Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-23T05:24:31.407Z Has data issue: false hasContentIssue false

An evaluation of Threshold therapeutic communities in Northern Ireland

Published online by Cambridge University Press:  13 June 2014

R Kapur
Affiliation:
Threshold (NI), McBrien House
MB Weir
Affiliation:
Threshold (NI), McBrien House
C McKevitt
Affiliation:
Threshold (NI), McBrien House, 432 Antrim Road, Belfast BT15 5GB, Northern Ireland
M Devine
Affiliation:
Threshold (NI), McBrien House, 432 Antrim Road, Belfast BT15 5GB, Northern Ireland
H Maxwell
Affiliation:
Threshold (NI), McBrien House, 432 Antrim Road, Belfast BT15 5GB, Northern Ireland
C Heaney
Affiliation:
Threshold (NI), McBrien House, 432 Antrim Road, Belfast BT15 5GB, Northern Ireland

Abstract

Objective: To measure the effects of providing a therapeutic community environment for patients suffering from severe mental illness.

Method: 35 patients who remained in a therapeutic community environment for a minimum of 18 months were administered three instruments which measured psychiatric symptomatology (Brief Psychiatric Rating Scale), intrapsychic and interpersonal functioning (Therapeutic Community Questionnaire) and overall psychiatric and psychological functioning (Global Assessment Scale). Assessments were carried out at zero and 18 months.

Results: The Brief Psychiatric Rating Scale revealed significant positive changes on the two items of blunted affect and un-cooperativeness while the global assessment scale revealed that patients significantly improved after 18 months.

Conclusion: Patients who remained in a therapeutic community environment for 18 months demonstrated benefits on three particular variables. While no causative link can be proposed in this study, it does seem that this environment does improve the functioning of severely mentally ill patients.

Type
Audits
Copyright
Copyright © Cambridge University Press 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.People First – Community Care in Northern Ireland for the 1990s. London: HMSO, DHSS.Google Scholar
2.Jones, M. The therapeutic community: a new treatment method in psychiatry. New York: Basic Books, 1953.Google Scholar
3.WR, Bion. Elements of psychoanalysis. London: Heinemann, 1963.Google Scholar
4.RN, Rapoport. Community as doctor. London: Tavistock, 1960.Google Scholar
5.Main, T. Group processes in large groups (1962). In: Coleman, H, Geller, A. Group relations reader, Vol 2. London: Routledge Kegan Paul, 1976.Google Scholar
6.WR, Bion. Differentiation of the psychotic personalities from the nonpsychotic personalities (1957). In: WR, Bion. Second thoughts. London; Heinemann, 1967: 4366.Google Scholar
7.Klein, M. Notes on some schizoid mechanisms (1946). Reprinted in: Journal, Mitchell. The Selected Melanie Klein. London: Penguin, 1986: 175200.Google Scholar
8.Kapur, R. Projective processes in psychiatric settings. Melanie Klein and Object Relations 1992; 9(1): 1625.Google Scholar
9.Holmes, J. A textbook of psychotherapy in psychiatry. London: Churchill Livingstone, 1992.Google Scholar
10.AK, Rice. Learning for leadership. London: Tavistock, 1965.Google Scholar
11.Anderson, J, Dayson, D, Wills, Wet al. The TAPS Project 13. Clinical and social outcomes of long-stay psychiatric patients after one year in the community. Br J Psychiatry 1993; 162(19): 4556.CrossRefGoogle Scholar
12.MA, Ferrari, EA, Corbett, MM, Coleet al.The effects of relocation on longstay psychiatric patients. Ir J Psych Med 1994; 11(1): 510.Google Scholar
13.Bollini, P, RG, Mollica. Surviving the asylum. An overview of the studies on the Italian reform movement. J Nerv Ment Dis 1989; 177(10): 607–15.CrossRefGoogle ScholarPubMed
14.Achte, K. Outcome studies on schizophrenic patients in Helsinki. Psychopathology 1986; 19: 12.CrossRefGoogle ScholarPubMed
15.Avison, R, KN, Speechly. The discharged psychiatric patient. A review of social, social-psychological and psychiatric correlates of outcome. Am J Psychiatry 1987; 144(1): 10–8.Google Scholar
16.LR, Mosher. A therapeutic community for psychotic persons. Int J Therapeutic Communities 1991; 12(1): 5367.Google Scholar
17.Werbart, A. The future of psychotherapeutic environments: learning from experience at a Swedish therapeutic community. Psychoanal Psychotherapy 1995; 9(3): 269–87.CrossRefGoogle Scholar
18.Endicott, J, RL, Spitzer, JL, Fleiss, Cohen, J. The Global Assessment Scale – A procedure for measuring overall severity of psychiatric disturbance. Arch Gen Psychiatry 1976; 33: 766–71.CrossRefGoogle Scholar
19.Overall, JE, Gorham, DR. The Brief Psychiatric Rating Scale. Psychol Rep 1962; 10: 799812.CrossRefGoogle Scholar
20.Wagenborg, JEA, Tremenonti, GW, Hesselink, S, Koning, RF. The follow-up project of psychotherapeutic communities: design and preliminary results. Int J Therapeutic Communities 1988; 9(3): 129–52.Google Scholar
21.Donnelly, M, McGilloway, S, Mays, Net al.Opening new doors: an evaluation of community care for people discharged from psychiatric and mental handicap hospitals. Belfast: HMSO, 1994.Google Scholar
22.Casement, P. On learning from the patient. London: Tavistock, 1985.Google Scholar
23.Glass, LL, Katz, HM, Schnitzer, RD, Knapp, PH, Frank, AF, Gunderson, JE. Psychotherapy of schizophrenia: an empirical investigation of process outcome. Am J Psychiatry 1989; 146(5): 603–8.Google Scholar
24.WE, Piper, AS, Joyce, McCallurn, M, Azim, H. Concentration and correspondence of transference interpretations in the short-term. Psychotherapy 1993; 61(4): 586–95.Google Scholar
25.AE, Kazdin. Methodological issues and strategies in clinical research. Washington: American Psychological Association, 1992.Google Scholar
26.AF, Lehman. The effects of psychiatric symptoms on quality of life assessments among the chronically mentally ill. Evaluation and Program Planning 1983; 6: 143–51.Google Scholar
27.Huxley, P. Quality measurements in mental health services: a discussion paper on quality of life measurements. London: Good Practices in Mental Health (GPMH), 1986.Google Scholar