CHAPTER TWO LITERATURE REVIEW

2.0 INTRODUCTION The purpose of this study is to discuss to what degree the average school could benefit from the principles that inform therapeutic communities. This section will therefore offer a review of the literature relating to therapeutic communities and pose the question whether some of the principles that inform therapeutic communities might benefit the members of the average school community. The review will address the meaning of community and question whether the average school could be understood to operate at certain levels as a community. This review must therefore define community, establish how schools are currently organised and managed and to what degree they can be regarded as communities. Secondly the background to therapeutic communities is explored and the principles which have evolved to the present. 2.1 DEFINITIONS OF COMMUNITY A Community, according to the Concise Oxford dictionary definition (1982), is an organised, political, municipal or social body, a body of people living in the same locality, a body of people having the same religion, profession or other in common

Having a sense of community means, having an interest in the community of which you are a member. Furthermore it is having an insight into how the group relates and progresses through difficulties as well as times of prospering. A group member must be aware that his contribution to group dynamics is important and necessary. Each individual member has a function within the group. Sometimes a person can feel outside their group. In the school situation a child or young person can be ostracised either intentionally or un-intentionally. According to Lanyado (2006) Many of our children live in chaotic, stressful environments in which the constant impingement of disturbed relationships, seem to be forever disrupting their feeling of on-going sense of self (p.32). She adds that: Their actual experience in the midst of maelstrom of conflicting emotions is that they feel angry, tense and unhappy which leads to disruptive behaviour and/or emotional defensiveness The community needs to ensure that these children are included by trying to access the childs inner world at some level. Acceptance and support of each for the other eventually leads to everyone becoming community members in the truest sense of the word. Michael D. Higgins in his inaugural speech, states that those presidents who preceded him have made: (2011) contributions that developed our consciousness of human rights, inclusion and the important task of deepening and sustaining peace within and between communities in every part of our island. It is work I will endeavour to continue and build upon We must seek to build together an active, inclusive citizenship; based on participation, equality, respect for all and the flowering of creativity in all its forms. A confident people is our hope, a people at ease with itself, a people that grasps the deep meaning of the proverb 'n neart go cur le chile' our strength lies in our common weal our social solidarity. His awareness that his country is a community is crystal clear in the speech and his wish to ameliorate this community of Ireland is a promising reflection of a man with a mission.

When I visited the Don Bosco community in Dublin on placement I encountered a community deeply dedicated to the needs of the young people in residence there. The Don Bosco vision states that: We the Salesians of Don Bosco commit ourselves to treat the boys as

members of the family. We are: Animators of the Pastoral Community This community is a working model of a therapeutic community where each person works for the benefit of the whole group. Each member is unique and protected within the community. Each person contributes to the wellbeing of all the individuals who form the whole society. The Philosophy of Kant is more than apt for each individual member of a community; ACT ONLY ON THE MAXIM THROUGH WHICH YOU CAN AT THE SAME TIME WILL THAT IT SHOULD BECOME A UNIVERSAL LAW Our own MATCC course is based on a community working together to support and empower the individual and the group by listening, talking, experiencing and working towards a common goal. We as community members contribute to our own and each others growth and development thus enriching the community of which we are all as individuals an integral part.

2.1 THERAPEUTIC COMMUNITY Throughout history people have attempted to encourage community feeling and especially the growth of the therapeutic community in all parts of the world. Certain beliefs led to the understanding of this need for therapeutic care for children: 1. the problem behaviours of such children were often the result of the experience of severe and repeated traumas or deprivations, especially in terms of parenting or care (Ward et al, p.44)

2.

To effect lasting change it was therefore necessary actively to attend to and repair the particular nature of their relationships with others (Ward et al p.44)

3.

Ward et al go on to state in Therapeutic Communities for Children and Young People that: The therapeutic approach was rooted in several disciplines, including education, care, reform, and mental health. It also drew on a variety of different ideas and philosophies to support and direct its practice He then adds: Looking at the history of the approach therefore involves consideration of both changes over time in the way the client group has been recognised, understood and responded to, and developments in the way various projects fitting the above criteria worked with such children. Ward defines the ten principles plus one, of the Therapeutic Community Approach as follows: 1. An emphasis on the value of group work as a medium both for therapeutic work and in some places for decision making with the young people. 2. A specific commitment to the use of the daily community meeting as a medium for both practical and therapeutic business between young people and staff. 3. Within this group context, a willingness on the part of the staff to commit themselves to medium/long-term Individual therapeutic relationships with young people. 4 .An emphasis on the potential for therapeutic communication between staff and young people to arise from every day interactions in daily living alongside each other (i.e. opportunity- led work) 5. In daily practice, a commitment to a personal and involved style of working, in which the quality of the relationship between the young people and staff is seen as playing a central role in the treatment process. 6. A commitment to the value of the physical and personal environment for its contribution to the therapeutic task. 7. Engagement with the other key systems in the young persons life, including their family and other personal networks, as well as with their educational, health and other developmental needs 8. The use of psychodynamic rather than solely behavioural or cognitive theoretical framework to underpin the treatment philosophy, and of systemic thinking to interpret connections between people, events and feelings. 9.In internal management structures, an emphasis on each persons role and potential contribution to the agreed task and philosophy rather than mainly on status, task and formal titles.

