Abstract
PurposeThe purpose of this paper is to explore staff and service users’ perceptions of therapeutic principles within a unique male high secure learning disability therapeutic community (LDTC).Design/methodology/approachA qualitative approach was adopted using deductive content analysis and inductive thematic analysis. In total, 12 participants took part in a semi-structured interview to explore their perceptions of Haigh’s (2013) quintessence principles and any further additional therapeutic features in the environment not captured by the theory.FindingsAll five quintessence principles were identified in the LDTC environment. Some limits to the principle of “agency” were highlighted, with specific reference to difficulties implementing a flattened hierarchy in a forensic setting. Additional therapeutic features were identified including; security and risk, responsivity, and more physical freedom which appear to aid implementation of the quintessence principles.Research limitations/implicationsThe study was performed within a single case study design. Therefore, results remain specific to this LDTC. However, the finding of these principles in such a unique setting may indicate Haigh’s (2013) quintessence principles are evident in other TC environments.Originality/valueThis is the first research paper that has attempted to test whether Haigh’s (2013) quintessence principles are evident within a given therapeutic community. The research provides empirical evidence for the quintessence principles in a novel TC setting and suggests recommendations for future research.
Highlights
The diagnosis of personality disorder (PD) within learning disability (LD)populations is prevalent within forensic settings (Blackburn et al, 2003) and associated with placements in higher security settings, serious and repeated offending and poorer long-term outcomes (Alexander et al, 2006; Torr, 2008)
Are Haigh’s (2013) quintessential elements of a therapeutic environment present in the environment of the learning disability therapeutic community (LDTC) within a high secure hospital according to service user and staff members’ perceptions?
Five out of six service users referred to experiences of belonging and feeling valued
Summary
The diagnosis of personality disorder (PD) within learning disability (LD)populations is prevalent within forensic settings (Blackburn et al, 2003) and associated with placements in higher security settings, serious and repeated offending and poorer long-term outcomes (Alexander et al, 2006; Torr, 2008). The diagnosis of personality disorder (PD) within learning disability (LD). Effective treatments are important for individuals and wider society. Democratic Therapeutic Communities (DTCs) have been commonly implemented in the treatment of personality disorder (PD) in non-LD populations (Rutter & Tyrer, 2003), and recently LD populations (Taylor, Crowther & Bryant, 2015). A DTC is defined as a ‘living-learning situation’. Rn whereby, ‘difficulties a member has experienced in relations with others outside are re-experienced and reenacted, with regular opportunities6to at examine and learn from these difficulties’ (Kennard, 2004: 296). DTCs are most usefully understood as a treatment modality (i.e. integrating a range of io psychological and/or pharmacological approaches) as opposed to a specific treatment method itself (Kennard, 1998)
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