Abstract
Purpose Democratic therapeutic communities (TCs), use a “flattened hierarchy” model whereby staff and clients are considered to have an equal voice, sharing administrative and some therapeutic responsibility. Using the sociological framework of interaction ritual chain theory, the purpose of this paper is to explain how TC client members negotiated and enforced community expectations through an analysis of power within everyday interactions outside of structured therapy. Design/methodology/approach The study used narrative ethnography, consisting of participant observation with two democratic communities, narrative interviews with 21 client members, and semi-structured interviews with seven staff members. Findings The findings indicate social interactions could empower clients to recognise their personal agency and to support one another. However, these dynamics could be destructive when members were excluded or marginalised. Some clients used their interactions at times to consolidate power amongst dominant members. Practical implications It is argued that the flattened hierarchy approach theoretically guiding TC principles does not operate as a flattened model in practice. Rather, a fluid hierarchy, whereby clients shift and change social positions, seems more suited to explaining how the power structure worked within the communities, including amongst the client group. Recognising the hierarchy as “fluid” may open dialogues within TCs as to whether, and how, members experience exclusion. Originality/value Explorations of power have not specifically focused on power dynamics between clients. Moreover, this is one of the first papers to look at power dynamics outside of structured therapy.
Highlights
Democratic therapeutic communities (TCs), like some psychiatric milieus such as Star Wards (2006), advocate clients’ involvement in their treatment and in the running of the unit
The findings show that social dynamics could empower clients to recognise their personal agency, when all clients felt a sense of belonging within the TC
Though this paper considers the power dynamics between clients outside of therapy, an analysis of power during everyday interactions could be expanded by considering staff to client interactions and exploring hierarchies within the staff team that may impact the overall organisation and fluidity of power within communities
Summary
Democratic therapeutic communities (TCs), like some psychiatric milieus such as Star Wards (2006), advocate clients’ involvement in their treatment and in the running of the unit. These TCs often use a “flattened hierarchy” model whereby staff and clients are considered to have an equal voice and share administrative and some therapeutic responsibility (Rapoport, 1960; Jones, 1976; Kennard, 1993). The findings show that social dynamics could empower clients to recognise their personal agency, when all clients felt a sense of belonging within the TC These dynamics could be destructive when members were excluded or marginalised.
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