9 - The Psychological Support Group

Summary

The therapeutic milieu in holistic rehabilitation

Holistic rehabilitation aims to create and operate within a therapeutic milieu, a supportive and therapeutic social context that is argued to support the process of change (Goldstein, 1942, 1959; Ben-Yishay, 1996, 2000). Ben-Yishay argues that this social context helps clients develop their sense of identity that they can then take back out into the world and other social contexts such as families, friends and work or college situations. At the Oliver Zangwill Centre (OZC) for Neuropsychological Rehabilitation, as with other holistic programmes, practices such as a daily community meeting, and an emphasis on group learning, contribute to the therapeutic milieu. In some programmes, the community meeting is used therapeutically as an opportunity for clients to feedback to one another regarding socially inappropriate behaviour, or successful use of coping strategies (e.g. Prigatano, 1999; Daniels-Zide and Ben-Yishay, 2000). At the OZC feedback between and to clients is supported in smaller group sessions such as the Communication Group and other functional groups, as described elsewhere in this volume. On occasion a more general discussion about expectations of one another's behaviour may occur during the community meeting. At the end of the week, the staff and intensive phase clients come together to review the points of learning from the groups and exercises completed over the week.