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The authors of this book, which contains over forty contributions and is a follow-up to a congress with the same title held in Milan in 1996, here discuss the results of the revolution represented by therapeutic communities in psychiatry. The sub-title, ‘Between myth and reality’, emphasises the need to determine the extent to which the myths of the anti-institutional psychiatry of the 1960s are reflected in the practice of community psychiatry. On the basis of the notion that the term ‘therapeutic community’ has come to be surrounded by a mythical halo, a kind of ‘caravanserai’ of meanings, the book stresses the need to return from the excess of the sense of myth to reality, establishing a minimum common denominator from the many different experiences and developing a common conceptual basis from the integration of the reference models. The volume is divided into four sections. The first, which is historical and geographical in character, examines the historical background to the development of the experience of the therapeutic community in British, French and Italian psychiatry. The second analyses the therapeutic factors operating in community treatment and distinguishes between the various types of communities (for adolescents, for young adult psychotics, and for chronic psychotics). The book ends with a section on the problem of training of those who work in this field in their various tasks and another on the meaning that may be assumed by functionality evaluation processes in a psychiatric unit.
The revolution represented by the institution of the therapeutic community is one of a long line of ‘revolutions’ that have punctuated the history of psychiatry. The word ‘revolution’, we find, is used again and again to indicate the discontinuities and radical turning points where psychiatry broke with the past and new approaches to mental suffering opened up. In this sense, every revolution seemed capable of opening the way to apparently decisive therapeutic possibil