, F., Menzies, D., Norton, K. <a rel="nofollow" class="external text" href="https://www.cambridge.org/core/journals/psychiatric-bulletin/article/costoffset-following-specialist-treatment-of-severe-personality-disorders/1D36A2BC4A13E2CAA297B7359A501384">'Cost offset following specialist treatment of severe personality disorders'</a> (1996) <a href="/wiki/Psychiatric_Bulletin" class="mw-redirect" title="Psychiatric Bulletin">Psychiatric Bulletin</a> 20, 413-417.</span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Therapeutic_community&action=edit&section=9" title="Edit section: Further reading"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFManning1989" class="citation book cs1">Manning, Nick (1989). <a rel="nofollow" class="external text" href="https://books.google.com/books?id=lc4OAAAAQAAJ"><i>The therapeutic community movement: charisma and routinization</i></a>. London: Routledge. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-415-02913-1" title="Special:BookSources/978-0-415-02913-1"><bdi>978-0-415-02913-1</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=The+therapeutic+community+movement%3A+charisma+and+routinization&rft.place=London&rft.pub=Routledge&rft.date=1989&rft.isbn=978-0-415-02913-1&rft.aulast=Manning&rft.aufirst=Nick&rft_id=https%3A%2F%2Fbooks.google.com%2Fbooks%3Fid%3Dlc4OAAAAQAAJ&rfr_id=info%3Asid%2Fen.wikipedia.org%3ATherapeutic+community" class="Z3988"></span></li> <li>Hickey, Brendan (2008) <a rel="nofollow" class="external text" href="http://www.lothlorien.tc/articles.html">Lothlorien Community: A Holistic Approach to Recovery from Mental Health Problems</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Therapeutic_community&action=edit&section=10" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20061018121234/http://www.eftc-europe.com/index.htm">European Federation of Therapeutic Communities</a> (EFTC)</li> <li><a rel="nofollow" class="external text" href="http://www.wftc.org/">World Federation of Therapeutic Communities</a> (WFTC)</li> <li><a rel="nofollow" class="external text" href="http://www.therapeuticcommunities.org">The association of therapeutic communities</a></li> <li><a rel="nofollow" class="external text" href="http://www.tc-of.org.uk">Therapeutic Community Open Forum</a></li> <li><a rel="nofollow" class="external text" href="http://www.gouldfarm.org">Gould Farm Healing Community</a></li> <li><a rel="nofollow" class="external text" href="http://www.cooperriis.org">CooperRiis Healing Community</a></li> <li><a rel="nofollow" class="external text" href="http://www.artausa.org">American Residential Treatment Association</a></li> <li><a rel="nofollow" class="external text" href="http://www.fountainhouse.org">Fountain House</a></li> <li><a rel="nofollow" class="external text" href="http://iccd.org">Clubhouse International</a></li> <li><a rel="nofollow" class="external text" href="https://comunidadeterapeutica.com/">Comunidade Terapêutica</a></li> <li><a rel="nofollow" class="external text" href="http://www.lothlorien.tc/">Buddhist Therapeutic Community in South West Scotland</a></li></ul> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1129693374">.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output 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