ABSTRACT
This chapter explains the history of therapeutic communities, with particular reference to the care and treatment of people suffering from psychosis. It distinguishes between three types of therapeutic community: psychiatric admission wards using a therapeutic community approach; settings providing 'alternative' asylum, including the Soteria model, to support people in an acute psychotic phase; and therapeutic communities supporting the rehabilitation/recovery for people with long-term psychosis. The 'therapeutic community approach' was the term used by David Clark to distinguish it from the 'therapeutic community proper' which followed the principles developed at Henderson Hospital for small specialised units for selected residents. The therapeutic community can be seen as a modality, a framework, rather than one theoretical model. As a framework, the therapeutic community offers unique opportunities for therapeutic learning, for both staff and patients, as literally everything that happens is open to examination. The chapter describes the different types and uses of groups with some clinical illustrations.