10. A commitment to the value of a full system of staff support and supervision, including the use of consultancy for senior managers 11. The use of consequence rather than punishment for children so that they can recognise that for every action there is a consequence. (Ward et al, p.34, Chapter two, The Core Framework)(Therapeutic Communities for Children and Young People) The term therapeutic community is usually used in the UK to describe small cohesive communities. Therapeutic communities, according to Penelope Campling are: Where patients (often referred to as residents) have a significant involvement in decision-making and the practicalities of running the unit. Based on ideas of collective responsibility, citizenship and empowerment, therapeutic

communities are deliberately structured in a way that encourages personal responsibility and avoids unhelpful dependency on professionals. Patients are seen as bringing strengths and creative energy into the therapeutic setting and the peer group is seen as all-important in establishing a strong therapeutic alliance. The flattened hierarchy and delegated decision-making are sometimes misunderstood as anarchy by outsiders. However, staff in modern therapeutic communities, are deeply aware of the need for strong leadership and their responsibility to provide a safe frame for therapeutic work. (Therapeutic Communities, 1999). In the USA, the term therapeutic community is more often used to describe userrun communities for substance misusers with: a hierarchical structure; a reward system; fierce encounter groups; and a simple explanatory model of addiction and its treatment. These are referred to as concept or behavioral therapeutic communities, as opposed to democratic therapeutic communities, which are the main focus of this paper. Phoenix House and Daytop are two major concept therapeutic community programmes that grew from this movement in the USA and spread to many different countries (Kennard, 1998 ). In the UK, this model is currently being developed within the prison service. In common with democratic

therapeutic communities, the primary mechanism by which these units aim to alter behavior is by encouraging residents to take responsibility for themselves and for others. Democratic therapeutic community principles are applicable to a wide variety of client groups and settings, for example HMP Grendon Underwood (Cullen et al1997), which helps offenders within the prison system, and Peper Harow ( Rose, 1990 ), for children with severe behavioural problems. This paper, however, focuses on the importance of the therapeutic community movement within the National Health Service (NHS). Therapeutic communities in mental health service settings date back to World War Two (Main, 1946; Kennard, 1999) and have a long history of research endeavor (Lees, 1999). However, most of the early work is descriptive or qualitative. A few contributions stand out, such as Robert Rapoport's Community as Doctor, which was published as a book in 1960 and described four themes by which therapeutic communities have become known; permissiveness, reality confrontation,

democratization and communalism. The study used an ethnographic and questionnaire method at Henderson Hospital, and analyzed the data using a grounded theory approach to distil the themes. 1. In the past few years the Association of Therapeutic Communities (ATC) has formed a committee to co-ordinate research in a way that meets modern demands for high quality evidence (Department of Health, 1999), while keeping mindful of the democratic and consensual way in which therapeutic communities necessarily work. The studies discussed here have all been developed in consultation between therapeutic communities, in this committee. It does not include the extensive qualitative and quantitative research undertaken recently in prison units run as therapeutic communities (see for example, Marshall, 1997; Rawlings, 1998). In the past ten years, there has been an explosion of new therapeutic community (TC) programs in prisons across the United States. By 2001, nearly every state in the country had at least one TC program in a prison within its borders, or was planning to start one, and 31 states had a TC program for women. Like other types of substance abuse or criminal thinking programs/approaches used in prisons, TCs

