Concepts for Democratic TCs

The there are usually two usual 'main types' of therapeutic community that are seen as different:

Various names	Hierarchical	Democratic
	Addiction	Mental health
	Concept or Concept House
	Behavioural	Psychotherapeutic
	Synanon-type	Maxwell Jones-type
Comes from…	New York Daytop Village in 1950s	British WW2 group experiments in 1942
Initially for…	Homeless drug addicts	Shell-shocked soldiers
Now for…	All addictions	Mental health and ‘personality disorder’
Distribution	USA and whole world. Few in UK	UK and some in Europe
Number	Many thousand	Low hundreds
Distinguishing features	‘The Concepts’ Strict rules Staffed by ex-users (usually ~50%) Stages and graduation ceremonies Always residential Initially some were punitive	Flattened Hierarchy (lately ‘fluid’) Permissiveness Mostly professional staff, plus co-creation with ‘experts by experience’ Residential, day, mini and micro Some were seen as anarchic
Sector/setting	Usually not-for-profit	Health service & hospital Prison Social care
Examples	Ley (Oxford) Coolmine (Dublin) Phoenix Futures	Henderson (closed 2008) HMP Grendon Thames Valley CNS

Coolmine has two residential TCs in Dublin, one for men and one for women - which includes their preschool children. We were there to do Community of Communities visits, the serious 3-yearly one for accreditation - and to have a think about why more addiction/concept TCs were not CofC members.

Jan - TC Specialist; Four good men from Grendon; Simon - Convenor; Rex - extra

We were received with a great mixture of high-intensity hospitality and efficiency: the welcome meetings with each of the whole communities were full on. When we each introduced ourselves, from a panel at the front, a instant loud chorus of "Thank you, Rex" (or whoever) rebounded from the assembled audience - with the precision of a military drill. This was clearly different from the soft and fluffy democratic TCs we are more used to. Several questions arose for us in our time there, so here's a quick skip through just three of them.

First Question: Why do some say that addiction/concept TCs are not 'democratic'?

...particularly as many of the procedures and goings-on were very democratic. For example, there are intricate structures for dealing with rules, and enforcing them, and changing them - all by going up through the crystal-clear hierarchy, and down again, as necessary. Well, maybe it's just that they're democratic in a different way - and, because we're dealing with addictions and powerful urges to use familiar ways of coping, the democracy must be hard-edged and have no possible loopholes or slipperiness, or shades of grey. And maybe we should stop thinking that hierarchies can't be democratic - they are completely different things, not opposites. So it's possible to be very hierarchical, and very democratic. And that's what Coolmine felt like.

Second Question: So what is it that feels so different?

Well, it's not that different a 'feel' from the prison DTCs in England - and it was useful to have a gang of four from HMP Grendon with us on the visiting team. And many of the Coolmine residents had been admitted straight from prison - over half the men, in fact. It's that old thing 'the nature of relationships' - or the 'us and them' factor that was so different. There was no balancing act that staff had to do, between being 'authentically there' and knowing the 'fluid hierarchy' underpinned it. It was quite easy and obvious to tell the difference between the way the staff conducted themselves and the way the residents did: and also between different seniorities of residents. Clear roles. BUT... it also felt a long way from that emancipatory sense that the service user / expert by experience movement generates, as in the English 'relational practice' movement. It almost certainly helps people to stop doing addictive stuff - but it doesn't necessarily make them fundamentally different inside. It's behavioural, not 'analytic' (for want of a better word). And maybe that his implications for the hybrid model we're trying to do in Slough...

Third question: Are these addiction TCs the only ones who have 'concepts'?

Indeed not: 'democratic' TCs could easily come up with a list of concepts that describe what they do. Indeed it might be a good way to summarise just what they do, and what they do differently. Here's a starter:

• Culture of enquiry / openness
• Fluid hierarchy
• No 'us and them'
• Co-creation
• Reality confrontation
• Emotional permisiveness
• Boundaries
• Belonging
• Safety and containment
• Inclusion and involvement
• Therapeutic ordinariness
• Creative chaos
• Here and now
• Relational practice
• Everything here is part of the therapy
• Tolerating uncertainty

We too could have pithy quotes about them, framed, and up on the walls - as our key 'concepts'.
Or could we? Maybe not... 

There's a paper in that, one day.