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Social Psychiatry |
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Moral Treatment |
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Sanctuary Model of Organizational Change |
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Components of the Sanctuary Model |
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Social Legacy of Trauma |
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Maxwell Jones |
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Special Issue of
Psychiatric Quarterly on the
Therapeutic Community |
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In the United
Kingdom, where the democratic
therapeutic community movement
had its origins, therapeutic communities
have been growing, specializing in treating people with severe personality
problems.
The idea for the Sanctuary
Network has grown from the experience of the participants in the
Community of Communities.
Community of Communities (C of C) is a standards-based
quality improvement network which brings together Therapeutic Communities (TCs)
in the UK and internationally. Member communities are located in Health,
Education, Social Care and Prison settings. They cater for adults with a
range of complex needs. In the National Health Service, TCs predominantly
work with those diagnosed with personality disorders. During the late
1990’s, TCs recognised the need for an appropriate professional profile for
TC practice and the Association of the Therapeutic Communities (ATC)
approached the Royal College of Psychiatrists’ Research and Training Unit (CRTU)
to help develop a system of accreditation. Early discussions and
negotiations gave rise to the network which would engage TCs in service
evaluation and quality improvement, but using methods and values that
reflect TC philosophy, specifically the belief that responsibility is best
promoted through interdependence.
In the UK, therapeutic communities are
located in National Health Service facilities, prisons, and in the
educational and independent sectors. 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.
The development of the standards involved
three main processes: a review of key documents; consultation with
therapeutic community members; and editing. A annual cycle of peer review
was created to provide an ongoing quality improvement process that would
involve each participating therapeutic community in peer review of every
other community, self review, action planning, an annual conference to
present aggregated data, a review and modification of standards.
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