Community of
Communities
SERVICE STANDARDS
for Therapeutic
Communities
Foreword
Development of the standards
The Standards
1. Environment and Facilities
2. Staff Resources
3. Access, Admission and Discharge
4. Care, Treatment and the Therapeutic Environment
5. Information, Consent and Confidentiality
6. Rights, Safeguards, Boundaries and Containment
7. Organisation, Policy and Procedures
8. External Relations
Appendix A: Acknowledgements
Appendix B: Feedback form
Appendix C: Order form
First Edition, March 2002. Edited by Adrian Worrall, Number CRU021.
Foreword
An important part of the work in therapeutic communities has always been to examine
and reflect upon what happens within them. In a world that increasingly expects
openness and accountability, these communities now need to prepare for this scrutiny,
and look outwards as well as inwards. Lone communities need to join a community of
communities, so that they can share their experiences and demonstrate the worth of
what they do.
This process is familiar to those of us who work in the field. In healthy communities, we
value each individual and their contribution; in this project, we will value each community
and what they will bring to us all. As in a community, we will expect change from our
members – change that makes us healthier and more creative, and that comes about
from getting to know each other and working closely together.
The publication of these standards is the first stage of the process. They cover generic
aspects of the services provided by therapeutic communities in England, Wales,
Scotland and Northern Ireland – in the NHS, prison, education and independent sectors.
This version builds on previous work including the Charterhouse Group Standards, the
Kennard and Lees Audit Checklists (KLAC and KLAC II), Clinical Governance Standards
for Mental Health and Learning Disability Services, developed at the College Research
Unit, and other policy documents and guidelines. Specific standards that apply to the
various specialty areas will be developed in the next revision.
Above all, this project aims to support staff and members of the communities and help
them become more confident and effective in their work. We hope it will also help
communities to be increasingly reflective in their practice, share their ideas, and develop
new and better ways of functioning. It will also show others outside the field what
happens in therapeutic communities and the compassionate, humane and intense
participation demanded of the members and staff.
Rex Haigh, Chair, Association of Therapeutic Communities
David Kennard, Consultant Clinical Psychologist, The Retreat, York
Jan Lees, Research Associate, Francis Dixon Lodge, Leicester & Nottingham University
Mark Morris, Director of Therapy, HMP Grendon
i
The Development of the Standards
Background
The Community of Communities is a quality network established by the Association of
Therapeutic Communities (ATC) and the Royal College of Psychiatrists’ Research Unit
(CRU) with support from the Community Fund. It manages a network of standardsbased reviews to help community members develop their service.
The standards are the basis for self-reviews and external peer-reviews. The aim of the
reviews is to gradually improve the quality of services using the principles of the clinical
audit cycle. Most standards represent ideal practice and so no service is expected to
meet every standard. Each year, after standards are agreed, data are collected using
self-review and external peer-review. The results are fed-back in local and national
reports and action taken to address any needs identified. The annual cycle is described
in the figure below.
The annual cycle
Annual conference and
presentation of aggregated
data
Agree standards
Action planning
Self-review
Local report compiled
External peer-review
Methods
The development of the standards involved three main processes: a review of key
documents; consultation with therapeutic community members; and editing. We used
information from members, including client members, to supplement the standards
derived from the literature review. This ensured that the standards were up-to-date and
took account of the views of staff and client members.
i. Review of key documents
Information from a review of key documents was used to revise the KLAC II. These
included standards and information from the Quality Network for In-patient CAMHS
(QNIC); the Charterhouse Group; the Clinical Governance Support Service (CGSS); the
Health Advisory Service (HAS); and the Commission for Health Improvement (CHI).
ii
General statements are classified as standards, and more specific statements as criteria
within these. Each standard has typically four or five criterion statements. In this
document standards are in bold text and relevant criteria are given in plain text below
these.
ii. Consultation
Therapeutic community members were asked to rate each standard as “very important”,
“important” or “not important” to the quality of the service provided. They were also
asked to suggest new standards. More general feedback was also obtained during an
induction event attended by over 70 delegates representing 38 therapeutic communities
across the country. The standards were discussed and piloted in small groups covering
each of the main section headings.
iii. Editing
Low rated standards were removed. Other editing criteria include ease of measurement;
achievability, (e.g. how achievable are statements); and local adaptability (e.g. how
adaptable statements are to variations in local practice). These revised standards will be
adapted into data collection tools or workbooks for use on self- and external peerreviews.
