Janine Lees on research, which certainly lives up to its' billing as an 'everything-you-need-to-know' account.
Suitable for those with an active interest in therapeutic communities, from psychiatrists to patients, nursing staff to social workers, this book is easy to read. It helped me understand some of the advantages and disadvantages of therapeutic communities, and manages to tell some difficult stories in a human way. The buoyant style, even if it at times borders on the messianic, might even manage to persuade some non-believers.
The therapeutic community movement faces two major challenges. The first, identified by John Cox in the foreword, is to take the message of therapeutic communities to those who work at the front line of psychiatry. This challenge is particularly resonant at a time when the pendulum is moving towards greater control through mechanisms like the care programme approach and supervised discharge. Unfortunately, this book, having been thrown a gauntlet, fails to respond. It sets out to put some distance between the therapeutic community movement and generic psychiatry, at times taking considerable pride in a separate identity. Although some attempts are made to muck in with the rest of psychiatry, most notably by Sarah Tucker, the proposals sound somewhat marginal and impractical.
The second challenge, identified by the Association of Therapeutic Communities (1999), is to provide good evidence of the effectiveness of the therapeutic community model, in particular to the treatment of personality disorder. It is to the credit of the book that it tackles this head on, presenting a critical account of available research, and setting a clear stall for the future in a way which might just manage to ensure a place for therapeutic communities in decades to come.