Daniela Ivanova, Andrew John Howe, Patricia Burns and Merryn Jones
The purpose of this paper is to explore the effectiveness of the therapeutic community and to look at the potential changes that some patients may experience following treatment…
Abstract
Purpose
The purpose of this paper is to explore the effectiveness of the therapeutic community and to look at the potential changes that some patients may experience following treatment at the therapeutic communities (TC).
Design/methodology/approach
A thematic analysis was conducted on an e-mail sent by an ex-patient of the TC. The text was reviewed multiple times and codes were generated. Based on the data found, three themes were identified. The e-mail was sent to the patient’s primary therapist, who was asked to provide an account of the e-mail. The therapist was sent six questions created by the authors of the paper; the responses were used to compare the two perspectives.
Findings
The main findings entailed the changes the patient went through after her treatment at the TC. The patient’s account described her inability to process the adversities she had been through at the time and therefore her inability to communicate them. However, the impact the service had on the patient, according to the e-mail was evident years later. The lack of a support network during treatment at the TC and evidence of one following treatment seemed to be the key factor in the patient’s improvement.
Originality/value
The authors confirm that the research presented in this paper is their original work. The authors hereby acknowledge that all material included in this piece of work, that has been published or written by another person has been referenced accordingly.
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Merryn Jones and Andrew John Howe
The COVID-19 pandemic has affected psychotherapy practice. A common change is a move to online sessions over video calls. In their therapeutic community (TC) for those with…
Abstract
Purpose
The COVID-19 pandemic has affected psychotherapy practice. A common change is a move to online sessions over video calls. In their therapeutic community (TC) for those with personality disorders, the authors have used video calls but not all clients could work in this way. The authors decided to meet patients outside and walked with them while adhering to government guidelines. This study aims to present the authors’ experience with one client who was interviewed afterwards about the experience.
Design/methodology/approach
A total of 10 walking therapy sessions of 60-min duration were conducted with the patient. After the sessions, both the patient and therapist were interviewed about their experience. The resulting interviews with both patient and therapist were thematically analysed independently by both authors.
Findings
There were common themes to both the client and therapist’s account following thematic analysis. These were: modelling and normalising in the real world, replacing what COVID-19 had taken away from the TC experience, changes at home, therapist disclosure, outcomes and good endings and being outside of the clinical environment.
Research limitations/implications
The authors have presented a single case of the patient and therapist experience of outdoor therapy sessions in a TC context response to the COVID-19 pandemic. The findings are not generalisable and can only provide a suggestion at the positive potential for working in this way. The authors hope that the positive effects of outdoor therapy noted here may inspire other clinicians to consider similar novel approaches in their work.
Originality/value
This study describes a novel way that a TC has adapted to the COVID-19 pandemic.
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Rachel Hopping, Daniela Ivanova and Andrew John Howe
National guidelines in the UK for emotionally unstable personality disorder and antisocial personality disorder (PD) do not recommend treatment with medication, suggesting instead…
Abstract
Purpose
National guidelines in the UK for emotionally unstable personality disorder and antisocial personality disorder (PD) do not recommend treatment with medication, suggesting instead psychotherapy. There is little evidence that medication has benefit from the literature. Despite this, many patients with PDs are prescribed medications. This study aims to quantify medication prescriptions within the therapeutic community for those with PD and assess if treatment led to changes in prescription.
Design/methodology/approach
An audit tool was designed in Microsoft Excel; 30 most recent patients discharged from the authors’ service since November 2018 were identified. Their discharge summaries were scrutinised for changes in medication comparing the beginning of treatment to the end. These were then analysed in terms of changes in class of medication and dose as well as total number of medications prescribed.
Findings
In total, 31 patients’ notes were scrutinised. Then, 25 patients were prescribed psychiatric medication at the start of their treatment, 24 had medications changed falling to 17 at the end of treatment. Antidepressants were the most commonly prescribed medications. By class, antidepressant prescriptions fell by 35 per cent, antipsychotics by 43 per cent, anxiolytics by 40 per cent. The prescription of mood stabilisers and Z drugs remained the same.
Originality/value
The assessment of medication changes during psychotherapeutic treatment within a therapeutic community is unique in the literature. Understanding and hypothesising the dynamics involved within this process has also received little attention in research. This study highlights the potential from which further research into this neglected but pertinent area could be conducted.
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The purpose of this paper is to investigate the theoretical potential of applying Jungian/analytical psychology concepts to a contemporary therapeutic community (TC) within the…
Abstract
Purpose
The purpose of this paper is to investigate the theoretical potential of applying Jungian/analytical psychology concepts to a contemporary therapeutic community (TC) within the national health service.
