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Innovation in Social Policy – the Case of the Therapeutic Community*

Published online by Cambridge University Press:  20 January 2009

N. P. Manning
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Abstract

Students of social policy have studied in some depth the fate of new ideas when they came close to inclusion in new policies, and especially new legislation. Less attention has been paid to the process whereby new ideas are generated, and the impact of advocacy on the future of simultaneous but independent innovation. Here, the therapeutic community, developed during the last war in response to largely neurotic difficulties in military personnel, is examined as a case study of innovation, and of the fate of innovation as a result of official support, and enthusiastic proselytization by committed practitioners.

Type
Articles
Information
Journal of Social Policy , Volume 5 , Issue 3 , July 1976 , pp. 265 - 279
Copyright
Copyright © Cambridge University Press 1976

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References

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8 This is only ‘potentially’ because the sociological study of social policy innovation is still in its infancy. Indeed two recent collections of case studies in this area rely heavily on a political science analysis: Hall, Phoebe, Land, Hilary, Parker, R. A., Webb, Adrian, Change, Choice and Conflict in Social Policy, London: Heinemann, 1975Google Scholar; Donnison, David et al. , Social Policy and Administration Revisited, National Institute for Social Work Social Services Library, London: Allen & Unwin, 1975Google Scholar, although chapter 12 in the latter provide a more sociological view of social policy innovation (pp. 293–300).

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39 This, as has been noted, included American connections. Interestingly the Americans did not develop the therapeutic community concept independently, which supports the interpretation that the catalytic impact of the war in Britain was an essential addition to an unsatisfactory hospital System and social science knowledge, both of which the Americans had. Indeed the Americans attempted hospital reforms after careful research, rather than innovating ‘on the run’, which resulted in more limited though broader changes.

40 Rees, (1945, op. cit.)Google Scholar records that initially there was considerable hostility to psychiatrists from other army personnel; but that success in tackling man-management problems earned the Army Psychiatric Services grudging acceptance.

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43 Op. cit.

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45 To separate. technique and values does not imply that technical development is valuefree, for the psychiatrist in attempting to normalize the abnormal immediately enters the realm of values, whatever his technique. Rather, to separate the technical from associated values merely means that the former shares the conventional wisdom of psychiatry.

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59 From unpublished data on referrals to Henderson Hospital.

60 Since the National Health Service reorganization the Area Health Authority has been pressing for evidence which proves its efficacy, and justifies its high staff-patient ratio. However the evaluation of therapeutic community practice presents certain problems: it is multi-dimensional, and research is often designed to investigate single dimensions; it combines efforts at both intra-psychic and behavioural change; most previous studies in this area have focused on process rather than outcome; even then outcome success is only one goal amongst many which have been and continue to change. For these reasons orthodox experimental designs do not work, and a more eclectic, flexible approach must be pursued. See for example, Clarke, R. V. G. and Cornish, D. B., The Controlled Trial in Institutional Research, London: HMSO, 1972.Google Scholar It is no doubt of significance for the relative decline of the therapeutic community that this evaluative work has not yet been adequately tackled.

61 Gralnick, A., The Psychiatric Hospital as a Therapeutic Instrument, New York: Brunner/ Mazel, 1969, pp. 91–2.Google Scholar