Important note
Therapeutic communities are organised and provided in many different ways and this
diversity is itself a valuable source of innovation. These standards attempt to be generic
but may not apply well to all services. We have classified the standards to describe
various topics within the service provided, but they could be equally classified in other
appropriate ways. Criteria are not comprehensive, but are generally given as examples
of good practice relating to the standard.
Standards are statements of best practice and, as such, no service would be expected
to meet every one. There are some statements that are based upon legal requirements.
This document, however, is not intended to act as a legal guide in any way, nor is it
intended to be a guide to a CHI review or to represent any methods CHI are using.
If you have any questions about these standards, or would like an electronic copy,
please contact Sarah Tucker at the Royal College of Psychiatrists’ Research Unit on
telephone: 020 7227 0830.
iii
1. Environment and Facilities
1 The therapeutic community is well designed and has the necessary facilities and
resources
1.1 The therapeutic community is clean and comfortable and has a welcoming atmosphere
1.2 There is space indoors and outdoors for recreation
1.3 There is a designated dining area
1.4 The therapeutic community contains large and small rooms for individual and group
sessions
1.5 Creative and play material is provided for recreational and therapeutic use
1.6 All confidential case material, e.g. notes, is kept in locked cabinets or locked offices
1.7 Where medication is used, it is kept in a secure place with due regard to safety
1.8 There is sufficient space for educational activities, e.g. a classroom or reading room
1.9 There is a room large enough for therapeutic community meetings, where everyone can
see each other
1.10 There are adequate facilities for preparing and cooking shared therapeutic community
meals
1.11 There are facilities for creative and action therapies
2 The privacy and dignity of client members is respected
2.1 In residential settings, all client members have the option of having a single bedroom
2.2 In residential settings, all client members may sleep, bathe and wash in privacy
2.3 There are suitably located quiet room(s) available
2.4 There are private rooms for meeting relatives and friends
2.5 Client members have access to a telephone in a private area
3 There is equipment and there are procedures for dealing with emergencies in the
therapeutic community
3.1 There is a procedure for evacuation in case of fire which is rehearsed at regular intervals
3.2 There is a crisis system in place, e.g. there is a way for members to meet at short notice
when there has been a serious incident
1
2. Staff Resources
4 The number of staff in the therapeutic community is sufficient to safely meet the
needs of the client members at all times
4.1 During normal social activity there is at least one member of staff on duty and others
available if needed
4.2 When active therapeutic programmes are offered there is at least one member of staff in
all activities and another available when necessary
4.3 At night-time in a typical residential therapeutic community there are two staff available
on site
4.4 There is sufficient flexibility in staffing numbers to accommodate the therapeutic
community's changing needs, e.g. the community has access to extra support staff
4.5 There is at least one qualified mental health practitioner on duty during the main daily
therapeutic programme
5 The therapeutic community comprises a core multi-professional team
5.1 Social work, psychiatric and psychological input is provided by qualified professionals in
a typical therapeutic community.
