UBC Theses and Dissertations

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UBC Theses and Dissertations

Creating the therapeutic reality : an ethnographic account of an outpatient therapeutic community at a university psychiatric hospital Brown, John


This thesis is an ethnographic account of the daily life of an outpatient centre for the treatment of non-psychotic patients. The centre is located in a university setting and is nominally attached to a university mental hospital. The setting is described and the case is made that it normally allows for only two categories of participant: patients and therapists. The situated activity of these two groups in structuring the setting is a major focus of the work. The roles embodied in the two categories are described in detail and the way in which these roles interlock to create the social reality that is understood by the participants as a "therapeutic community" is set out. A belief system which is embedded in, and a determinant of each role is proposed. The practice of "doing therapy" is described and a preliminary formulation of this practice as a situated activity which depends on the social structure of the setting is attempted. A section which describes the observer's experiences in the setting is included as an appendix. It is argued that because the setting allows for only two classes of participant, the observer role is seen as deviant and that this leads to mistrust on the part of both sets of participants.

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