ABSTRACT
This chapter describes the therapeutic community we developed and the ways our ideas are linked to the concepts of role security and therapeutic commitment. Though the basic beliefs on which the community was founded existed prior to its opening, the form in which they are presently described only emerged from the day-to-day experience of developing and conducting the therapeutic programme. The view of the unit presented in this document seems to represent the consensus of staff opinion about the way they work, though the presentation of the ethos below represents my latest understanding of these ideas. The original Maudsley Alcohol Pilot Project (MAPP) work had left the concept of therapeutic commitment somewhat unbalanced, stressing that an attitude of optimism, self-worth and confidence presented to the patient by a therapist, working within a clear role structure, who could draw on others for help, was a critical therapeutic element. Detoxification, if required, is normally conducted while the patient attends daily.
