WELCOME TO THE COMMUNITY OF COMMUNITIES

10TH ANNUAL FORUM 2012

The Community of Communities Update2011-2012

Sarah Paget

Membership 2011-2012

31%

15%39%

8% 8%

80 MembersADTC HMP CYP Addiction LD

Membership Trends

Year 1

Year 2

Year 3

Year 4

Year 5

Year 6

Year 7

Year 8

Year 9

Year 10

0102030405060708090

100

Members

Members

2011-2012Headlines

• 54 peer-reviews taken place• 12 HMP TC Audits• 3 Accreditation Visits• Revision of HMP Standards, Democratic and Addiction • Involvement of HMP Addiction TCs• Increased learning across sector and client groups• Cheerio to Rex, Hello Rex• New Team

• Steve Pearce • Josie Thorne• Natalie Fildes

Performance of TCs against the standards

1. Core Standards 2. Areas of special attention3. Data is presented in National Report 2011-2012

• Based on 56 TCs• Struggle comparing standards across networks• Complexity of processes e.g. Accreditation affects

data – not all or different standards reviewed4. See upcoming National Report for full details

• 15 standards

• Operationalise the Core Values inherent in Therapeutic Community work

• Reviewed by all members of the Community of Communities

• % based on number of TCs meeting the standards

Core Standards

CS 1 The community meets regularly

CS 2 The community acknowledges a connection between emotional health and the quality of relationships

CS 3 The community has clear boundaries, limits or rules and mechanisms to hold them in place which are open to review

CS 4 The community enables risks to be taken to encourage positive change

CS 5 Community members create an emotionally safe environment for the work of the community

CS 6 Community members consider and discuss their attitudes and feelings towards each other

CS 7 Power and authority in relationships is used responsibly and is open to question

CS 8 Community members take a variety of roles and levels of responsibility

CS 9 Community members spend formal and informal time together

CS10 Relationships between staff members and client members are characterised by informality and mutual respect

CS 11 Community members make collective decisions that affect the functioning of the community

CS 12 The community has effective leadership which supports its democratic processes

CS 13 All aspects of life are open to discussion within the community

CS 14 All behaviour and emotional expression is open to discussion within the community

CS 15 Community members share responsibility for one another

Performance against the Core Standards

CS 1 CS 2 CS 3 CS 4 CS 5 CS 6 CS 7 CS 8 CS 9 CS10 CS 11 CS 12 CS 13 CS 14 CS 150%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

% Not Met% Partly Met% Met

Performance against the Core Standards

CYP ADTC HMP0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

% Not met% Partially met% Met

Performance against the Core Standards

CS 1 CS 2 CS 3 CS 4 CS 5 CS 6 CS 7 CS 8 CS 9 CS10 CS 11 CS 12 CS 13 CS 14 CS 150%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

CYP % Met

ADTC % Met

HMP % Met

Average % Met

Performance against the Core Standards

Overall a small improvement seen for the Children and Young Peoples TCs (80% met 2010-2011) and a slight fall in performance for Adult Democratic TCs (88% met 2010-2011)

Notably ADTCs struggle with:• Setting and maintaining boundaries (60%)• Sharing responsibility for each other (68%)

• HMP TCs:• Informal time (50%)• Sharing responsibility for each other (66%)

• All CYP TC above 70%

Strengths and Challenges

Network

Total number of standards

No Standards above 80%

% above 80%

No standards below 60%

% below 60%

CYP 117 64 55% 11 9%ADTC 98 50 51% 12 12%

STAFFING ADTC CYP

2.1There are enough staff members for the community to operate effectively 56% N/A

2.1.1During informal therapeutic activity there is at least one member of staff available and others available if needed 82%

N/A

2.1.2

During the formal therapeutic programme there is at least one member of staff in each group and activity and others available if needed 100%

N/A

RESEARCH ADTC CYP

5.4.2 The community has a structure for considering and disseminating current research 50% 63%

5.4.4Staff and client members are given time to write and publish papers concerning therapeutic communities, and present at and attend conferences