5.2 The therapeutic community has access to a range of practitioners offering
psychotherapeutic sessions, e.g. group analysis, TA, psychodrama and art therapy
6 Therapeutic community staff work effectively as a multi-disciplinary team
6.1 There is a line management structure with clear lines of accountability for all staff
6.2 Staff have authority and show leadership, or share this with the therapeutic community,
in response to the changing needs of the therapeutic community
6.3 There are regular multi-disciplinary team meetings for i. client member matters and ii.
policy and administration, e.g. the team is consulted on relevant management decisions
such as developing and reviewing operational policy
6.4 Good staff morale is recognised as important and efforts to improve morale are made
when necessary, e.g. the levels of vacancies and sick leave are monitored and
investigated
6.5 There is a forum where staff are able to discuss their relationships with client members
and explore these in an open and sensitive way
6.6 All staff are clear regarding their roles in the therapeutic programme, e.g. this is defined
in the therapeutic community's policies and procedures and in job descriptions
6.7 There are regular meetings to examine how the therapeutic community is dealing with
events
6.8 There is a daily handover process
2
6.9 Staff demonstrate personal values compatible with therapeutic community principles and
practice
7 There is a budget for training relating to therapeutic community work
8 The training needs of therapeutic community staff have been formally assessed
8.1 The training needs of the therapeutic community are assessed in relation to the skills
needed, staff appraisal reports, individual development plans and support and
supervision systems
8.2 The employing organisation has supplied training material to help managers conduct
staff appraisals
9 Staff have received education and training appropriate to their role in the
therapeutic community. This includes training on:
9.1 A range of appropriate interventions, e.g. group therapy, cognitive and behavioural
techniques, brief psychotherapy techniques, family interventions
9.2 Psychodynamic concepts including transference and counter-transference
9.3 Defence mechanisms, projection and splitting
9.4 Small and large group dynamics
9.5 Group facilitation skills
9.6 Key information about a range of relevant conditions
9.7 Pharmacological interventions in units where medication is used
9.8 The use of support or supervision networks
9.9 Risk assessment and awareness of risk factors in abuse and abuse to others, indicators
of abuse and procedures for dealing with abuse
9.10 Culturally sensitive practice, disability awareness, and other equality issues
9.11 Clinical audit and research skills
9.12 Management of imminent and actual violence
9.13 Senior staff have had further training in management and team leadership
9.14 Non-clinical staff have received relevant mental health awareness training and receive
supervision as needed
10 Appropriate training methods are used to ensure staff training is effective
10.1 All clinical staff participate in continuing professional development e.g. practitioners have
at least 5 days training each year
10.2 Whenever appropriate, staff training is multidisciplinary and multi-agency
3
10.3 Staff have access to books, journals, video tapes and access to the Internet, e.g. from a
library to support their professional development
10.4 Induction training is provided for temporary and permanent staff before they have
unsupervised contact with client members
11 All staff receive regular supervision from a person with appropriate experience
and qualifications
11.1 Staff receive regular supervision and access to a staff support system
11.2 Junior staff have at least one hour per week group or individual supervision and are able
to contact a senior colleague as necessary
11.3 There are staff after-groups following all therapeutic community or group meetings
11.4 There is a regular staff sensitivity group
11.5 The staff team examine their own roles and relationships, and the impact they have as
members of the team
11.6 Staff members, as a group, tolerate the expression of conflict among themselves
11.7 Staff challenge each other’s perceptions of events in the therapeutic community and
work to integrate the difference in each other’s perceptions
11.8 Staff members regularly examine their attitudes and feelings towards clients. In doing
this, they are able to disagree with one another, and to explore these disagreements as
a source of understanding about the client, e.g. the way a client presents different facets