have been put in place in women's correctional settings without regard to whether they are the best approach for women. Under the guise of gender-neutrality, programming developed for and tested on men has too often been uncritically applied to women. This paper will review the theory and research supporting the use of TCs in relation to the literature on gender-specific issues in substance abuse treatment. The core philosophy, principles, and tools of a TC will be examined given what we know about women's development and treatment needs.(PMC ,US National Library of Medicine (Bio Med Central, The open Access publisher) National Institutes of Health)(Michele J. Eliason, 2006,retrieved 2nd April 2013) When Victor Frankl was struggling for survival in Auschwitz, his community was threatened at every level imaginable. He managed to hold himself and others together by adopting the last of the human freedoms - the ability to choose one attitude in a given set of circumstances. (Mans Search for Meaning,p.12) This is what we all learn when part of a community. There are disagreements and personality clashes but rising above these is what empowers the community to grow and prosper. We can choose our own attitudes and improve our relationships. (ref to book) The Scottish Prison Service (SPS) is an Agency of the Scottish Government and was established in 1993. The purpose of the Service is to maintain secure custody and good order within prisons, whilst caring for prisoners with humanity and delivering opportunities which give the best chance to reduce reoffending once a prisoner returns to the community The idea of community and of all people as part of a community is an obvious factor in the running of this prison. The mission of returning prisoners to the community as functioning adults in society is paramount here.

2.2 THE HISTORY OF EDUCATION When the National School System was set up in Ireland in 1831, its main object was to unite in one system children of different creed.( A History of the Irish Education System, Teach, Dont Preach, p.1) However this did not become a working model as schools did not accept amalgamation of differing religions in practice.

In Ireland the main focus was on religious instruction and this above all was the predetermined goal in the majority of schools in the South of Ireland. Community or lack of it did not enter into the equation as long as Religion was taught and enforced. According to the 1831 objective of uniting children in one system with their differing creeds it was presented in theory but in practice most schools continued to indoctrinate young people in Religious teachings. In terms of curriculum the main principle was that the schools should offer combined moral and literary instruction, the patron of each school would determine the form and content of religious instruction in the schools under his patronage (The History of Education) Notably children were instructed in the Catholic and Protestant schools separate to each other. In some instances protestant children attended catholic schools but were removed to other venues for religious instruction. Children in many schools suffered abuse in the name of religious teaching. As far as community was involved there is little evidence of it. Corporal punishment was often doled out for those students who for whatever reason did not conform to the norm, Special needs children, Autistic children and other deficient children were not recognised as

needing special care. All children who displayed any form of weakness academically were very often beaten for supposed laziness. It occurred for many that not being able to remember the religious instruction led to punishments which generally incurred more beatings. Nowhere were schools seen as wholesome communities in which children could thrive and were empowered. Fear factored in this community, fear of failure. Fear should never be the basis on which learning will occur. It is a well -known fact that love of learning is what is needed, to encourage and inspire students to engage more in their own education. I still struggle with this concept daily as I endeavor to complete the lengthy curriculum and yet develop a sense of enjoyment and pride in the learning process. Our schools must instruct and learn from the young people in our care. Dr.Theodore asked the question in Deweys School as a Community Are we more prepared for living as adults in society if we have learned how to become part of a community? (.p.14)

He further states that: Being part of a community requires you to work together even if dont particularly like your neighbours or agree with them. When you are working as a group one of the things you quickly realise is that each member is valuable and you must complete your part for others to continue their own work A good example of the school functioning as a community shows the entire class and school working together towards a common goal---they are working to accomplish something important. That is the importance of a community, or at least a good and decent community. Classroom environments need to make the student s feel welcome to share their ideas. This should not stop at the arrangement of desks. Dewey wanted the environment of the classroom to promote peer interactions and the stimulations students get from group work. He goes on to talk about classroom organisation, the desks and furnishings, the layout. The Author feels that children should be allowed to move around the classroom so that peer interaction can take place Furthermore he states that peer interactions are a strong part of learning. The number one way that students learn is from peer interactions A society is a number of people held together because they are working along common lines, in a\ common spirit, and with reference to common aims(Dewey,p.14) Dewey thought that, not only should a school teach children how to be part of a community, but it should also be a society itself

2.3 THE EDUCATION SYSTEM TODAY In 2006 Mary Hanafin TD, the then minister for Education and Science Addressed the ASTI annual congress with a speech entitled: Ensuring a Supportive Climate for Teaching and Learning in All Our Schools. Her opening words were:

