Introduction

Two of the best-known pioneers of therapeutic communities, Tom Main and Maxwell Jones, defined them as follows.

An attempt to use a hospital not as an organization run by doctors in the interests of their own greater technical efficiency, but as a community with the immediate aim of full participation of all its members in its daily life and the eventual aim of the resocialization of the neurotic individual for life in ordinary society. (l)

What distinguishes a therapeutic community from other comparable treatment centres is the way in which the institution's total resources, staff, patients, and their relatives, are self-consciously pooled in furthering treatment. That implies, above all, a change in the usual status of patients. (2)

Today therapeutic communities can be defined by a number of common features, but a word of warning is in order. The term has been adopted by two distinct sets of practitioners, one working in the fields of adult and adolescent mental health, and the other in the field of drug addiction. The latter are often known as concept-based therapeutic communities. The two models have similar goals, but their methods differ. This chapter deals mainly with therapeutic communities in mental health, but reference will also be made to concept-based therapeutic communities which are internationally more widespread. It is worth noting that members of a therapeutic community are not often referred to as 'patients', but are usually known as residents, clients, or members.

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