Towards an Italian model of therapeutic community

Abstract

In this paper the author reflects on research undertaken by the Association Myth and Reality in the context of the psychiatric reforms in Italy which resulted in the closure of the asylums and the organisation, over the last 20 years, of a network of services in the community. These include thousands of residential units operating on a rehabilitative model. The focus of this paper is on the concept of the therapeutic community as a dynamic evolutionary path, individually tailored to people with different diagnoses and different ages – e.g. psychosis; borderline; adolescents and children. The therapeutic – and more specifically the environmental – factors are presented here. This includes the aesthetics of living and the sensory/emotional climate in relation to the care of the self and protection, regulation and safety, transitional playful climate, everyday life and the sharing implicit in relationships. The emotional climate is a fundamental component that transverses and intersects all the other factors. Treatment is central to the group with its potential for containment and dynamism in relation to relationships, cohesion, belonging, integration of the self in the community and connections with social networks outside the group aimed at reintegration into society of the resident as a citizen. A system of evaluation through peer reviews between therapeutic communities in Italy is being built in order to continuously improve the quality of service delivery.

Keywords:

• Italian psychiatric reform
• therapeutic communities
• therapeutic factors
• emotional climate