Psychiatric Quarterly [psaq] ph259-psaq-482367 June 3, 2004 10:30 Style ﬁle version June 4th, 2002
Psychiatric Quarterly, Vol. 75, No. 3, Fall 2004 (
THE THERAPEUTIC COMMUNITY AS AN
ADAPTABLE TREATMENT MODALITY
ACROSS DIFFERENT SETTINGS
Simple core statements of the therapeutic community as a treatment modal-
ity are given, including a “living-learning situation” and “culture of enquiry.”
Applications are described in work with children and adolescents, chronic and
acute psychoses, offenders, and learning disabilities. In each area the evolu-
tion of different therapeutic community models is outlined. In work with young
people the work of Homer Lane and David Wills is highlighted. For long term
psychosis services, the early inﬂuence of “moral treatment” is linked to the
revitalisation of asylums and the creation of community based facilities; acute
psychosis services have been have been run as therapeutic communities in both
hospital wards and as alternatives to hospitalisation. Applications in prison are
illustrated through an account of Grendon prison. The paper also outlines the
geographical spread of therapeutic communities across many countries.
KEY WORDS: therapeutic communities; children; psychosis; prison; learning disability.
The author is Head of Psychological Services, The Retreat, York, England. Address
correspondence to David Kennard, The Retreat, York, YO10 5BN, United Kingdom;
2004 Human Sciences Press, Inc.