My overriding goal in this job is to ensure that our education system enables all our young people to reach their full potential This is a well written, detailed yet very clear piece of writing. It in the outset reflects the main aim of a therapeutic community model. The intention of a therapeutic community is to empower the students to fulfil their potential within and throughout their years in the education system and carry this learning into their adult lives. Minister Hanafin states her intentions clearly and follows them up with methods of implementation. Many references are made to the school as a community and the need to involve the community outside the school, that of parents and others in the improvements suggested by minister Hanafin. Inclusion as stated by the speaker is an important focus as that is how communities are built by including all people present. I agree that all available resources should be made available to encourage this inclusion. A community is made up of people who support and trust as well as empower each other. There needs to be mutual respect and care for each individual member of the community at their own individual stage of growth However this speech is idealistic and doesnt take into account the recession we now find ourselves immersed in. All the resources that were promised back in 2006 are now being taken away albeit slowly. The economic downturn has had a detrimental effect on our young people. Special needs teachers are being withdrawn or their hours are cut back drastically. The lack of foresight here is startling when we read the promises made in 2006. Minister Hanafins focus on the special needs child is all too ironic when we look at the limited resources being made available to these children and how they are very low on the list of priorities today. That is not to say that Principals and staff place these children low on their priority list. It is the department of Education is at fault here. Her speech highlights the need for the speaker to receive adulation rather than being realistic in the face of economic climates and how they change. A community needs to be forward planning in order to ensure continuity for the young people in their care.

Mary Boyles ideas on Managing Behaviours in 2012 state that she recommends that teachers be up skilled to better deal with disruptive behavior in schools. Her awareness of the reality of life in some classrooms is refreshing. Behaviour as we know it is a form of communication and to help improve or turn around behaviour we must try to understand what is being communicated by the troubled child, why is he behaving like this. This is not an easy task even on a one to one or small group basis. Time, Patience and emotional availability are essential. With a classroom full of students up to maybe thirty, the chances of achieving this are slim and frustrating. Boyle suggests that a teacher who specialises in behaviour management be placed in schools. I think this is a futuristic idea and I am fully supportive of it. Although I have noticed a big improvement in schools becoming more of a community in the past twenty years or more, there is a pressure and demand on teachers to live and work with some dreadful behaviours. Without the knowledge that I now possess after such a short time studying the psychodynamic approach to behaviour I would be frustrated with the amount of bad behaviour one has to try and work with in a classroom situation while teaching academics. I feel the benefits of a teacher specifically trained to help students and teachers around behaviour could only lead to greater possibilities and empowerment of our youth. This is indeed the key to community involvement. Hanafins statement saying that this could be achieved in a three day seminar is displaying a lack of insight on the then ministers presentation. One cannot possibly reach a significant level of understanding of behaviour in a three day seminar. Perhaps she means three days every year or every term. I am aware as a teacher and as a student of the Masters in TCC that it will take a lot of time and finance to create the circumstances and people who will make themselves available to work with the badly behaved and investigate the reasons behind their behaviours in a view to exploring the crises within which these children are embroiled. In an attempt to move them on from whatever stage of growth they are at we must become aware of their individual needs. Their chaotic lives must be appreciated in order to empower these children to accept their unique beauty and wonder as part of the community of the whole world.

We cannot expect a child to work effectively in school if other issues are impinging on him. Maslows hierarchy of needs defines our needs as physical followed by emotional, then educational and finally spiritual. If the first two are not in place then the educational focus cannot be present Orfords Wrestling with the Whirlwind is a journal focusing on ADHD. She is seeking to answer the question Is there another way to tackle this educational and social and emotional need other than medication. Can we use the therapeutic approach when working with these children? Can we find out whats behind the behaviour? The parent finds a label and feels now they can medicate and blame something other than the early childhood issues for their sons erratic behaviour s. This journal is well written and is interesting in the way in which it searches for ways to help the child other than sedating him with tablets. Orford compares the way children cope with the ups and downs of life to the process involved in the construction of a ship in order that it can ride the waves and wrestle with the whirlwind This clearly relays to the reader the absolute terror and difficulty involved in dealing with ADHD from the childs perspective. How can I as a mainstream teacher possibly understand what is going on for this child? The shock tactic needed by us as readers is achieved. Orfords use of language is perfect and accurately impinges on our consciousness. The children are jumpy and overactive, and they find it difficult to give their attention to anything. They respond impulsively and without thought. They are typical troublesome children, and for them this can be quite an ordinary state of affairs Her use of language is vocal and definite here and leaves us in no doubt as to what these children have to deal with on an everyday basis. And even with this knowledge how can we possibly understand what ADHD means for children. Orford displays a good knowledge of what a sufferer of ADHD has to deal with. She knows her stuff and this is an extremely well written article from an established journal. Her insight is refreshing and alarming at the same time. Such children find themselves in trouble everywhere and their families despair of them ever settling down ,growing up and achieving ordinarily at school or in life (Orford:254)