of themselves in different situations
11.9 Staff members are aware of mechanisms used by group members to avoid painful
exposure or confrontation, including denial, rationalisation, and splitting
11.10 Staff members demonstrate a knowledge of group dynamics that can impair effective
team functioning, including dependence, idealisation, and "them-us" splits
12 Vacant posts are filled quickly with well qualified candidates
12.1 The selection of candidates is guided by awareness of desirable gender and ethnic
representation within the team
12.2 All therapeutic community staff are police-checked before their appointment in
communities where this is required
12.3 Client members are involved as appropriate in the process of appointment of potential
new staff members
12.4 Staff members are involved in decision-making about the appointment of new staff
members
4
3. Access, Admission & Discharge
13 Referrers and other related professionals have ready access to information about
the therapeutic community
13.1 Referrers can readily access information about the therapeutic community, e.g. who can
refer and basic referral criteria
13.2 An information booklet is available for referrers and other related professionals
14 Provision and procedures ensure that therapeutic community care is available to
all those who would need it
14.1 The therapeutic community has clear, written criteria for admission. These consider i.
age restrictions, ii. type and severity of psychopathology, iii. potential scope for
intervention
14.2 Client and staff members are involved in discussions about the selection and admission
of potential new client members
14.3 Prospective members are involved in decision-making about their own selection and
admission
15 Assessment and care are offered without unacceptable delay
15.1 Client members do not experience delay in assessment or care that leads to care being
offered in inappropriate settings, e.g. admission to acute psychiatric wards
16 There is equity of access to the therapeutic community in relation to ethnic origin,
social status, disability, and physical health
16.1 The service is culturally sensitive, e.g. special dietary arrangements are made when
needed
16.2 The environment meets the needs of people with physical disabilities, for example doors
are of sufficient width and there are appropriate facilities including toilet, parking and
ramps
16.3 Client members' location of residence does not affect their access to services, e.g. client
members from remote areas have access to services
17 Before leaving the therapeutic community, decisions are made about client
members' continuing needs
17.1 When client members are referred back to local services for further treatment, e.g. to
social services or voluntary organisations, these services are included in discharge and
further treatment planning
17.2 When a client member needs to transfer to other mental health or social care services a
joint review is undertaken to ensure effective hand-over takes place
17.3 The therapeutic community informs the client member's general practitioner, and
involves relevant local services prior to discharge
5
17.4 A discharge planning meeting is held for all client members
17.5 Client members are involved in decisions about care after discharge from the therapeutic
community
17.6 Client members know the workers involved in follow-up after their discharge where this is
part of the treatment programme
17.7 Ongoing planning with the relevant social services departments is arranged for relevant
client members
6
4. Care, Treatment and the Therapeutic
Environment
18 All client members are assessed for their health and social care needs
18.1 This assessment takes into account relevant background, presentation, problems and
risks
18.2 Assessment interview/s are noted in the member's health record
18.3 Each assessment provides a formulation or sufficient description of the presenting
problems to enable the development of an individual treatment plan
19 The therapeutic community uses a structured treatment programme
19.1 There is a daily therapeutic community meeting, attended by all available residents and
staff
19.2 Time each working day is spent in therapy groups, as well as therapeutic community
meetings
19.3 There is a structured daily programme of group activities
19.4 There are opportunities for informal interactions between staff and client members of the
therapeutic community, e.g. cooking together, playing games together, outings,
socialising, etc, and members are expected to make use of these
19.5 There is provision for crisis meetings, with a recognised procedure for calling one that
can be used by staff or client members
20 Living as a community is an integral part of the treatment process
20.1 Discussions take place which encourage members to learn from everyday living,
including informal interactions with staff and each other
20.2 Discussions take place which encourage members to verbalise their thoughts and
feelings rather than act them out behaviourally
20.3 Members are encouraged to identify parallels between their behaviour and perceptions
and similar situations within the therapeutic community
20.4 Peer members offer each other supportive identifications and advice on constructive
ways of coping with conflict and frustration
20.5 Members are given positive feedback by their peers to enhance their self-esteem
20.6 Members are given feedback about their anti-social attitudes and behaviour, as they
appear in the therapeutic community, and the effects these have on other members
20.7 Members are given feedback about impulsive or self-defeating behaviour, as it occurs in
the therapeutic community and the effects on others
20.8 Members know details of the past experiences of members of their small group
7
20.9 Members encourage each other to talk openly about situations that made them feel
angry or of low self-worth
20.10 Members help each other identify present behaviour that makes them feel angry or of
low self-worth
21 A range of therapeutic opportunities is available in the therapeutic community.
This will depend upon the nature of the client member group, but is likely to
include:
21.1 Group analytic psychotherapy
22 Wherever possible the treatment provided is evidence-based
22.1 Staff know the evidence underpinning the range of treatments they provide
22.2 Treatments are selected according to the evidence of their effectiveness
23 The team has good access to services appropriate to the needs of the client
member. These include the following:
23.1 Adult mental health services
23.2 Forensic mental health services
23.3 Substance and alcohol misuse services
23.4 General practitioner services
23.5 Accident and emergency facilities
24 There is an agreed plan or contract for all client members
24.1 There is a written plan or contract for every client member
24.2 Client members and relevant others are actively involved in the development of their
plan
24.3 The plan is written or signed by the client member
24.4 Client members own and hold the plan, or are given a copy of it or at least have ready
access to it
24.5 The plan is reviewed at defined intervals and client members are involved in this
process, e.g. there is regular discussion of progress towards goals identified in the plan
