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Therapeutic community

Therapeutic community

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Therapeutic community

  1. 1. -Mr. ANEEZ. K Ist year M.Sc. Nursing EMCH CON
  2. 2. The concept of therapeutic community was first developed by Maxwell in1953. He wrote a book entitled “ social psychiatry” which was first published in England. Later on when it was published in the United states, its title was changed to “Therapeutic Community.”
  3. 3. Small cohesive communities where patients have a significant involvement in decision-making and the practicalities of running the unit.
  4. 4. Collective responsibility Citizenship Empowerment Encourages personal responsibility Avoids unhelpful dependency on professionals
  5. 5.  To use patient’s social environment to provide a therapeutic experience for him. To enable the patient to be an active participant in his own care and become involved in daily activities of his community.
  6. 6. To help patients to solve problems plan activities and to develop the necessary rules and regulations for the community To increase their independence and gain control over many of their own personal activities.
  7. 7. To enable the patients to become aware of how their behavior affects others.
  8. 8. Dependence syndrome Depressive disorders Neurosis Somatoform disorder Personality disorder
  9. 9.  Self harming nature Drug abuse Violent patients Schizophrenia Enduring mental illness
  10. 10. Size of the unit Duration of treatment Relationship with the parents, organizations and wider community
  11. 11.  Free communication  Shared responsibilities  Active participation  Involvement in decision making  Understanding of roles, responsibilities, limitations and authorities
  12. 12. 1. Daily Community meetings  composed of 60-90 patients.  All levels of unit staff are involved  including administrative personnel  acute patients are not involved in the meetings.  Discussion should focus mainly on day to day life in the unit.
  13. 13. 1. Daily Community meetings  During discussions patient’s feelings and behaviors are examined by other members.  Frank discussions are encouraged  much outpouring of emotions and anger.
  14. 14. 2. Patient Government or Ward council  to deal with practical unit details  A group of 5-6 patients will have specific responsibilities , such as  house keeping  physical exercise  personal hygiene  meal distribution  a group to observe suicidal patients
  15. 15. 2. Patient Government or Ward council  staff members should be available always.  All decisions should be feedback to the community through the community meetings.
  16. 16. 3. Staff Meetings or Review  A staff meetings should be held following each community meetings  patients are excluded and only staff are present  In this meeting the staff would examine their own responses, expectations and prejudices.
  17. 17. 4. Living and learning Opportunities  provided within the social milieu  provide realistic learning experiences for the patients.
  18. 18. Psychiatrist Psychiatric nurse Clinical psychologist Psychiatric social function
  19. 19. Occupational therapist Recreational therapist Art therapist Music therapist Dietician
  20. 20. Psychiatric nurse  Authoritarian role Social role  Therapeutic role Psychiatrist  Leader  Diagnose and treatment
  21. 21. Clinical psychologist  Assist to diagnose by psychological test Psychiatric social worker  Concerned with client need  Fulfil family and community requirement Assist in conduction of therapeutic skill
  22. 22. Recreational therapist  Encourage to express their feeling Occupational therapist  Develop independent skill  Assist to productive  Creative activities and skills are developed
  23. 23.  Patient develop harmonious relationships with other members in the community.  Gains self confidence  Develops Leadership skills.  Learns to understand and solve problems of self and others.  Becomes Socio- Centric.
  24. 24.  Learns to live and think collectively with the members of the community  provides opportunities to participate in the formulation of hospital rules and regulations that affect patient’s personal liberties like bedtime , meal time, weekend permission, control of radio or T.V, Social activities, late night privileges, etc.
  25. 25.  Role blurring between staff and patients  Group responsibility can easily become nobody’s responsibility.  Individual needs and concerns may not be met.  Patient may find the transition to community difficult.
  26. 26. Identify the difference between therapeutic community and milieu therapy in detail and submit it on 21.8.2015 before 4 pm. Total mark is 20
  27. 27. Townsend M C. Psychiatric Mental Health Nursing-concepts of care. (3 rd edition). F.H Davis Publishers; Philadelphia: 2000. Pg.No. 158-160. Kapoor B. Text book of psychiatric nursing. Publishers of medical and nursing books; Delhi: 2006.Pg.No. 12-57.
  28. 28. Sreevani R.A guide to mental health and psychiatric nursing. Jaypee Brothers Medical Publishers; New Delhi: (2006). Pg.No. 148-149. Stuart gail.w. principles & practices of Psychiatric Nursing. (9th edition). Elsevier publishers: 2011. Pg. No. 115-120. www.austinecc.edu/richb/thercom. html http//nursing.planet.com/pn/thera peutic-communication.html
  29. 29. ANY DOUBT

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Therapeutic community

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