Терапевтические сообщества

Статья посвящена описанию основ деятельности особых лечебных учреждений — терапевтических сообществ, получивших ныне широкое распространение во всем мире. От обычных психиатрических лечебных центров терапевтическое сообщество отличается, прежде всего, своим главным методом, характерная черта которого — осознанное объединение всех ресурсов, имеющихся в распоряжении учреждения, медперсонала, самих пациентов и даже их родственников, ради успешного лечения иресоциализации тех, кто оказался его «жителем». Подробно рассматриваются исторические и научные истоки таких сообществ, практические аспекты и определяющие принципы их деятельности, роли и функции персонала и «жителей», показания и противопоказания для лечения, а также виды данных сообществ. Особое внимание уделяется вопросу эффективности их деятельности.

1. Aveline M. (1997) The limitations of randomized contolled trials as guides to clinical effectiveness with reference to the psychotherapeutic management of neuroses and personality disorders. Current Opinion in Psychiatry, 10, 113—115.
2. Barton R. Institutional Neurosis. Bristol: Wright, 1959.
3. Bridgeland M. Pioneer Work with Maladjusted Children. London: Staples Press, 1971.
4. Campling P. and Haigh R., eds. Therapeutic Communities: Past, Present and Future. London: Jessica Kingsley, 1999.
5. Ciompi L., Dauwalder HP., Maier С et al. (1992). The pilot project «Soteria Berne»: clinical experiences and results. British Journal of Psychiatry, 161 (suppl. 18), 145—53.
6. Clark D.H. The Story of a Mental Hospital: Fulbourn 1853—1983. London: Process Books, 1996.
7. Clark D.H. (1965). The therapeutic community — concept, practice and future. British Journal of Psychiatry 131, 553—64.
8. Cooke D.J. (1997) The Barlinnie Special Unit: The rise and fall of a therapeutic experiment. In Therapeutic Communies for Offenders (ed. E. Cullen, L. Jones and R. Woodward), p.101—20. Wiley, Chichester.
9. Cullen E. (1997). Can a prison be a therapeutic community: the Grendon template. In Therapeutic Communies for Offenders (ed. E.Cullen, L.Jones and R.Woodward), p.75—99. Wiley, Chichester. Department of Health and Home Office Working Group on Psychopathic Disorder. A review of services for mentally disordered offenders and others with similar needs.London: HMSO (1994).
10. Goffman I. Asylums. New York: Doubleday, 1961. Harmondsworth: Penguin, 1968.
11. Isohanni I. (1993) The therapeutic community movement in Finland: past, current and future views. Therapeutic Communities, 14, 81—90.
12. Jones M. Social Psychiatry in Practice, p.85—6. Harmondsworth: Penguin, 1968.
13. Jones M. Social Psychiatry in Practice, p.105—112 Harmondsworth: Penguin, 1968.
14. Kennard D. An Introduction to Therapeutic Communities. 2nd edn. London: Jessica Kingsley, 1998.
15. Lees J, Manning N. and Rawling B. (1999) A systematic international review of therapeutic community treatment for people with personality disorders and mentally disordered offenders.
16. Leff J and Trieman N. (1997). Providing a comprehensive community psychiatric service, In Care in the Commuity: Illusion or Reality (ed. J.Leff), p.189—201. Wiley, Chichester.
17. Mahoney N. (1979) My stay at the Henderson Therapeutic Community. In Therapeutic Communities: Reflections and Progress (ed. R.D.Hinshelwood and N.Manning), p.76—87. Routledge and Kegan paul, London. Main T. (1946). The hospital as a therapeutic institution. Bulletin of the Menninger Clinic 10, 66—70.
18. Main T. (1957). The Ailment. British Journal of Medical Psychology 30, 129—45.
19. Main T. (1975) Some psychodynamics of large groups. In The Large Group (ed. L Kreeger), Constable, London.
20. Main T. (1983). The concept of the therapeutic community: variations and vicissitudes. In The Evolution of Group Analysis (ed. M. Pines), p.197—217. Routledge and Kegan Paul, London.
21. Menzies I. (1960). A case-study in the functioning of social systems as a defence against anxiety. Human Relations, 13, 95—121.
22. Mosher L.R. (1991). Soteria: a therapeutic community for psychotic persons. International Journal of Therapeutic Communities, 12, 53—67.
23. Norton K. and Fainman D. (1994). Applications of the TC concept: dynamic psychotherapy training. Therapeutic Communities 15, 99—105.
24. Rapoport R.N. Community as Doctor. London: Tavistock. 1960.
25. Roberts J. (1998). Questions of training. In An Introduction to Therapeutic Communities (2nd edn) by D.Kennard, p.143—66. Jessica Kingsley, London.
26. Rose M. Transforming Hate to Love: an outcome study of the Peper Harow treatment process for adolescents. London: Routledge, 1997.
27. Stanton A. and Schwartz H. The Mental Hospital. New York: Basic Books, 1954. The Charterhouse Group. Poor starts, lost opportunities, hopeful outcomes. London: The Charterhouse Group, 1993.
28. Tuke S. Description of The Retreat. First published 1813. Reprinted London: Process Press 1996.
29. Warren F. and Dolan B. (1996). Treating the «untreatable»: therapeutic communities for personality disorders. Therapeutic Communities, 17, 205—16.
30. Wexler H. (1997). Therapeutic communites in American prisons. In Therapeutic Communies for Offenders (ed. E.Cullen, L.Jones and R.Woodward), p.161—79. Wiley, Chichester.