Therapeutic Communities are for people with long-standing and complex emotional problems. These communities host groups of people, where individuals will often attend for weeks, and even months in some cases – typically attending a large house.

Most therapy is provided in small groups. Patients are taught about interacting with others, and by partaking in group activities, learn the importance of getting on with others.

When disagreements arise, the patients in the treatment are entrusted with setting rules to prohibit conflict. The patients also improve social skills by engaging in common behaviour – such as meal preparation.

Not everyone is allowed into a Therapeutic Community, with the patients already situated at the community deciding whether or not an individual can enter.

Overall, these measures can lead to a supportive environment where the wellbeing of those in the community improves.

Therapeutic communities aim to be supportive environments

The Science Behind Therapeutic Communities

Therapeutic Communities are unique locations. The idea behind Therapeutic Communities is that a safe space is provided for someone to examine their own problems – whether it be relationship problems or maladaptive coping mechanisms.

By having others around, each person is not only an active participant in their own mental health treatment, but also in others. By living together and bonding as a group, participants will commonly see their relationship and interpersonal skills improve.

A range of therapies are offered, meaning it is highly likely that a person will find a form of therapy that appeals to them.

Finally, by being an active part of a community, it helps prepare a person for general day-to-day life following the community.

How Do Therapeutic Communities Work?

Therapeutic Communities are made of up around 10-40 individuals, each of whom will typically have long-term mental health problems, including personality disorders or substance-related disorders.

Over the course of a person’s stay, a range of therapies – such as Cognitive Behavioural Therapy, Arts Therapy, Psychoanalytical Psychotherapy – will be employed to help teach healthy patterns of thought, improve wellbeing and improve friendship and interpersonal skills.

But as well as an emphasis on personal recovery, being an active participant in the community is also expected. This will typically involve in the upkeep of the community – with areas like group meetings, household chores and preparing meals. Sport and art are common recreational activities.

A person will usually attend a Therapeutic Community for 4-5 days a week, staying residentially, before returning home, and then returning again.

The length of stay for each person differs, with individual circumstances dictating this, but generally a stay of 4-12 weeks is common.

Fully committing to a Therapeutic Community is important – this includes working with others, focusing on personal recovery, and putting skills learnt into practice.

Most people leave a therapeutic community with a marked improvement in mood. This is certainly the aim.

When are Therapeutic Communities Useful?

Therapeutic Communities are most useful for a person with long-standing emotional problems. This may manifest itself in poor relationships with others, in self-harm, or any other form of harmful behaviour.

Those offered to attend a Therapeutic Community will usually have had a long history of psychological distress.

Typical conditions that people at communities commonly have include Borderline Personality Disorder, other Personality Disorders, Eating Disorders and Substance Related Disorders among others.

But any individual that has a long history of problems may derive benefit from a Therapeutic Community.

However, Therapeutic Communities aren’t suitable for everyone. People with behavioural problems will not be suitable for communities, as they are strictly governed. A community doesn’t automatically let people join, with groups making careful selections as a means of trying to avoid conflict.

How effective are Therapeutic Communities?

Therapeutic Communities appear to be effective in many cases. Most studies have focused on the effect of Therapeutic Communities within the confines of Prisons. These studies have largely proven positive [1].

Most people attending a community for mental health problems will find they improve their interpersonal skills. Research does suggest that the existence of a community, as well as the influence of others, are important areas that help bring about change [2].

As mentioned, not everyone will succeed at a community. Studies suggest that those who are impulsive and sensitive to punishment have a higher dropout rate than those without [3].

While many people will find their symptoms lessen from this condition, Therapeutic Communities are not for everyone. Everyone is unique.

How to find a therapist?

It is recommended that you contact your GP and inform them of your problems. They will refer you to the relevant mental health team.

If you are aiming to use the private sector, you could ask your GP or someone you know for a recommendation. You can also look online – the British Association for Counselling and Psychotherapy have a therapist directory on their site.

See Also

Disclaimer

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We strive to keep all of our pages updated, and ensure that our website is full of factual and in-depth information. However, we encourage you to browse this website with care.

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Helplines

If you are struggling with your mental health, help is available. With the right support and treatment, you can make a recovery. For information on helplines, or if you are in a state of crisis, please visit our crisis page by clicking on the relevant link for your geographical location (United Kingdom), (United States), (International). You can also see how to get mental health treatment and the process involved by clicking this link.

References

[1]          Bennett, J. & Shuker, R. (2017). The potential of prison-based democratic therapeutic communities. International Journal of Prisoner Health. 13 (1): p19-24.

[2]      Smith, L., Gates, S. & Foxcroft, D. (2006) Therapeutic communities for substance related disorder. Cochrane Database of Systematic Reviews 2006. 1.

[3]      Lyvers, M., Jones, V., Edwards, M., Wood, K. & Thorberg, F. (2018). Traits associated with treatment retention in a therapeutic community for substance dependence. Therapeutic Communities: The International Journal of Therapeutic Communities. 39 (3): p137-147.