Grendon and the emergence of forensic therapeutic communities: developments in research and practice

This book describes the development of prison therapeutic communities (TCs) and also offers descriptions of the work that happens there, either qualitatively or quantitatively. It contains a rich variety of perspectives: some chapters describe the experience of different groups of prisoners in TCs, and others describe the work of therapists, such as arts therapy or drama therapy. There is an especially valuable research section in which a number of studies that demonstrate the effectiveness of the TC intervention in terms of enhancement of empathy and the reduction of antisocial attitudes and behaviors are reported. I warmly recommend this book to all forensic practitioners. I think it is not fully appreciated that forensic psychiatric services owe a debt of gratitude to the TC paradigm. The origins of the psychiatric treatment of offenders in both prisons and secure psychiatric units lie in a TC principle: that our social identity is part of what makes us human, and if we lose that, we suffer, go mad and die early. Offenders are people who have disconnected themselves from their social worlds; and for those who are mentally ill or severely personality disordered, this has happened twice over. The TC model can also be seen as the forerunner of the biopsychosocial model and the recovery paradigm. These models have in common not only a respect for individual autonomy, but also an understanding that this autonomy consists of multiple elements woven into a narrative of experience. One of those elements is our relationships with other people; and the TC model was arguably the first to suggest that acting antisocially had a meaning that was social and not just an expression of individual psychodynamics. Indeed, I would go so far as to say that the development of prison TCs helped us to understand that people who break the rules are acting ‘‘anti-the-social,’’ i.e. they are unconsciously making a statement about their relationship with the larger groups that they relate to: gender, ethnicity, family, and local community. I am thinking here of a man who killed several members of his family in the context of some very odd beliefs about the world and his place in it. After some time in prison, he came to a secure hospital, where it quickly The Journal of Forensic Psychiatry & Psychology Vol. 22, No. 4, August 2011, 620–627