Assessing the therapeutic impact of a community group on a secure hospital ward.

The constructs of ward staff and patients in a medium secure rehabilitation ward were assessed before and after an eight-month trial of a twice weekly community group. One of the aims of this group was to address day-to-day interpersonal issues and to encourage patients to take social responsibility for their actions and to learn to support one another. Another aim was to encourage staff and patients to consider the possibility of applying some therapeutic community principles on the ward. These aims were assessed using repertory grid techniques. The results were that over the eight-month pilot both staff and patient groups shifted towards viewing their ideal ward as a therapeutic community (TC). However qualitative information suggested that considerable difficulties arose in bringing about the necessary cultural changes. As a result both staff and patients felt confused and disempowered. Future attempts are highly recommended, however better resourcing, particularly in the form of employing a trained full-time individual to co-ordinate activities, is essential.