Descrizione dei principi della comunità terapeutica democratica e degli ambienti abilitanti in salute mentale di Rex Haigh

1. TCs 2016:
Some interesting trends
For the Annual Forum of the Sicily Visiting Project
5 March 2016
Rex Haigh

2. Four ideas
• TC ideas used in other settings:
the ENABLING ENVIRONMENTS project
• Using the natural world as part of therapy in TC:
GREENCARE in UK and India
• Training in ‘the essence’ of TC experience for staff
INTERNATIONAL NETWORK OF LIVING-LEARNING
EXPERIENCES
• Using TC ideas ‘in public’
WHOLE TOWN THERAPEUTIC ENVIRONMENTS

3. • Core features derived from Royal College of
Psychiatrists ‘Community of Communities’ quality
network [ www.communityofcommunities.org.uk ]
• Distilled into 10 core values
• Set as standards for ‘Enabling Environments’ award
[ www.enablingenvironments.com ]
• Can be applied in diverse settings
• Currently expanding successfully in UK prisons and
homelessness services
• Key concept is ‘the quality of relationships’ in a unit
(1) Enabling Environments

4. BELONGING
The nature and quality of relationships are of
primary importance
BOUNDARIES
There are expectations of behaviour and
processes to maintain and review them
COMMUNICATION
It is recognised that people communicate in
different ways
DEVELOPMENT
There are opportunities to be spontaneous
and try new things
INVOLVEMENT
Everyone shares responsibility for the
environment
SAFETY
Support is available for everyone
STRUCTURE
Engagement and purposeful activity
is actively encouraged
EMPOWERMENT
Power and authority are open to
discussion
LEADERSHIP
Leadership takes responsibility for
the environment being enabling
OPENNESS
External relationships are sought
and valued
Enabling Environment Standards

5. (2) Greencare
• Using any aspect of the natural world as the major part
of a TC programme
• Can include food production, cooking and eating – or to
sale and make money
• Also therapeutic to be working with animals, ecological
systems, permaculture, environmental restoration, etc
• 2014 award winners: Growing Better Lives.
• “Greencare is a holistic and economically viable
alternative to treatment with medication and
hospitalisation. Sustainability is about connecting
people to each other and to nature, helping people to
see that there is a life worth living, and on a planet that
is worth living on.”

6. • cooperation by scientists
brought together under
the COST 2011 (European
Cooperation in Science
and Technology)
programme.
• describes & defines green
care; sets it within the
context of theoretical and
practical frameworks
(including those of
psychology,
psychotherapy, health
promotion, social inclusion
and others).
Greencare – EU COST 866

7. • An ideal therapeutic space
• Circular – everybody is
equal
• No corners to hide
• ‘A magical place’
Greencare - yurts
• Growingwell,
Cumbria
• Khiron House,
Oxford
• The Retreat,
York
• Growing Better
Lives, Slough

8. Greencare – Growingwell, Cumbria

9. Greencare – Khiron House, Oxford

10. Greencare – Our project, near Slough

11. Also – formal qualitative research…
“This is the best
therapeutic
experience of the
week”
“working together on
cooperative projects…
break down barriers…
a calming & peaceful
space”
“I used to think that this greencare
was a heap of shit, but I went home
and realised I felt a lot better”
Greencare – what people say about it

12. Krakadawna Organic Farm, Mysuru, India

13. • ‘Living-Learning Experience’ – 3-day intensive residential group
workshops
• Based on the programme from UK Democratic TCs
• The experiential component of formal training for TC staff (all grades
and seniority and professions – all together)
• To accompany theoretical instruction and supervised clinical practice
• To give staff the opportunity of feeling ‘what it is like to be in a TC
myself’
• With published qualitative and outcome research
• Started in 1980s, current format in 1995
• Now regularly in UK, India and Sicily
• Also have been in other part of Italy, and Australia. Portugal in
October.
• Other possibilities from INDTC.
• International Network of LLEs started 2015 – www.inlle.org
• To share expertise across different countries and ensure standards
(3) Living-Learning Experiences

14. LLE training base in UK – Commonwork Farm, Kent

15. Two UK training events in Trapani, 2004 & 2005

16. Regular LLE training in Sicily
October 2013
Caltagirone
April 2015
Catania

17. Regular LLE training in India

18. • Sopo, Bogota, Colombia
• What we are trying to do in Slough, UK
• Your work in Sicily
(4) TC ideas ‘in public’: Therapeutic Towns

19. • Alberto Fergusson,
INDTC and AIRSAM
in Matera
• Residential – day –
distributed – virtual
• Now ‘experts by
experience’ help
with local political
processes
Therapeutic Towns – SOPO, Colombia

20. • Embrace 2½ hour per week = TC
‘hub’
• Joined with many other activities
eg psychotherapy and
psychoeducation groups, family
groups, art, sports, singing for
health, greencare, public library
events etc – across the town
• New ‘recovery college’ being run
as a TC: co-production, peer
mentoring
• Intend to include other areas of
civic life
Therapeutic Towns – SLOUGH, UK

21. Therapeutic Towns – in Sicily!!

22. In conclusion…
• Therapeutic communities will need to look
different to survive and thrive in the modern world
• But they contain a very powerful idea that is hard
to put into words but has wider application
• And that is what we are all trying to do!
Thank you!
Grazie