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S009-4

TaCIT: A Randomised Controlled Trial of Democratic Therapeutic Community
Treatment for Personality Disorder

Steve Pearce

Complex Needs Service, Oxford Health NHS Foundation Trust, UK

Background/Objective: Democratic therapeutic community (DTC) is a treatment method
originating in the UK in the 1940s, finding its most well known manifestations in the Henderson and
Cassel Hospitals, originally under Maxwell Jones and Tom Main respectively. This approach has
been used with prisoners, children with educational difficulties, people with intellectual disabilities,
and adults with personality disorder. The approach encourages empowerment, responsibility, and
authenticity, and famously operates with a flattened hierarchy between staff and members.
Practitioners have generally been resistant to the use of experimental methods to evaluate the
approach. We present the results of the first randomised controlled trial of DTC treatment for
personality disorder.
The objective of this presentation is to investigate the effectiveness of DTC treatment in the
treatment of adults with personality disorder.

Method: A randomised controlled trial of people with PD referred to a specialist PD community
treatment service in Oxford, UK. 70 participants were randomised to DTC or a brief crisis planning
intervention. Two year follow-up data are presented.

Result: At follow-up, fewer people in the intervention arm had an admission to hospital for
psychiatric treatment, the primary outcome measure. A range of other outcomes were also improved
compared to control treatment.

Conclusion: The experience in China will be shared.

Reference: Barr, W., Kirkcaldy, A., Horne, A., Hodge, S., Hellin, K., & Gompfert, M. 2010,
"Quantitative findings from a mixed methods evaluation of once-weekly therapeutic community day
services for people with personality disorder", Journal of Mental Health, vol. 19, no. 5, pp. 412-421.
Campling, P. 2001, "Therapeutic communities", Advances in Psychiatric Treatment, vol. 7, no. 5, pp.
365-372.