Anti-therapeutic dimensions of a community meeting in a therapeutic milieu

A central feature of many inpatient settings, especially those that attempt to be "therapeutic communities," is the community meeting. Such meetings are often quite large and difficult to manage, and therefore susceptible to confusion and chaos. The present article documents the difficulties associated with a community meeting in a particular hospital setting, which is often psychonoxious for patients and debilitating of staff morale. The need to define achievable tasks that are commonly understood and agreed upon is addressed. The confusion and paralysis that results when roles are not clearly delineated is described, as is the destructive potential of not carefully managing the various boundaries that define the relationship between the community meeting and the context in which it is conducted. Finally, the danger of insufficient structure in a community meeting is illustrated. Suggestions for conducting successful meetings are offered.