An exploration into the processes of change in a non-residential “fusion” therapeutic community
An exploration into the processes of change in a non-residential “fusion” therapeutic community
Therapeutic communities (TCs) have been a longstanding intervention for individuals with complex mental health needs; however, there remains a lack of research into how UK-based TCs work to support their members. Modifications to TCs include the merging of “concept” and “democratic” TC practices, producing a “fusion” model. The aim of this study was to explore processes of change that occur within a community-based, non-residential “fusion” TC across two community sites. This was done through exploring lived experiences of active members and graduates of an established and a newer TC site. Eleven participants took part in online or face-to-face interviews. Interviews were analyzed using interpretative phenomenological analysis. Three themes emerged from the analysis: (1) Exploring the Authentic Self: Encouraged and Supported in Showing Emotional Vulnerability Within the TC (subthemes: “Nowhere to Hide”: Sharing With Others and Looking Back to Move Forward: Reflecting On Change and Self-Discovery); (2) Developing a Sense of Community: Learning to Navigate Relationships Within the TC (subthemes: “They seem to fit”: Building Connection With Others and Unravelling the Clashes: Holding Space to Manage and Tolerate Conflict); and (3) “Me to We”: The Lasting Benefits of the TC Co-Production Experience. Staff were integral in supporting change identified across all three themes. The findings highlight processes that could be implemented into existing TCs to support change for members and evolve the community structure. The study provides insights into how TC practice could be informed to accommodate the growing diversity of TC members and support staff development.
change, experiences, processes, qualitative research, therapeutic community
Fernandes, Candida
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Sivyer, Katy
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Berthollier, Natasha
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Maguire, Tessa
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Fernandes, Candida
775b1abc-dbc2-412a-a394-a9bd277d29aa
Sivyer, Katy
c9831d57-7d6b-4bb6-bb3c-770ea7f9b116
Berthollier, Natasha
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Maguire, Tessa
f720bf11-2227-470f-b9bf-b323a59e176c
Fernandes, Candida, Sivyer, Katy, Berthollier, Natasha and Maguire, Tessa
(2025)
An exploration into the processes of change in a non-residential “fusion” therapeutic community.
Qualitative Health Research.
(doi:10.1177/10497323251389791).
Abstract
Therapeutic communities (TCs) have been a longstanding intervention for individuals with complex mental health needs; however, there remains a lack of research into how UK-based TCs work to support their members. Modifications to TCs include the merging of “concept” and “democratic” TC practices, producing a “fusion” model. The aim of this study was to explore processes of change that occur within a community-based, non-residential “fusion” TC across two community sites. This was done through exploring lived experiences of active members and graduates of an established and a newer TC site. Eleven participants took part in online or face-to-face interviews. Interviews were analyzed using interpretative phenomenological analysis. Three themes emerged from the analysis: (1) Exploring the Authentic Self: Encouraged and Supported in Showing Emotional Vulnerability Within the TC (subthemes: “Nowhere to Hide”: Sharing With Others and Looking Back to Move Forward: Reflecting On Change and Self-Discovery); (2) Developing a Sense of Community: Learning to Navigate Relationships Within the TC (subthemes: “They seem to fit”: Building Connection With Others and Unravelling the Clashes: Holding Space to Manage and Tolerate Conflict); and (3) “Me to We”: The Lasting Benefits of the TC Co-Production Experience. Staff were integral in supporting change identified across all three themes. The findings highlight processes that could be implemented into existing TCs to support change for members and evolve the community structure. The study provides insights into how TC practice could be informed to accommodate the growing diversity of TC members and support staff development.
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CF_Qual Synthesis With Author Details_V2_accepted version
- Accepted Manuscript
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CF_TC Process of Change Research Submission_final_edits_Accepted_Changes
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Processes of Change_Figure 1_edited_CF
More information
Accepted/In Press date: 26 September 2025
e-pub ahead of print date: 24 December 2025
Keywords:
change, experiences, processes, qualitative research, therapeutic community
Identifiers
Local EPrints ID: 510039
URI: http://eprints.soton.ac.uk/id/eprint/510039
ISSN: 1049-7323
PURE UUID: 43ab7207-3ec0-4811-8885-295039761641
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Date deposited: 16 Mar 2026 17:40
Last modified: 17 Mar 2026 02:53
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Contributors
Author:
Candida Fernandes
Author:
Natasha Berthollier
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