TCs 2016:Some interesting trends

For the Annual Forum of the Sicily Visiting Project5 March 2016

Rex Haigh

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

• 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

BELONGINGThe nature and quality of relationships are of primary importance

BOUNDARIESThere are expectations of behaviour and processes to maintain and review them

COMMUNICATIONIt is recognised that people communicate in different ways

DEVELOPMENTThere are opportunities to be spontaneous and try new things

INVOLVEMENTEveryone shares responsibility for the environment

SAFETYSupport is available for everyone

STRUCTUREEngagement and purposeful activity is actively encouraged

EMPOWERMENTPower and authority are open to discussion

LEADERSHIPLeadership takes responsibility for the environment being enabling

OPENNESSExternal relationships are sought and valued

Enabling Environment Standards

(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.”

• 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

• 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

Greencare – Growingwell, Cumbria

Greencare – Khiron House, Oxford

Greencare – Our project, near Slough

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

Krakadawna Organic Farm, Mysuru, India

• ‘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

LLE training base in UK – Commonwork Farm, Kent

Two UK training events in Trapani, 2004 & 2005

Regular LLE training in SicilyOctober 2013

Caltagirone

April 2015Catania

Regular LLE training in India

• Sopo, Bogota, Colombia• What we are trying to do in Slough, UK• Your work in Sicily

(4) TC ideas ‘in public’: Therapeutic Towns

• Alberto Fergusson, INDTC and AIRSAM in Matera• Residential – day –

distributed – virtual• Now ‘experts by

experience’ help with local political processes

Therapeutic Towns – SOPO, Colombia

• 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

Therapeutic Towns – in Sicily!!

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