The case for ‘fluid’ hierarchies in therapeutic communities

Abstract

Purpose: Democratic therapeutic communities, use a ‘flattened hierarchy’ model whereby staff and clients are considered to have an equal voice, sharing administrative and some therapeutic responsibility. Using the sociological framework of interaction ritual chain theory, this paper explains how TC client members negotiated and enforced community expectations through an analysis of power within everyday interactions outside of structured therapy. Design: The study used narrative ethnography, consisting of participant observation with two democratic communities, narrative interviews with 21 client members, and semi-structured interviews with seven staff members. Findings: Findings indicate social interactions could empower clients to recognise their personal agency and to support one another. However, these dynamics could be destructive when members were excluded or marginalised. Some clients used their interactions at times to consolidate power amongst dominant members. Practical implications: It is argued that the flattened hierarchy approach theoretically guiding TC principles does not operate as a flattened model in practice. Rather, a fluid hierarchy, whereby clients shift and change social positions, seems more suited to explaining how the power structure worked within the communities, including amongst the client group. Recognising the hierarchy as ‘fluid’ may open dialogues within TCs as to whether, and how, members experience exclusion. Originality/value: Explorations of power have not specifically focused on power dynamics between clients. Moreover, this is one of the first papers to look at power dynamics outside of structured therapy.