Dialogue, conflict, Green care.

Dialogue, conflict, Green care.

How to practice democracy in therapeutic communities and society

Tusday 11 October 2022 | Florence + Online

The international network of democratic therapeutic communities INDTC, which proposes the conference, is a network that welcomes individuals, therapeutic communities, mental health services, associations and groups from different countries, who share the values of democracy, dialogue in mental health, in therapeutic communities and in the local community.

The proposed event “Dialogue, conflict, Green care. How to practice democracy in therapeutic communities and in society” is the result of on-going reflections of the international collective INDTC and the Italian board of directors on these issues. Such reflections have led to the organisation of several events in recent years, which have further developed the themes in question. In particular, the “International Meeting of Babel: The Democratic Therapeutic Community in the World, Today” which was held in May 2021. On that occasion, from the dialogue between participants from different corners of the world, the ‘difficulty of creating and maintaining democracy in non-democratic systems and places’ emerged as a theme of
common interest, which also became the theme of the March 2022 conference “How to practice democracy in non-democratic places and systems”.
In a historical period of great changes, also amplified by the Covid-19 pandemic, democracy is a value that we cannot take for granted not only in mental health services but in society in general.

Many questions come to mind: what is the direction democracy is moving towards? What are the values that define and motivate life within society and local therapeutic communities? Today more than ever, within a global context where institutions appear to have become more rigid and often regressed/old fashioned; and where democracy is at risk, therapeutic community culture and values, together with democratic participative practices can represent an opportunity, not only for therapeutic communities, mental health and psychosocial services but also for global and local communities. Today, more than ever, it is possible to revive the importance of terms such as democracy, dialogue, group, participation, responsibility and conflict management.

Hence the themes of today’s event: dialogue, conflict and green care. In particular, the theme of ‘dialogue’ arises from the importance that INDTC places on dialogical approaches such as Open Dialogue, Psychoanalysis Multifamiliare, democratic therapeutic community, in mental health and in the promotion of community well-being. The theme of ‘conflict’ is of crucial importance especially in light of the current war events that are unsettling the global stage. And, the theme of ‘green care’ dedicated to the acknowledgment and recognition of the crucial importance of the relationship between human beings and environment, as it has been explored in the recently published book edited by INDTC “Green Care. A contribution from therapeutic communities”.

PROGRAMME

The conference is scheduled for Tuesday 11 October 2022 from 09.00 to 16.30, in hybrid mode (Florence + online) and will be structured as follows:

  • 09.00 – 10.00  DIALOGIC OPENING By the international collective INDTC and the CD INDTC Italy
  • 10.00 – 11.30 THEMATIC SMALL GROUPS DISCUSSION/THEMATIC TABLES
  • 11.30 – 12.00  Coffee break
  • 12.00 – 13.00 PLENARY WITH REPORTS FROM EACH THEMATIC SMALL GROUP
  • 13.00 – 14.00  Lunch
  • 14.00 – 16.00  PLENARY WITH DRAFTING OF THE MANIFESTO
  • 16.00 – 16.30  CLOSING CEREMONY Italian management INDTC and introduction of Portuguese Board

THEMATIC TABLE

Table 1: Green care and terapeutic communities

Facilitators:
Marino De Crescente –Head of Central Italy Community and Visiting Project (Adults), Mito&Realtà, Vice President INDTC Italy
Luca Mingarelli –National Head of Therapeutic Communities (Minors), Mito&Realtà. President, Fondazione Rosa dei Venti Onlus, Italy

Table 2: How to practice democracy in no-democratic contexts

Facilitators:
Giuseppe Cardamone – Director of the Adult Mental Health Area; Director U.F.C. SMA Prato, USL Toscana Centro
Giuseppe Lunardo –Psychiatrist MDSM Caltagirone

Table 3: The use od dialogue and conflict in therapeutic and socio-political processes.

Facilitators:
Raffaele Barone – Psychiatrist, Director MDSM Caltagirone
Angela Volpe –Psychologist, Psychotherapist, Group Analyst; President, INDTC International Network

Amongst others: Anando Chatterij (IND), Peter Cockersell (UK), Rex Haigh (UK), Laura Liverotti (UK), Andrea Nicosia (ITA), Joao Pereira (PT), Marcelo Rodriguez (PT), Bruno Pinkus (ITA), Marta Vigorelli (ITA), Gary Winship (UK)

HOW TO PARTICIPATE

Participation in the conference is FREE, with compulsory registration, and will be used in hybrid mode (in-person and online).