Design/methodology/approach
A literature review concerning a Jungian understanding of group psychotherapy and TCs was undertaken. A summary and discussion of a detailed written account of a previous Jungian TC was then conducted. A comparison between a modern-day TC and Jungian approaches was then conducted with an ending discussion on the feasibility of incorporating Jungian ideas into modern work.
Findings
While Jung is thought to have a wholly negative view of groups and group psychotherapy, this was not found in the case. Furthermore, post-Jungian authors have attempted to use ideas from analytical psychology in their group work. While there are some aspects that could be implemented with relative ease in the modern TC, a complete shift into this different way of working would be a challenge and its current evidence base would not support this.
Originality/value
To the best of author’s knowledge, there are no other academic papers that have considered this subject.
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Vafa Pirjamali, Daniela Ivanova and Andrew John Howe
The intensive 18-month treatment in the personality disorder (PD) therapeutic community (TC) is felt to offer improvement in many aspects of patients’ lives. This study aims to…
Abstract
Purpose
The intensive 18-month treatment in the personality disorder (PD) therapeutic community (TC) is felt to offer improvement in many aspects of patients’ lives. This study aims to understand if the use of acute services was also affected via a service evaluation project.
Design/methodology/approach
The authors collected data from electronic records on the use of local services in the two years before, during and the two years after treatment in the TC. Specifically, the authors counted inpatient bed days, Emergency department (ED) presentations and days under home treatment team and liaison psychiatry; the authors used ANOVA to analyse the data.
Findings
The study included 25 adult service users, 17 female and 8 male, with an average age of 40. Whilst there were reductions in the use of inpatient beds and ED presentations, on analysis, these were not found statistically significant. The small size of the study is a limitation and may limit the generalisability of the findings. The study concludes there may be reductions in acute psychiatric service use during and after treatment in the TC. The findings were not statistically significant; the authors suggest larger multi-centre studies may be able to demonstrate statistical significance.
Originality/value
PD patients have a relatively high use of acute psychiatric services compared to other patient groups. The authors are not aware of any similar studies in the published literature.
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This paper examines the potential relationship between the history of American generations and the development of American management thought. The paper reviews the recently…
Abstract
This paper examines the potential relationship between the history of American generations and the development of American management thought. The paper reviews the recently developed generational theory of American history, along with the generational concept itself. Then, the leading thinkers in the history of the management discipline are classified according to their generational membership. The potential theoretical and research implications of the interplay of managerial and historical generations are then discussed.
Briefly reviews previous literature by the author before presenting an original 12 step system integration protocol designed to ensure the success of companies or countries in…
Abstract
Briefly reviews previous literature by the author before presenting an original 12 step system integration protocol designed to ensure the success of companies or countries in their efforts to develop and market new products. Looks at the issues from different strategic levels such as corporate, international, military and economic. Presents 31 case studies, including the success of Japan in microchips to the failure of Xerox to sell its invention of the Alto personal computer 3 years before Apple: from the success in DNA and Superconductor research to the success of Sunbeam in inventing and marketing food processors: and from the daring invention and production of atomic energy for survival to the successes of sewing machine inventor Howe in co‐operating on patents to compete in markets. Includes 306 questions and answers in order to qualify concepts introduced.
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The purpose of this paper is to explore the interaction between a liminal rural Australian city (Lithgow) and the development of higher education options across the city's…
Abstract
Purpose
The purpose of this paper is to explore the interaction between a liminal rural Australian city (Lithgow) and the development of higher education options across the city's history. The paper proposes a nuanced interaction between national, social, religious, political, regional and local forces to explain why an industrial city such as Lithgow, with obvious educational strengths, would be overlooked while others (such as Wollongong and Bathurst) were not.
Design/methodology/approach
The paper takes the form of a longitudinal study of educational institutions, placed in their historical contexts, in order to demonstrate the fluctuation of educational vision with the rise and fall of socio-economic contributors to the town's fortunes.
Findings
The paper finds that the city's formation and dependence on war-related industries created boom-bust cycles which negatively impacted on its entrepreneurial, managerial and working class elites, and so on its ability to bring cultural and political influence to bear in the formation of local higher education options, across a period in which higher education becomes an increasingly federal responsibility.
Practical implications
The paper suggests policy ramifications for the support of higher education options in the city.
Social implications
The paper supports the interpretation that it is not merely that education itself promotes social mobility, but that what type of education is important, along with an eye to how education contributes to the overall well-being and cross-class profile of the city of Lithgow.
Originality/value
This paper fills a gap in historical knowledge about Lithgow's educational institutions, the study of which heretofore has tended to be located with either labor historical or heritage approaches. This paper takes a socio-cultural and longitudinal/holistic approach which brings together a variety of approaches previously not treated.