25 Client members can meet readily with members of staff
25.1 Client members may invite family, friends and others to review meetings if they would
find this helpful
25.2 Client members can arrange appointments with staff as needed
8
26 Where drugs are administered this is according to the relevant guidelines
26.1 UKCC standards relating to the control and administration of drugs are applied
26.2 Where medication is used it is at the minimum effective dose, e.g. a graded approach to
medication has been taken
26.3 Maintenance doses are in the accepted dose range for the age and weight of the client
member
9
5. Information, Consent and
Confidentiality
27 Client members have good access to information about their care
27.1 A full range of appropriate leaflets and posters relevant to the services offered is on clear
display and readily available
27.2 Client members are presented with information in a way that they can understand e.g.
language is plain and "user friendly"
27.3 Information about the therapeutic community is provided to referrers and potential
members that gives a clear description of therapeutic community life
27.4 The information provided contains clear statements of the philosophy of the therapeutic
community, its aims, and the current programme
27.5 The information provided to clients and staff is open to comment, change and
development by any member of the therapeutic community
27.6 Telephone numbers of helplines and social services departments are available
28 Each client member knows to which groups they can take any queries, problems
or grievances
29 Client members know the names of staff in the therapeutic community
30 Client members can find out about the therapeutic community before they begin
the programme
30.1 Client members can visit the therapeutic community and find out about the services
offered before beginning the programme
30.2 There is a preliminary meeting to discuss the aims of the programme
30.3 An information leaflet is provided to client members before they join the therapeutic
community
31 Client members are involved in decisions about their care and treatment
31.1 The existing therapeutic community asks new client members what information they
need to make informed decisions
31.2 Verbal and written information is provided about all aspects of the programme
32 Client members have access to their health records
32.1 Client members have easy access to their own health records
32.2 Personal information about client members is kept confidential, unless this is detrimental
to their care or safety
10
32.3 Confidentiality and its limits are explained to client members, e.g. it is made clear to
client members that this is extended beyond the therapeutic community only if the quality
of their care and/or the safety of another depends on this and then only to those who
need to know
32.4 Communities that use personal disclosure therapeutically have agreed procedures for
maintaining confidentiality
32.5 Client members are told if information is passed on
33 All therapies are provided with the appropriate consent
33.1 The client member is approached by a practitioner capable of providing a particular
therapy to obtain consent, and this process can include the participation of other client
members
33.2 Consent is obtained in writing whenever appropriate
34 The therapeutic community maintains useful and informative client member health
records
34.1 The health record clearly states the date of referral and all key stages of the treatment
process
34.2 Where necessary there is a copy of any relevant court order kept with the client
member's health records
11
6. Rights, Safeguards, Boundaries and
Containment
35 The service is client-centred and members have their rights respected
35.1 Client members are encouraged to bring some of their own things with them when they
stay in residential communities
35.2 There is a choice of food from a menu that suits all dietary needs
35.3 The therapeutic community is sensitive to the needs of different ages, for example, age
appropriate recreational facilities are provided
35.4 Therapeutic community staff are polite and friendly
35.5 Therapeutic community rules and what they can expect are explained to new client
members
36 The therapeutic community provides a safe therapeutic environment
36.1 Staff members provide an emotionally safe environment for the work of the therapeutic
community
36.2 The tension between risk and therapeutic opportunity is safely managed by the whole
therapeutic community, and is used as a learning process
36.3 The therapeutic community is able to understand, learn from and react appropriately to
incidents of harm to self and others
36.4 Client members are involved in maintaining a safe physical environment for the
therapeutic community, including managing the interface with the external world. This
includes:
a. the safety and comfort of the building and environment
b. the physical safety and containment of all members
c. management of external disruption, e.g. refurbishments
37 Client members can complain or ask questions if they are unhappy with their care
and treatment
37.1 Staff and client members' complaints are dealt with in group meetings
37.2 Client members and staff can make complaints outside of the normal group meetings
37.3 Complaints procedures are well publicised and there is help on how to use them
38 The therapeutic community is committed to the management of clinical risk
38.1 The therapeutic community has a policy on dealing with allegations of abuse against
staff, other client members or visitors, including contact visits by relatives or friends
12
38.2 The therapeutic community promotes an open, blame-free culture for reporting incidents
38.3 The therapeutic community provides an annual report on risks and incidents to enable
the therapeutic community to learn from risks and provide a safer environment
13
7. Organisation, Policy and Procedures
39 Client members and staff agree the therapeutic community's operational policies
and procedures
39.1 Client members are responsible for the day-to-day running of the therapeutic community,
e.g. chairing the therapeutic community meeting, shopping for food, showing visitors
round. This is managed in conjunction with therapeutic community staff when
appropriate
39.2 Client members are responsible for allocating therapeutic community members to
therapeutic community roles, jobs, etc.