The event will start in:

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The conference, in-person, will be held in Florence at Hotel Albani in via Fiume, 12 (250 meters on foot from the central station Santa Maria Novella) 

It is possible to participate online

SCIENTIFIC MANAGER

Giuseppe Cardamone – Director of the Adult Mental Health Area; Director U.F.C. SMA Prato, USL Toscana Centro

WITH A NON-CONDITIONAL CONTRIBUTION BY:

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Florence (also online) 10 October 2022 from 9.30 to 16.30

How to practice democracy in non-democratic places and systems

Virtual Event 

How to practice democracy in non-democratic places and systems
This event follows the “International Meeting of Babel: The Democratic Therapeutic Community in the World, today”. On that occasion, the dialogues between participants from different corners/parts of the world led to discover a theme of common interest to all; the difficulty or the possibility of creating and maintaining democracy within non-democratic systems and places.

In a historical period of great change, amplified by the COVID-19 pandemic, democracy is a value that we cannot take for granted within both mental health services and society in general.

Many questions come to mind: what direction is democracy moving towards? What are the values that provide meaning to life within society and local therapeutic communities?

Today more than ever, in a global context where institutions appear rigid and often old fashioned; putting democracy at risk, therapeutic community culture and values, together with democratic participative practices can represent an opportunity, not only for therapeutic communities, the mental health and psychosocial services but also for global and local communities. Today more than ever, we would like to re-launch the importance of terms such as democracy, dialogue, group, participation, responsibility and conflict management.

These reflections, through a group dialogue between voices from different territories, shall drive the event on the 22nd March 2022.

PROGRAMME

The Meeting will begin on Tuesday 22 March 2022 at 15.00 Italian time (2 p.m. English time), will last 3 hours and will be structured as follows:

  • 15.00 – 15.15  Introductory session conducted by the INDTC International Collective
  • 15.15 – 16.15  Small discussion groups
  • 16.15 – 16.30  Break 
  • 16.30 – 17.30  Large group meeting: feedback from small discussion groups and open dialogue – chaired by Angela Volpe and Joao Pereira
  • 17.30 – 17.45 Final plenary session: refelctive session chaired by small discussion groups’ representatives

HOW TO PARTICIPATE

Participation is free. To connect, simply download the Zoom Meeting platform (free) on your PC or smartphone.

The event will begin on Tuesday 22 March at 3 pm, Italian time

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* Optionally use this meeting ID 312 158 1543

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4th International Mental Health Meeting – From Symptoms to Stories | Lisbon 2021

4th International Mental Health Meeting – From Symptoms to Stories | Lisbon 2021

Romão de Sousa Foundation, in collaboration with ISPA – Instituto Universitário, is delighted to present the Fourth International Mental Health Meeting of Romão de Sousa Foundation on the 5th and 6th of November 2021 and Associated Events:

  • On the 5th of November (Workshops) we will have three Workshops dedicated to Relational Practice, Open Dialogue, Democratic Therapeutic Communities and Power Dynamics in Clinical Practice.
  • On the 6th of November (Mental Health Meeting with online transmission [registration required]) we will start with Professor Dainius Puras, Ex – UN Special Rapporteur on the right to physical and mental health  and prominent figure in the WHO rights based mental health movement. Then we have two Keynote presentations, one from Professor Peter Rober, family therapist and full professor at the Institute for Family and Sexuality Studies at Leuven University, who will speak about use of self of the therapist and the therapist’s inner conversation. Professor Jeremy Howick, philosopher and medical researcher, will present his work on the Oxford Empathy Program. There will also be three panels with new research and a number of cultural, social and artistic activities along the day.

The theme of the Meeting in Lisbon is “From Symptoms to Stories: epistemological revolution(s) in mental health care

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Babel Meeting. The democratic therapeutic community in the world today

Global Virtual Event 

Babel Meeting. The democratic therapeutic community in the world today

A moment of meeting and discussion on the period we are going through, in the different corners of the world and an opportunity to dialogue on common interests to be developed in INDTC.

