The concept of “sanctuary” refers to the important emphasis we place on the active and conscious development of a sense of safety within the context of a therapeutic milieu [1]. In other organizational settings it has been referred to as the creation of a “safety culture” defined as “the product of individual and group values, attitudes, perceptions, competencies, and the patters of behaviors that determine the commitments to and the style and proficiency of, an organization’s health and safety management…. characterized by communications founded on mutual trust, by shared perceptions of the importance of safety and by the confidence in the efficacy or preventative measures”(p.1124) [2].
Safety, however, is not a particularly easy subject to define. Haigh has described this fundamental necessary attribute of any therapeutic environment as “containment”, and in doing so focuses on the bimodal aspect of true safety: the “maternal” sense of support, tolerance of distress, and connection along with the “paternal” sense of limits, discipline and rules [3]. We found that to adequately talk about safety in the community context, we had to understand four levels of safety simultaneously and dynamically: physical safety, psychological safety, social safety, and moral safety. For any of us thrive and grow we must feel safe. For people who have been the victims of violence and abuse this is all the more important. We know that people who have been injured by violence are keenly attuned to any and all threats in the environment. Although it is always possible they will react to perceived threats, we want to ensure real threats do not exist.
By making a commitment to nonviolence we commit to eliminating all threats to safety including physical, aggression, demeaning language, threatening glares, apathy, avoidance and any other behavior that permits people to impose their will on each other and abase power. If staff do not feel safe they cannot help clients feel safe and if clients do not feel safe they cannot do the difficult work necessary to change.
WHAT DO WE MEAN BY PHYSICAL SAFETY?
WHAT DO WE MEAN BY PSYCHOLOGICAL SAFETY
WHAT DO WE MEAN BY SOCIAL SAFETY?
WHAT DO WE MEAN BY MORAL SAFETY?
SAFETY is taking care of your body and your Self: Physically, Psychologically, Socially, and Morally
- Physical Safety: Being safe in your body and safe in the world
- Psychological Safety: Being safe with yourself
- Social Safety: Being safe with other people
- Moral Safety: Being safe with a guiding value system
SAFETY is about setting appropriate BOUNDARIES
- Saying YES only when you mean it
- Saying NO (and sticking to it) when you mean it
- Knowing the UH-OH or warning signals of “danger ahead”
- Knowing and experiencing the OUCH of having your boundaries violated or violating the boundaries of someone else
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References
- Bloom, S.L., Creating Sanctuary: Toward the Evolution of Sane Societies. 1997, New York: Routledge.
- Cox, S., B. Jones, and D. Collinson, Trust relations in high-reliability organizations. Risk Analysis, 2006. 26(5): p. 1123-1138.
- Haigh, R., The quintessence of a therapeutic environment: Five universal qualities, in Therapeutic Communities: Past, Present and Future, P. Campling and R. Haigh, Editors. 1999, Jessica Kingsley Publishers: London:. p. 246-257.
- Whitwell, J., Management issues in milieu therapy: Boundaries and parameters. herapeutic Communities: The International Journal for Therapeutic and Supportive Organizations, 1998. 19(2): p. 89-105.
- Campling, P. and R. Haigh, eds. Therapeutic Communities: Past, Present and Future. 1999, Jessica Kingsley: London.
- Austin, W., V. Bergum, and L. Goldberg, Unable to answer the call of our patients: mental health nurses' experience of moral distress. Nursing Inquiry (NURS INQUIRY), 2003 Sep; 10 (3): 177-83 (23 ref).
- Janoff-Bulman, R., Shattered assumptions: Towards a new psychology of trauma. 1992, New York: Free Press.
- Bloom, S.L., Neither liberty nor safety: The impact of trauma on individuals, institutions, and societies. Part III. Psychotherapy and Politics International, 2005. 3(2): p. 96-111.
- Bloom, S. and M. Reichert, Bearing Witness : Violence and Collective Responsibility. 1998, Binghamton NY: Haworth Press.
- Bloom, S.L., Neither liberty nor safety: The impact of trauma on individuals, institutions, and societies. Part IV. Psychotherapy and Politics International,2006 4(1): 4-23.
- Bloom, S.L., Neither Liberty Nor Safety: The Impact Of Fear On Individuals, Institutions, And Societies, Part I. Psychotherapy and Politics International, 2004. 2(2): p. 78-98.
- Bloom, S.L., Neither Liberty Nor Safety: The Impact Of Fear On Individuals, Institutions, And Societies, Part I I. Psychotherapy and Politics International, 2004. 2(3): p. 212-228.