39.3 The therapeutic community can make decisions by voting on matters that are genuinely
empowering
39.4 The therapeutic community is managed democratically to allow self-management and
altruism to emerge
40 Client members are consulted about the environment and have a choice when this
is appropriate
40.1 Client members are consulted on noise levels, security, décor and furniture
40.2 In residential settings, client members are encouraged to personalise their bedroom
spaces
41 The therapeutic community discusses the consequences of decisions made in
community meetings
41.1 The therapeutic community as a whole is responsible for making, maintaining and
changing the community rules
41.2 The therapeutic community can discuss and question what decisions are made by the
staff group or the community as a whole
41.3 The therapeutic community is responsible for identifying, maintaining and changing
community boundaries, e.g. time-keeping, and for discussing breaches in these
41.4 Senior members take equal responsibility with staff for initially supporting and containing
newer members of the therapeutic community, and for transmitting the therapeutic
community culture to newer members
42 All available information is used to evaluate the performance of the therapeutic
community
42.1 A regular service evaluation is conducted and a report is compiled
42.2 Members' views on the therapeutic community programme are included in the report
42.3 The views of staff and referrers are used in the service evaluation and included in the
report
14
42.4 The evaluation also includes accident and incident records, key performance data such
as drop-out rates, waiting times, number of rejected referrals, bed or place occupancy,
non-attendance, and the findings of key audits
43 The therapeutic community has appropriate procedures for assuring the quality of
its service (e.g. clinical governance procedures)
43.1 The therapeutic community has designated a senior clinician who ensures that steps
and procedures are in place to assure the quality of care
43.2 There are procedures relating to clinical audit and service evaluation, clinical risk
management, staff training, evidence based practice, information management, client
member consultation, complaints and poor performance of staff
43.3 There are dedicated resources to support clinical audit and research within the
therapeutic community, for example, protected staff time and a dedicated budget
43.4 There are clear policies aimed at managing risks, such as self-assessment to identify
and manage risks and the systematic assessment of clinical risk
43.5 Procedures are in place to identify and remedy poor performance, such as critical
incident reporting, complaints procedures open to client members, their families and staff
44 The therapeutic community has a comprehensive operational policy document
44.1 There are written referral criteria
44.2 There are written admission and discharge procedures
44.3 There is a contingency plan and procedures to cover emergencies and disasters such as
client member suicide
44.4 There is a procedure regarding obtaining client member consent
44.5 There is a policy on the use of drugs and alcohol
45 The therapeutic community promotes a culture of enquiry
45.1 All members (staff and clients) can question managerial issues and group and
institutional dynamics, e.g. client members can question why staff members are grumpy,
why a staff member is leaving, why a meeting is cancelled, etc.
45.2 Solutions to problems are discussed and understood in the therapeutic community
before action is taken. The discussion is regarded as a learning opportunity
45.3 Potentially difficult topics can be openly discussed (e.g. sex, drugs, staff misconduct)
45.4 The therapeutic community promotes a permissive environment which allows for
catharsis, self-disclosure and the assumption of self-responsibility
45.5 Managerial information and issues which affect the therapeutic community are shared
with the whole therapeutic community
45.6 Staff show awareness of ways in which issues may be avoided or denied within the staff
team, or in the therapeutic community as a whole
15
8. External Relations
46 The commissioning body has a recent written strategy, developed in consultation
with all relevant parties, which addresses the provision of therapeutic
communities
47 Adequate levels of local services are provided for those who require it
47.1 Each region has a residential TC of 25 beds and an additional 225 places in day units
