SWIMMING AGAINST THE TIDE - A REVIEW OF THE THERAPEUTIC-COMMUNITY

Objective: The therapeutic community is an established psychiatric tre atment method which may be in decline. This paper reviews the nature o f inpatient therapeutic community treatment, and re-evaluates its role . Method: The principles and practice of such treatment are summarised , with a focus on the functions of staff. Results: The inpatient thera peutic community is conceptualised as combining socio-therapeutic trea tment, psychotherapeutic treatment, and the advantages of the inpatien t setting. This unique treatment environment allows for therapeutic re gression while mitigating against anti-therapeutic behavioural regress ion. Research evidence supports the efficacy of therapeutic community treatment for patients with borderline personality disorder. Conclusio n: Further research is needed to assess its efficacy for other diagnos tic groups. This intensive treatment approach may be most appropriate for patients who have proved treatment resistant by other means. Possi ble reasons for the marginalization of therapeutic community treatment are considered. Access to quality inpatient therapeutic community tre atment is essential in the provision of a comprehensive psychiatric se rvice.