The structure

Our title sums it up  The therapeutic community is a middle ground, a relational and experiential space/time for a transition between recognizing needs, the more or less severe discomfort of the adolescent and recognizing evolutionary resources and potential.

The therapeutic community for adolescents is a place where the difficult social challenge of living together is compounded by the natural complexities of the aging and personal issues of the youth living there. We understand and explore it as a place of observational action that seeks to integrate education and therapy.

We see the therapeutic community as a living being, a new way of living relationships, an open system that sets boundaries, divides and connects with the social world, namely with families and loved ones of young people, public services , citizenship. . The management of the boundary is a critical and fundamental point that affects not only the treatment success of the therapeutic community and the containment of young people’s impulses, but also the processes in care, the osmotic modalities in action in the pathological families and influences the frequent bureaucratic closures of the treatment system.

The internal and external components of the network are integrated “each in their own way”, from the young people to the parents, from the sending services to the operators, and become protagonists of the project with different subjective characteristics. The treating network (social clinic) includes both the clinical managers of the therapeutic community and the sending area services: the fact that the public services are invited to regular meetings in the therapeutic community is an integral part of the intervention methods of the communities accredited to M&R and applies as an essential requirement for treatment. The therapeutic community is therefore a complex microsystem in constant motion, like adolescence, and consists of subsystems that relate to each other and are inserted into the social macrosystem: the intervention in the therapeutic community therefore includes both the relationship and the relationship between me and the group and that of the relationship between community and society.

In this “relational environment” we first try to create the conditions that allow each adolescent to flourish and gain “sufficiently healthy” life experiences, but also to accept their basic needs and traumatic suffering: that means being present in crises, episodes of Violence, boredom and crossing borders and striving  to walk the difficult path together, which can lead the client to a deeper self-confidence and to a lastingly satisfying autonomy.

Length of stay is a key concept; The teenage guests arrive, meet by chance, and then part. It seems important to us to make the provisional nature of this experience clear to residents, families and referring physicians as soon as they enter: This can make it easier for young people to carry out the sometimes difficult task of being able to live in community.

In fact, being removed from a young person’s family system is at the root of intense feelings of distress and severe separation anxiety. This makes us realize how delicate is the moment of entering the therapeutic community, which requires special attention.

The therapeutic community is often imagined in the fantasies of adolescents, their parents and society as a place for the “crazy” or “criminals” and therefore as a reality not suited to any of them. The comments of the young people, especially during the initial period of integration into the therapeutic community, are: “There are prison rules here: It’s disgusting, you can’t do anything about it”. Or, conversely, residents expect the community to be “a five-star hotel” where anything is possible and one can be “served and adored.” Operators are projectively endowed with the function of “watchmen” or “waiters” from time to time, with a constant pressure that makes it very difficult to maintain their professional role. From this perspective, the community has the fundamental function of being a container, a place where the disturbed and turbulent actions of clients collide and meet educational and therapeutic interventions.

The exchange between the inside and outside of the therapeutic community is a topic that is much discussed in the therapeutic community meetings and all staff are involved in facilitating an interaction process between these two dimensions. Today it can be generally assumed that the society’s contribution is very useful for the therapeutic community and its clients, who benefit greatly from the exchange with the region. We also believe that, in perspective, the values of the therapeutic community can also be influenced externally, since the community is a place where the observance of the rules of coexistence are “trained” and the democracy of roles, affections and attachments.

How one experiences the home that welcomes the community is another subject of constant reflection. In the way we relate to the house we try to integrate the artistic, poetic and aesthetic aspects with the therapeutic vision and pedagogical action. In fact, the house in which the community lives is understood as a collective body to be cared for, the great laboratory and container of the community. Teenagers typically bring their own internal chaos and turbulent history to the community and are consequently not interested in or familiar with housekeeping. The care team then seeks to encourage their ability to relate to home: keeping domestic, personal and shared spaces in order. Of course, as the sort of order that is tolerable for a teenager, this relates to what we might define as fairly disordered or juvenile order.

The way the adult caregivers/staff live in the home is also a fundamental aspect that can trigger a process of imitation from which a sense of belonging and respect for the home community can gradually develop. An empowerment process can only be started after an initial phase of bonding and trust development.

“The level of responsibility that is to be given to clients must be compatible with their abilities” This usually occurs during the last phase of stay in the institution, in which space is left for the widest possible self-management in order for it to achieve this Being able to experience and verify their degree of autonomy.

The tolerance level of frustration and gratification is the order of the day in the Adolescent Therapeutic Community: education to endure that one cannot have everything one wants, nor can one have it immediately, but at the same time one can have conditions and negotiations under certain circumstances, is considered to be one of the basic goals in the education and treatment of young people.