HOW TO PARTICIPATE

The Babel Meeting will begin Friday 7 May 2021 at 3.00 p.m. English Time (16.00 Italian time) and will be structured as follows:

3.00 p.m – 3.35 p.m  Plenary

3.35 p.m. – 4.00 p.m. Small group

– 4.00 p.m – 4.35 p.m.  Final plenary with reports from the groups.

Participation is free and to access it is necessary to download the Google Meet platform (with the possibility of subtitles).

To register send email to: admin@indtc.org

Use the virtual room link of Google Meet (below) to access the platform:

With the participation of:

Albania, Canada, Croatia, Japan, India, England, Italy, Kazakhstan, Portugal, Turkey and the USA

The event will start on Friday 7 May at 3.00 pm English time

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«Tutta la terra aveva una sola lingua e le stesse parole. Emigrando dall’oriente gli uomini capitarono in una pianura nel paese di Sennaar e vi si stabilirono. Si dissero l’un l’altro: “Venite, facciamoci mattoni e cociamoli al fuoco”. Il mattone servì loro da pietra e il bitume da cemento. Poi dissero: “Venite, costruiamoci una città e una torre, la cui cima tocchi il cielo e facciamoci un nome, per non disperderci su tutta la terra”. Ma il Signore scese a vedere la città e la torre che gli uomini stavano costruendo. Il Signore disse: “Ecco, essi sono un solo popolo e hanno tutti una lingua sola; questo è l’inizio della loro opera e ora quanto avranno in progetto di fare non sarà loro impossibile. Scendiamo dunque e confondiamo la loro lingua, perché non comprendano più l’uno la lingua dell’altro”. Il Signore li disperse di là su tutta la terra ed essi cessarono di costruire la città. Per questo la si chiamò Babele, perché là il Signore confuse la lingua di tutta la terra e di là il Signore li disperse su tutta la terra.»

(Gen. 11, 1-9)

The narrative gives an account of why men split up on Earth and populated it; at the same time it mythologically explains the origin of the language differences between men.

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Considerations about the current situation in time of pandemic

Considerations about the current situation in time of pandemic

We are living a terrible situation. Tragic. Fear, anxiety, loss, desperation and depressive thoughts are just some of the feelings I experience at times. They come in waves, contrasting with hope, serenity and the capacity to feel pleasure with small, important routines and interactions.

At a social level it is catastrophic. The current impact of the quarantine and the loss of lives is already a reality. The economic and the wider social and cultural impact is yet to come. The consequences are unforeseen. The biggest economic collapse since the 1930´s? A door to totalitarianism? Biological terrorism?

At the same time, absolute power is now more relative. Everyone, every group, and every country is vulnerable. I am hopeful that the current crises, opens an opportunity to reflect on ourselves, the others and the World. There is a push for cooperation and compassion, to value friends and family, neighbours and small communities, local products, local production, local knowledge. Pollution has reduced, consumerism has declined, travelling has almost stopped. The planet was crying for compassion with climate change, for better rules in the neoliberal arena, for political cooperation, for global union, for global causes.

The crisis brings an opportunity for change, a real one, perhaps the last one. I am hopeful and fearful about the future.

At a professional level, 80% of my practice is now online. Many relational features are lost, but others (in a smaller amount) are gained, such as the possibility of monitoring our own behaviour by constantly looking at ourselves on the camera. I continue to visit Casa de Alba, a democratic residential therapeutic community I manage in Portugal, 2 or 3 times weekly. Life in the TC has changed dramatically, with rules for physical (not social) distancing, the use of masks by the staff, permanent disinfection, and other unforeseen rules. Impressively, residents are relatively calm, and staff is reacting professionally. So far we have no cases of covid-19. I feel similarly about the Democratic Therapeutic Communities as I feel for myself and the World. The crisis brings many losses to the life of the community, but it also brings new opportunities for reflection, cooperation and unity. The values of dialogue and democracy keep well alive, even the tuff contingency plans of covid-19 can be discussed and decided democratically in the TC, even if some decisions must be made by the staff alone. The concept of fluid hierarchy comes foreword in times of crisis. Staff has more knowledge and information on how to act, residents allow staff to create many of the current rules.

Hopefully, we will be able to learn and grow with what´s happening. And remember the year of 2020 as a dark, traumatic, but life changing (for the better) year.