43% 40%

4.5.4 There are opportunities for children and young people to become actively involved in research N/A 42%

5.3.4The community routinely collects data via environmental measures in order to demonstrate therapeutic qualities of the community (e.g. WAS/COPES, GAS, RESPPI)

31% N/A

4.5.3The community is currently participating in a research project concerning effectiveness as a therapeutic community

67% 42%

4.4 The community contributes to building an evidence base for TC practice N/A 47%

5.3.3The community routinely collects psychometric data in order to demonstrate severity and complexity of client member problems (e.g. CORE, Brief Symptom Inventory, PDQ, SCID, IIP)

85% N/A (61%)

Learning and Sharing ADTC CYP

2.9.3 Induction training includes a visit to at least one other therapeutic community 56% N/A

3.7 There is a culture of learning and sharing with other therapeutic communities N/A 40%

3.7.2The community provides training placements for students and post-qualifying professional development opportunities for qualified practitioners

100% 50%

3.6.1Staff have the opportunity to experience being a client member of a therapeutic community (e.g. ATC ‘Living-Learning’ Residential Workshop) 59% 35%

2.4.4 There is a regular staff sensitivity or dynamics group 88% 53%

3.6.2 Staff are encouraged to undertake their own personal therapy N/A 50%

Achievements

Unsurprisingly perhaps, all TCs meet standards relating to:

• Involving service users• Encouraging expression of feelings• Building relationships and emotional

containment• Formal and informal learning• Service users consistently report that

experience of being in a TC is “life changing”.

Issues to be addressed in 2002

Empowering Decisions**

Sharing Managerial Information

Complaints dealt with in Groups

Rules changed by community

Well designed with facilities

Enough Staff to meet Needs

Operational Policies agreed by all

0 10 20 30 40 50 60

57

56

56

54

43

39

32

2002

2002

Aims - 2002

To provide• a distinctively TC framework for quality

improvement• a systematic forum for exchange• a cost effective and time efficient system

of quality improvement• regularly revised and agreed service

standards• a body to influence statutory regulation

1. We are still here and learning2. Standards for all TCs3. Continued enthusiasm and involvement of

members4. Developing a simple and well defined framework

of Values and Core Standards for all communities5. Developing TC thinking across a range of services 6. Improvements in TC practice -Accreditation7. Developing cross network learning8. Recognition by some external regulatory

structures – CSAP, commissioning bodies9. Annual Forums

Areas of Achievement

1. Responding to the needs of different types of TCs – mini TCs, addictions

2. Improving administrative inefficiencies3. Improving dissemination of achievements e.g.

publications and papers4. Helping TCs address persistent difficulties e.g.

research5. Improve communication between members6. Further lobbying of external legislators and

regulatory bodies7. Streamlining standards and methods

Areas for Improvement

C of C Commitments for 2012-2013

1. Improve and streamline standards and methods – Standards Workshop 9th November 2012

2. Training Issues • Support shared learning opportunities – workshops,

improve website and discussion• Improve service user involvement - Newsletter • Core Competencies for TC staff• Develop Training TCs this year

3. Research1. Work with TCTC to help develop realistic options –

Workshop 3rd July2. Improve use of service data collected by all TCs and

report on this in next year’s National Report.4. C of C to improve feedback opportunities on standards,

process and methods

Members Feedback

What a fantastic experience we all had in Dublin, networking and team building!

I think it will take sometime to fully evaluate some of the issues that our reviewers explored… it was enriching as our reviewers’ experience of different approaches celebrated some of the things we took for granted, suggesting new avenues to develop and above all shared their ability to listen, drawing (us) into that self reflective and evaluative space that is where I believe TC’s should reside.

The Community of Communities has been an exciting process to validate the ethos of (our) approaches and make further explicit those values both to new members and for others.

It was fantastic! The whole day was open, real, looking at core values and issues that make these models unique. The review team were really supportive and their skills and experience surrounding some of the issues we currently face enabled us to plan a way forward, as a community.