Skip to main content
Log in

The Art and Challenges of Long-Term and Short-Term Democratic Therapeutic Communities

  • Published:
Psychiatric Quarterly Aims and scope Submit manuscript

Abstract

This paper, cowritten by Kingsley Norton, since 1989 Director of Henderson Hospital (a therapeutic community founded by Maxwell Jones in 1947 in the United Kingdom), and Sandra Bloom, Founder of the Sanctuary Model in the United States, compares and contrasts the practice of the democratic therapeutic community (TC) as applied to the notion of long-term care (up to twelve months), to that of the democratic therapeutic milieu (TM) as applied to short-term care (up to one month).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  1. Jones M: Social Psychiatry: A Study of Therapeutic Communities. London, Tavistock Publications, 1952.

    Google Scholar 

  2. Norton K: Inpatient psychotherapy: Integrating the other 23 hours (Comment). Current Medical Literature 8(2):31–37, 1997.

    Google Scholar 

  3. Edelson M: Sociotherapy and Psychotherapy. Chicago, University of Chicago Press, 1970.

    Google Scholar 

  4. Rapoport R: Community as Doctor. London, Tavistock Publications, 1960.

    Google Scholar 

  5. Haigh R: The Quintessence of a Therapeutic Environment—Five Essential Qualities. London, Jessica Kingsley, 1999.

    Google Scholar 

  6. Kennard D: The therapeutic community as an adaptable treatment modality across different settings. Psychiatric Quarterly 75(3), in press.

  7. Bloom SL, Bennington-Davis M, Farragher B, et al: Multiple opportunities for creating sanctuary. Psychiatric Quarterly 74(2):173–190, 2003.

    Google Scholar 

  8. Norton K: Personality disordered individuals: The Henderson Hospital model of treatment. Criminal Behaviour and Mental Health 2:180–191, 1992.

    Google Scholar 

  9. Norton K: A culture of enquiry: Its preservation or loss. International Journal of Therapeutic Communities 13(1):3–25, 1992.

    Google Scholar 

  10. Bloom SL: Creating Sanctuary: Toward the Evolution of Sane Societies. New York, Routledge, 1997.

    Google Scholar 

  11. Bloom SL: Creating Sanctuary: Healing from systematic abuses of power. Therapeutic Communities: The International Journal for Therapeutic and Supportive Organizations 21(2):67–91, 2000.

    Google Scholar 

  12. Roberts JP: Destructive processes in a therapeutic community. International Journal of Therapeutic Communities 1(3):159–170, 1980.

    Google Scholar 

  13. Bloom SL: There's an elephant in the room: The impact of trauma on individuals, institutions and societies. Psychotherapy and Politics International, in press.

  14. Main T: The hospital as a therapeutic institution. Bulletin of the Menninger Clinic 10(3):66–70, 1946.

    Google Scholar 

  15. Norton K, Dolan B: Acting out and the institutional response. Journal of Forensic Psychiatry 6(2):317–332, 1995.

    Google Scholar 

  16. Lees J, Manning N, Rawling B: A culture of enquiry: Research evidence and the therapeutic community. Psychiatric Quarterly 75(3), in press.

  17. Norton K: Joining and leaving: Processing separation, loss and re-attachment, in Therapeutic Communities: Past, Present and Future. Edited by Haigh R, Campling P. London, Jessica Kingsley, 1998.

    Google Scholar 

  18. Bloom SL: The Sanctuary Model: Developing generic inpatient programs for the treatment of psychological trauma, in Handbook of Post-Traumatic Therapy, A Practical Guide to Intervention, Treatment, and Research. Edited by Williams MB, Sommer JF, Westport, CT, Greenwood Publishing, 1994.

  19. Whitely JS: Sociotherapy and psychotherapy in the treatment of personality disorder. Discussion paper. Journal of the Royal Society of Medicine 79:721–725, 1986.

    Google Scholar 

  20. Norton K, Vince J: Outpatient psychotherapy and mentally disordered offenders, in Care of the Mentally Disordered Offender in the Community. Edited by Buchanan A. Oxford, Oxford University Press, 2002.

    Google Scholar 

  21. Main T: The ailment. British Journal of Medical Psychology 30:129–145, 1957.

    Google Scholar 

  22. Norton K, Smith S: Problems with Patients: Managing Complicated Transactions. Cambridge, Cambridge University Press, 1994.

    Google Scholar 

  23. Gabbard GO: A contemporary perspective on psychoanalytically informed hospital treatment. Hospital and Community Psychiatry 39:1291–1295, 1988.

    Google Scholar 

  24. Davies R: The inter-disciplinary network and the internal world of the offender, in Forensic Psychotherapy. Edited by Cordess C, Cox M. London, Jessica Kingsley, 1995.

    Google Scholar 

  25. Smith S, Norton K: Counselling Skills for Doctors. London, Open University Press, 1999.

    Google Scholar 

  26. Norton K: The significance and importance of the Therapeutic Community working practice. International Journal of Therapeutic Communities 11(2):67–76, 1990.

    Google Scholar 

  27. Whitely JS: The response of psychopaths to a Therapeutic Community. British Journal of Psychiatry 116:517–529, 1970.

    Google Scholar 

  28. Copas JB, O'Brien M, Roberts JC, et al: Treatment outcome in personality disorder: The effect of social, psychological and behavioural variables. Personality and Individual Differences 5:565–573, 1984.

    Google Scholar 

  29. Dolan BM, Evans C, Wilton J: Therapeutic community treatment for personality disordered adults: Changes in neurotic symptomatology on follow-up. International Journal of Social Psychiatry 38(4):243–250, 1992.

    Google Scholar 

  30. Dolan B, Warren F, Norton K: Change in borderline symptoms one year after therapeutic community treatment for severe personality disorder. British Journal of Psychiatry 171:274–279, 1997.

    Google Scholar 

  31. Dolan B, Warren F, Menzies D, et al: Cost-offset following specialist treatment of severe personality disorders. Psychiatric Bulletin 20(7):413–417, 1996.

    Google Scholar 

  32. Rivard JC, Bloom SL, Abramovitz RA, et al: Assessing the implementation and effects of a trauma-focused intervention for youths in residential treatment. Psychiatric Quarterly 74(2):137–154, 2003.

    Google Scholar 

  33. Rivard JC, McCorkle D, Duncan ME, et al: Implementing a trauma recovery framework for youths in residential treatment. Child and Adolescent Social Work, in press.

  34. Winnicott DW: The use of an object and relating through identifications, in Playing and Reality. London, Tavistock Publications, 1971.

    Google Scholar 

  35. Main TF: The concept of the therapeutic community: Variations and vicissitudes, in The Evolution of Group Analysis. Edited by Pine M. London, Routledge & Kegan Paul, 1983.

    Google Scholar 

  36. Norton K: Henderson Hospital: Greater than the sum of its sub-groups. Groupwork, in press.

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Norton, K., Bloom, S.L. The Art and Challenges of Long-Term and Short-Term Democratic Therapeutic Communities. Psychiatr Q 75, 249–261 (2004). https://doi.org/10.1023/B:PSAQ.0000031795.54790.26

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/B:PSAQ.0000031795.54790.26

Navigation