The therapeutic community movement has been in decline since its heyday after the Second World War. The timing of this book may well be prescient: is a revival of the therapeutic movement taking place? There are a number of books on various aspects of therapeutic communities. This book does not set out to emulate these, but to paint a picture of the diversity and colour within the movement. It is a multi-author book, several of the contributors having written their own authoritative works. It embraces the roots of the therapeutic community movement and goes on to span present practice and possible future development. It is easy to read and there is considerable factual content, not only of the historical development of the therapeutic community movement but the basic concepts of therapeutic communities, their psychoanalytic roots and their application — including the application of group analytic approaches and understanding. Contributors from current therapeutic communities address various clinical issues that arise in the management of their patients who, by and large, have severe personality disorders. These issues include containment, the significance of management of boundaries, the process of attachment and separation, and the management of the conflict between encouraging personal responsibility and the inherent paternalism in the Care Programme Approach.

Chapters describe the application of therapeutic community approaches to various settings, including that of the prison service. The final section of the book responds to contemporary challenges of survival in the market, research and evidence, and issues regarding training in an approach that is fundamentally multidisciplinary. The book is written with passion and conviction and conveys the creative experimentation and radicalism that has characterised the movement. It is salutary to note how few therapeutic communities now exist within the National Health Service.

The content of this book, its tone, the energy that is conveyed and the commitment of the multi-disciplinary teams contrast vividly with what, by many, is seen as the creeping increase in social control and bureaucratisation of the present time. The style and presentation, with an emphasis on the art of therapeutic practice, is a challenge to the current dominance of the scientific clinical approach with the apparent idealisation of a logic, which would appear to be applied even in such complex and challenging cases as the management of severe personality disorders. I recommend this book to all aspiring and practising colleagues, if only to remind themselves of times when the practice of psychiatry could more comfortably embrace notions such as creativity and play, and to consider whether the time has come for their renaissance.