In-patient and residential services still account for the bulk of spending on mental health services, yet they tend to be undermanaged, underresearched and neglected. The idea of how to establish and protect a therapeutic environment is at the root of residential mental health care, but has become lost in recent years. There is an urgent need to reassert what this involves in the context of current knowledge, practice and evidence. It has become too easy to see in-patient settings as part of the problem, rather than part of the cure. It is time to turn this situation around.

 

Of interest to consultant psychiatrists, mental health service managers, ward managers and senior nurses, and all those with responsibility for in-patient settings, this book will interest all those who encounter and who hope to change the in-patient environment.

 

You may also be interested in the book:   Intelligent Kindness: Reforming the Culture of Healthcare

“This book is a wake-up call for trainers and trainees. Neglect supervised experience in large and small groups, neglect the discipline of the community meeting, cease to regard patients as people, and mental health services will become increasingly impoverished.” John Cox Secretary General, World Psychiatric Association Past President, Royal College of Psychiatrists

“It is important for everyone who works in mental health care to understand that a new age is upon us. As part of this transformation, this book has an important role in raising awareness of what goes wrong when an environment becomes dehumanised and, conversely, what can be done to enhance and humanise an environment so that it can fulfil its therapeutic potential.” Anthony Sheehan Director of Care Services, Department of Health

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Part I. Understanding the problems
1. The historical context of therapeutic environments - Kathleen Jones
2. How good staff become bad - Graeme Farquharson
3. Toxic institutions - Steffan Davies
4. A psychoanalytical understanding of what goes wrong: the importance of projection - Penelope Campling
5. Users’ experiences of in-patient services - Alan Quirk and Paul Lelliott
6. Difficulties with attachment and separation: joining and leaving a therapeutic community - Nick Humphreys and Anthony Bree

 

Part II. Towards a better future
7. The physical environment and use of space - Teresa von Sommaruga Howard
8. Connecting with the natural environment - Sarah Paget and Terry White
9. A gender-sensitive therapeutic environment for women - Sarah Davenport
10. In-patient care and ethnic minority patients - Leela Thampy and Dinesh Bhugra
11. Leadership and management in therapeutic institutions - Graeme Farquharson
12. The quintessence of an effective team: some developmental dynamics for staff groups - Rex Haigh
13. Preventing and managing violence and aggression in in-patient settings - Mick Collins and Paul Munroe
14. Measuring the therapeutic environment - Christine Timko and Rudolf H. Moos

 

Part III. Acute wards
15. What users want - Joel McCann
16. A carer’s perceptions of the therapeutic value of in-patient settings - Peter Ruane
17. Acute psychiatric wards: an overview - Wilson Firth
18. Developing the workforce - Justine Faulkner
19. Delivering psychological therapies in acute in-patient settings - Peter Kinderman
20. What can psychotherapy contribute to improving the culture on acute psychiatric wards? - Jeremy Holmes

 

Part IV. Specialist settings
21. The residential care and treatment of adolescents - Jim Rose
22. The ideal home and community for people with learning disabilities - Valerie Sinason and Sheila Hollins
23. Secure psychiatric services - Steffan Davies
24. A nurturing environment for older adults - Wendy Ferguson, Shelley Hammersley and Lin Burton
25. Therapeutic communities - Sandra Kelly, Judith Hill, Heather Boardman and Ian Overton
26. Rehabilitation and continuing care - John Howat

 

Index