Compare this to Mary Boyles statement that a three day seminar would present teachers with the tools needed to work efficiently and effectively with troublesome children (Orford: 254) Orfords insights go much deeper and indeed it is obvious that she has much more a It is my contention that there are few children who are classically hyperactive and need treatment, but that the symptoms of ADD/ADHD ARE often based on other difficulties and therefore that very careful attention to each childs situation is required if an understanding of the causes of his or her behaviour is to be reached(Orford:254) Despite the ubiquity of the symptoms they have only relatively recently found a clear place in the classification of psychiatric disorders,(Orford:254) She goes on to say that: Children who are insecure and anxious about problems in the family (marital disharmony, for example) may well find concentration difficult, for their minds are on these problems not their school work Orford makes use of studies by other authors on the same subject: Eric Taylor(1991), who is in the forefront of work on ADHD in this country advocates the use of Ritalin in some cases and also maintains that such pharmacological interventions be accompanied by psychological therapies.. This gives us a clear indication of her interest and the depth of her own studies on the subject of ADHD. In fact I feel it may be of great personal interest to her. She makes reference to Schores assertion (1994) of the mothers importance for the neural underpinning of the infants capacity for self- regulation Bowlby and Klein also get a mention when Orford refers to the relative importance of the internal state of the infant and of his experience of his environment. These references are essential to a good understanding of what Orford is attempting to relay to the reader. My experience of teaching children with these difficulties in a whole class situation is none too empowering. Unless an adult with an understanding of the real reason for the childs behaviours is placed in the class with the mainstream teacher it is improbable that any advancement can be encouraged no matter what a teachers knowledge of ADHD.

Not alone for this diagnosis but a child who displays a behavioural problem of any kind needs extra support especially of the emotional kind. A school I teach in at the moment in Co. Clare has children who came to my notice for different reasons. Georgina from Cornwall does not speak in school. She has not spoken since she was about 8. She was 13 when I met her. I was intrigued and concerned. My immediate reaction was I am going to help this child wherever and whenever I get a chance. She would write down answers to my questions, she would smile and laugh whilst interacting with other classmates but she never spoke. I found out that she spoke at home but something had happened in the home with her dad which silenced her. Georgina was taken out of class for special needs help each Friday. When I met her she asked me (on paper) why was she was removed from her class. She was obviously angry and hurting at being thought of as in need of help. She wrote down why must I be taken out when most of my class cannot even write a sentence! Following this expression of concern I spoke to her class tutor and asked for her to be allowed to remain in class as her being removed seemed like a punishment for not speaking. However I was then left with no way to spend time on my own with this child. This meant that it was more difficult to discover how I could help her. The advice I received from a child consultant was to allow Georgina time, to work psychodynamically with her and to wait. Another child who had been abandoned by her mother at the age of 5 or 6 was displaying attention seeking behaviours and from my limited understanding of attachment disorders i immediately recognised that Sheila was crying out for a mother .How was I to help her? She didnt make it easy as she disrupted all my classes and the other children found this very entertaining. I was frustrated and searched for ways of helping this child without ostracising her and making her isolation all the more intense. Those early days were difficult as I tried to be gentle yet teach a whole class and not rise to the behaviour displayed by Sheila. I took to speaking to her at the end of each session to enquire how she was feeling. If I noticed her being tired I would ask

if she was sleeping ok. She would say she hadnt slept well for a couple of nights. I then asked was she worried about anything. In retrospect I suppose there were so many things worrying her she didnt think to mention any particular one She just said no I dont think so but at least I engaged with her in some way and demonstrated concern, care and awareness that all was not well in her troubled world. I followed up on this the next day and checked in with her to see if she had had a better sleep. She said she had. I hoped that my attempts to hold her and provide somewhat of a secure base for her to express herself would empower this child in some small way. I am still working with these children and will continue to use the psychodynamic approach including the therapeutic principles as appropriate. In conclusion some recognised definitions of community are presented in this review as well as the principles of a Therapeutic Community. These principles are what the author is seeking to observe in the school community. The history of education has been outlined in order to understand why children learn more effectively in a therapeutic based setting as opposed to a behavioural setting. Punitive measures pressure children into working out of fear. This approach is detrimental to the emotional health and overall functioning of the young people. The final point that of the study of the education system today purports to relate how improvements in the relationship between teachers and the children in their care has improved and how schools are becoming more like communities where effort and personal struggle is attended to in an appropriate manner. The next chapter the Methodology will evidence how best the principles of the Therapeutic community can inform our mainstream school system.