47.2 Assessment and treatment are offered without unacceptable delay
47.3 There is co-ordinated provision where the therapeutic community forms part of a range
of domiciliary, community, day and residential services so that clients are not admitted to
communities inappropriately
47.4 There are sufficient numbers of places properly matched to need, i.e. client members
who would be admitted on clinical grounds are not refused due to limitation of resources
47.5 Any restrictions on admissions to the therapeutic community are matched by alternative
resources
48 The therapeutic community contributes to effective multi-disciplinary and multiagency working, between health, education, social services
48.1 The therapeutic community liases effectively with other public services and has a good
working relationship between disciplines, departments and levels of care
48.2 Joint training is an ongoing activity, e.g. therapeutic community staff have received child
protection training with local social services
48.3 Therapeutic communities are used as a training placement for professionals involved in
mental health generally
49 Research about therapeutic communities is supported
49.1 In addition to outcome studies looking at therapeutic communities as a single therapeutic
intervention, research into therapeutic factors, and the relationship between them,
including prediction of favourable outcome, is supported
49.2 Research is supported to determine the characteristics of service users who require
residential as opposed to day care
50 The therapeutic community team meets regularly with managers of the employing
organisation
16
Appendix A
Acknowledgements
1. Advisory Group
Mike Allen
Jon Broad
Sheila Gatiss
Michael Göpfert
Yolandé Hadden
Rex Haigh (Chair)
Jan Lees
Mark Morris
Mary Beth Primmer
Richard Shuker
Sarah Tucker
Kati Turner
Anne Wise
Adrian Worrall
User representative
User representative
Consultant Psychiatrist
In Psychotherapy
User representative
Chair
Research Associate
Director of Therapy
Researcher
Manager
User representative
Senior Project Officer
Project Lead
Friends Therapeutic Community Trust
Webb House
Association of Therapeutic Communities
Francis Dixon Lodge
HMP Grendon
Winterbourne House
HMP Grendon
Community Housing and Therapy
Clinical Governance Support Service - CRU
Clinical Governance Support Service - CRU
2. Induction Day Attendees
Yolandé Hadden
David Millard
Jon Broad
Deborah Fairlie
Dawn Street
Lesley Hayward
Chris Newrith
Peter Sandiford
Linda Jennings
Valerie Miller
Patricia Burns
Jann Oliver
Sarah Tucker
Jasmine Boughaler
Vasilli Magalious
Alfredo Felices
Tracey Preece
Gilly Fairbairn
Louise Dallyn
Claire Thorley
Sandra Kelly
Affiea Rehman
Steven Simpson
Anthony Bree
Jane Ackland
Peter Clarke
Harjinder Sehmi
Alex Esterhuyzen
Stuart Whiteley
User representative
Retired Psychiatrist
User representative
Head of Therapy
Tenant
Supported Housing Manager
Consultant Psychotherapist
Deputy Director
Principal Officer
Head Teacher
Nurse Therapist
Nurse Therapist
Training Manager
Project Manager
Deputy Project Manager
Project Manager
Business Administrator
Service Manager
Primary Nurse
Clinical Charge Nurse
Lead Nurse
Resident
Ex-resident
Outreach Team Leader
Outreach Team Member
Clinical Director
Clinical Nurse Manager
Consultant
Formerly Medical Director
i
Acacia Hall Therapeutic Community
Asclepion Therapeutic Community
Asclepion Therapeutic Community
Birmingham Therapeutic Community Service
Caldecott Foundation
Caldecott Foundation
Caldecott School
Cawley Centre
Cawley Centre
Community Housing & Therapy
Community Housing & Therapy
Community Housing & Therapy
Community Housing & Therapy
Connect Therapeutic Community Ltd
Cranstoun Drug Services
Crisis Recovery Unit
Crisis Recovery Unit
Francis Dixon Lodge
Francis Dixon Lodge
Francis Dixon Lodge
Francis Dixon Lodge
Francis Dixon Lodge
Friends Therapeutic Community Trust
Henderson Hospital
Henderson Hospital
Henderson Hospital
Maggie Hilton
Paul Cocking
Roland Woodward
Mark Morris
Alison Hunt
Ian Marsh
Ruth Hirons
Tim Rodwell
Graham Slate
Colwyn Griffiths
Paul Goodman
Dave Vanderhoven
Vanessa Morris
John Diamond
Joan Smith
Cathy Castle
Bill Dillon
Alison Cookson
Debbie Hague
Keith Wilson
Paula Taplin
Carol Whitehead
Neil Palmer
Craig Fees
Lucy Mills
Cathy Hume
Carol Davies
Rachel Jukes
Adrian Worrall
Ginny Smith
Anne Wise
Harry Wright
Mike Forrester
Jan Birtle
Steve Pearce
Adam Jefford
Katie Bourton
Rebecca Neeld
David Kennard
Darren Black
Una Maguire
Paul Campbell
Keith Hyde
Michael Göpfert
Rex Haigh
