Types of large-group meetings in the therapeutic community: with special emphasis on the long-term unit

LARGE-GROUP meetings in which all of the patients and staff of a unit or small hospital gather together have been an invariable component of therapeutic communities since the time of Maxwell Jones (1953). Equally invariable is the finding in the large-group event in group relations conferences that work is extremely difficult to accomplish in the large group (Turquet 1975). Considering how much the large group is used in therapeutic communities, how many claims are made for its usefulness, and how many human resources are employed, only a modest amount of literature now exists on the large group in the therapeutic community. There is a paucity of systematic research on the topic (Trauer 1987), and except for a kind of ritualized staff wrap-up following the meeting, there is virtually no formal teaching about the meaning, goals or leadership of such meetings. In the literature to date are several overlapping proposals for typologies of community meetings according to the nature of the patient population, the nature of the tasks assigned to the meeting, and the optimal degree of structure for the meeting. The task of this contribution is twofold: first, to suggest a tripartite differentiation in the types of large-group meetings, which takes into account the authors' experience as well as previous literature; second, to suggest that these are pure types and that most settings require a mixture of two or three types. In particular we are interested in those meetings most appropriate to the long-term unit. It is our hope that a clarification of types will facilitate a more systematic approach to clinical, administrative and educational dilemmas.