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Underpinnings of the therapeutic community individualgroup dialectic, between clinical organisation and daily life

Underpinnings of the therapeutic community individualgroup dialectic, between clinical organisation and daily life

Abstract

This contribution offers a general overview that departs, above all, from a relationship with the Mito&Realtà network, and describes the underpinning of the community architecture, highlighting the basic arrangement and internal articulations that work together to achieve the clinical, rehabilitative and social aims that form its mission. The TC is presented as a complex organism and course of treatment defined in space and time, and that develops from an initial moment of reception (trial period, assessment process and rehabilitative therapeutic contract), into individual, group interventions (assemblies, meetings, various group typologies) and interventions with families, a phase of insertion, attachment and start of detachment from the social network. Great importance is placed on daily life and the climate as background for integration and transformation, beginning with the results of the international literature and recent infant research studies on processes of affective attunement, rupture and reparation.

 

Intro

The Therapeutic Community (TC) is a living organism, an orchestration of multiple instruments and players (workers, residents, family members, referrers, natural networks, etc.). An institution, therefore, aptly evoked by the above-cited image suggested by Anna Ferruta of a solid but light and mobile architecture. I will attempt, in this contribution, to describe the underpinning of this architecture, highlighting its foundations and the distribution of its interior spaces, which combine to allow it to accomplish its clinical, rehabilitative and social aims. Beyond its specific objectives, it is important to categorise the various therapeutic communities (TCs) according to their diverse features.

There are those for adult, adolescent and minor-age residents, psychotics, mothers and children, battered women, and so forth; typologies both long-lived as well as those that have sprung up recently across the country. An overview, in other words, prompted by knowledge of the communities of the Mito & Realtà network that, for some years now, have been elaborating indicators that could constitute a common denominator for an Italian “community model”.

Despite the diversity of types of underpinnings and organisation (privately accredited or public), they do share an initial fundamental: their democratic foundation. This consists of a distinct yet conversant clinical and administrative leadership, a staff that functions as a “followership” (1) that promotes and supports its multiple activities with a group co-responsibility oriented toward the integration (2) and maintenance of a safe and protective emotional/affective climate for residents and workers alike. (Correale 1990; Obhlozer, Perini 2001, Perini 2012; Ferruta 2012). Communities with clear confines but permeable and open to continuous theoretical/clinical encounter with other TCs and to integration with the local or broader regional, national and international social fabric (Barone, Bruschetta 2015). 

For those seeking integration, the therapeutic community offers a course of treatment with a definite time and space in which to develop that continuing dialect between individual intimacy and private listening and group experiences that foster encounter with the other (both symbolic and real) in the multiple behaviours and projects that continuously intersect in daily life. Thus, on the one hand, it offers a “custom-fit” evolutionary project with a personalised central reference point (caregiver or psychotherapist) aimed at cohesion, strengthening of the self and acquisition of the ability for reflection.

On the other, a group dimension that can increase a sense of belonging and responsibilization as the premise for a gradual receptiveness to connection with the social and family networks outside the TC. It is on this difficult co-existence and oscillation between the Self and the Other that the majority of the treatment’s efficacy depends, even with inevitable upsets that range from shut-down and withdrawal to enthusiastic and often explosive immersion (Napolitani, 1987). 

Residential treatment immerses us in a highly complex and multidimensional situation that requires a specific kind of organisation. Indeed, a patient in a community undergoes various “interventions” contemporaneously: psycho-pharmaceutical, individual and group therapy, psychosocial rehabilitation, family intervention, the influence of the milieu on the natural course of the disorder, contingent events, and so forth. It is therefore necessary in a TC that we speak of “therapeutic relations” rather that of the “therapeutic relationship” (Maone, 2011).

In any case, however, even for more serious patients, the quality of the interpersonal relations is revealed as the core of the practice, and favourable results stem from a wide range of settings and patient populations. Therefore, the question is to articulate these multiple settings flexibly according to the phase of the personalised and shared therapeutic course of treatment, utilising the potential of both individual and collective spaces fully. 

On what does the successful development of this individual-group dialectic depend? 

According to international studies (Priebe, Gruyters, 1993; McCabe, Priebe, 2004), and countless years of treatments administered and patients released, the prerequisites are the shared involvement of the patient, family, referral service and TC group in the project’s construction, and the therapeutic alliance that is forged in the preliminary phase that every community that calls itself therapeutic must seek to ensure…

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