Gary Winship
Hugh Greenlaw
Consultant Clinical & Forensic
Psychologist
Senior Mental Health Officer
Director of Therapy
Director of Therapy
Treatment Manager
Adult Psychotherapist
Consultant Psychotherapist
Principal
Chief Executive
Assistant Programme Director
Senior Project Worker
Director
Co-ordinator of Programme
RGN & Manager of the House
Psychotherapist
Consultant Adult
Psychotherapist
Senior Project Worker
Project Worker
Project Worker
Project Worker
Assistant Supervisor
Archivist
Policy Advisor
Therapeutic Communities
Policy Advisor
Ward Manager
Consultant Psychotherapist
Project Manager
Quality Improvements Project
Manager
Senior Project Officer
Principal Adult Psychotherapist
Nurse Therapist
Director - Therapeutic
Community Service
Psychiatrist
Team Leader, IPTS
Psychology Assistant
Lead Nurse
Consultant Clinical
Psychologist
Project Worker
Deputy Project Manager
Research
Clinical Director
Consultant Psychiatrist in
Psychotherapy
Chair of the ATC
Adult Psychotherapist
Team Manager
ii
Henderson Hospital Outreach Service
Highgate Centre
HMP Dovegate: Premier Custodial Group
HMP Grendon
HMP Wormwood Scrubs
Ingrebourne Centre
Invicta Community Care NHS Trust
Jacques Hall Foundation
Jessica Kingsley Publishers
Jessica Kingsley Publishers
Ley Community
Ley Community
MACA (Mental Aftercare Association)
Mulberry Bush School
Our Lady of Victory Trust
Our Lady of Victory Trust
Our Lady of Victory Trust
Pele Tower Project
Pele Tower Project
Pele Tower Project
Pele Tower Project
Pele Tower Project
Pine Street Day Centre
Planned Environmental Therapy Trust
Prison Service
Prison Service
Rampton Hospital
Redhouse Psychotherapy
Royal College of Psychiatrists' Research Unit
Royal College of Psychiatrists' Research Unit
Royal College of Psychiatrists' Research Unit
Royal Cornhill Hospital
Royal Cornhill Hospital
South Birmingham Mental Health NHS Trust
South London & Maudsley NHS Trust
South London & Maudsley NHS Trust
The Acorn Programme
The Cassel Hospital
The Retreat - York
Threshold
Threshold
Threshold
Webb House
Webb House
Winterbourne House
Winterbourne House
Young People's Service
3. Other Expert Advisors
Penelope Campling
John Gale
Robert Hinshelwood
David Kennard
Jane Pooley
Jean Rees
Stuart Whitely
Consultant Psychotherapist
Chief Executive
Francis Dixon Lodge
Community Housing and
Therapy
Professor of Psychoanalysis
University of Essex
Consultant Clinical Psychologist
The Retreat
Director of Strategic Development, Sawmill Cottage
Charterhouse Group
Principle Psychotherapist and
Winterbourne TC
Service Manager
Consultant Psychotherapist &
Henderson Hospital
Former Director
iii
Appendix B
Feedback Form
We hope you have found these standards for therapeutic communities useful and would very
much appreciate any feedback you may have. Your comments will be incorporated, with the
approval of network members, into future editions of this publication.
1. Have you found these standards useful?
Yes
No
Comments:
2. Do you have suggestions for new sections or topic areas you would like to see included in
future versions?
3. Do you have suggestions for new standards or criteria you would like to see included in future
versions?
4. Do you have any general suggestions about this document that would improve its
usefulness?
5. What is your name and job title?*
_____________________________________________________________
* Please supply further contact details of you wish
Please photocopy and return to: Sarah Tucker, Royal College of Psychiatrists’
Research Unit, 6th Floor, 83 Victoria Street, London SW1H 0HW. Fax: 020 7227 0850
iv
Appendix C
Order Form
Further copies of these standards can be obtained by photocopying and
completing the form below:
I would like to order __________ copies of Service Standards for
Therapeutic Communities at £10 each.
Title:(Dr, Mr, Mrs, Ms etc.):
First name:
Surname:
Job Title:
Organisation Name:
Address:
Postcode:
Tel:
Fax/E-mail:
Please indicate your preferred method of payment:
By cheque. I enclose a cheque for £_______ made payable to ‘The Royal
College of Psychiatrists’
By credit card. Please charge my VISA/Mastercard (not AMEX) for the amount of
£__________
My Credit Card number is:
________/________/________/________
Expiry Date:
___/___
Today’s Date:_____/_____/_____
Signed:__________________
Please invoice my organisation for £_________
PLEASE RETURN TO: The Community of Communities, The Royal College of
Psychiatrists’ Research Unit, 6th Floor, 83 Victoria Street, London SW1H 0HW.
Tel: 020 7227 0830. Fax: 020 7227 0850.
v