Where the change is: everyday interaction rituals of therapeutic communities

Clarke, Jenelle M. (2015) Where the change is: everyday interaction rituals of therapeutic communities. PhD thesis, University of Nottingham.

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Abstract

This thesis has been concerned with how everyday social interactions facilitate personal change in the lives of therapeutic community (TC) client members. TCs are planned social environments that aim to provide a safe setting whereby troubling relational patterns can be explored through confronting past trauma and dysfunctional interpersonal dynamics. All aspects of community life, particularly everyday social encounters, such as smoking breaks and meal times, are potentially therapeutic. Whilst there are have been numerous studies focusing on treatment effectiveness and clinical outcomes, there have been relatively few studies that explore how interactions during these potentially therapeutic informal periods facilitate personal change. Thus, everyday social encounters are not only underrepresented in the literature in terms of mechanisms of personal change, they remain poorly understood in practice.

Therefore, this research specifically investigates how everyday interactions support personal change by: examining the mechanisms of interaction rituals outside of structured therapy; questioning the function of peer-to-peer interactions; exploring how social interactions reflect TC values; studying the influence of power and social control that may exist; and looking to understand client members’ definitions of change. The study used a narrative ethnographic approach within two adult-democratic TCs, one residential and one a day community, for individuals with a diagnosis of personality disorder. Specific methods of data collection included over 700-hours of participant observation, in-depth interviews with clients and staff members and document analysis.

Drawing on Interaction Ritual (IR) theory, this study explores the role of emotions, feelings of inclusion and how power is used during everyday interactions. One of the key findings is that transforming negative emotions into positive long-term feeling occurs through the process of inclusion and solidarity. Crucially, community members will tolerate high levels of negative emotions if they feel included in the TC. Both communities had an overall rhythm to community life that provided the emotional tone and pace of each day. Importantly, solidarity and emotional rhythmic entrainment, the process by which individuals become in synch with one another, were crucial for establishing and maintaining inclusion and producing positive change outcomes. Where solidarity and entrainment are broken, communities will invoke restoration rituals to establish connection with the entire community in order continue working towards positive change. Additionally, interaction rituals highlight dynamics of power, authority, and social control within communities, particularly between client members. Several clients reported increased feelings of confidence and tolerance towards themselves and others as a result of participating in community life.

There are two main contributions of this research for IR theory and TCs. Firstly, IR theory has not been applied widely to the field of mental health. The thesis suggests clarifying the use of emotions to include an analysis of how negative emotions are sustained in successful interaction rituals. Secondly, for TCs, this research highlights the significance of times spent outside of structured therapy. Exploring personal transformations through the lens of interactions, rather than individuals, provides a multi-layered explanation of how change occurs.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Manning, N.P.
Winship, Gary
Keywords: Change (Psychology), Social interaction, Therapeutic communities
Subjects: H Social sciences > HM Sociology
R Medicine > RC Internal medicine
Faculties/Schools: UK Campuses > Faculty of Social Sciences, Law and Education > School of Sociology and Social Policy
Item ID: 29531
Depositing User: Clarke, Jenelle
Date Deposited: 09 Feb 2016 08:55
Last Modified: 13 Sep 2016 12:34
URI: http://eprints.nottingham.ac.uk/id/eprint/29531

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