From hospital community to the wider community: Developing a therapeutic environment on a rehabilitation ward

Abstract

The establishment of a therapeutic environment on a psychiatric ward is described. Aims, procedure and method are outlined. The use of the daily community meeting is extensively discussed, together with a description of the use of small therapy groups on the ward. It emerges that the community meeting was a useful contributor to organisation and treatment and that its progress was an indicator of the development of the ward. The small groups helped some people but were less influential in the development of the ward as a whole. The results of the ward activities are recorded in terms of individual outcomes. They indicated that it was possible in a number of cases to improve apparently irremediable personal and psychological deterioration. It is concluded that group methods can contribute to the development of a rehabilitation unit, but that careful integration with individual support and care is necessary. The paper highlights shortcomings of current developments in social psychiatry and argues the worth of a community in the hospital relating to the community outside of the hospital.