A positive transformational place for adults is an intentionally created community, agency or program designed to improve the quality of life and level of functioning for its membership. To be effective it must follow the practices and principles found in naturally occurring formative institutions like the family, cultural and religious, communities and educational institutions. It should also follow the principles and practices of already existing and compelling Intentionally created transformational places. Depending on its goals a transformational place, can embrace a hierarchical organizational structure, the army, prisons, have cult like values and practices, the Branch Davidian’s or be positive place. To be a positive place it must espouse and foster humanistic values inclusive decision making, and a minimally stratified organizational structure. Fountain House a very effective psychiatric rehabilitation program located in New York City is such a place. Its goal is to help adults with serious mental illness re adjust to general community life, after hospitalization and to avoid additional hospitalizations. This article will focus on the elements of service provided to this population by Fountain House, in relation to their consistency with humanitarian values and the principles and practices found in naturally occurring formative institutions. An exploration that can yield the practice elements that should be useful to those program designers who recognize that place matters in transformational effectiveness and want to study its intrinsic components.
Practice Element One: Transformation requires a place that proclaims humanistic values and a significant relationship with a mentor
In a family, there are two related interactive factors that are influential in the development of a child. The nature and strength of the parent child relationship is one and the place we call family and home, characterized by a history, values, emotional tones, traditions and relationships is the other. Fountain House uses its staff to form significant relationships with its members in a place that has a history, positive emotional tones, values and relationships. The family the most powerful formative experience known and Fountain House, an effective transformational community, effects change in its membership, through a relationship type with staff and a relationship type with it as a place. Applying this observation to intentionally created transformational places allows me to assume that the nature and power of the transformational experience, will depend on the extent to which a special mentoring or counseling relationship, exists and the extent to which values, principles, sense of and identification with place is established. A bond with a mentor, without the opportunity to bond with a place and vice versa will be less powerful and ultimately less effective in achieving the goals of learning, relationship building and change that are necessary for a transformational place to be compelling and efficacious.
Although, it is possible to satisfy basic needs of people with serious mental illness with the help of a caring case manager, it is necessary to provide a place, if the goal is to increase self efficacy, improve cognitive functioning, motivation and self esteem. The former a service provider and the latter a provider of what is necessary to accomplish personal transformation. To change identity, build ego and ameliorate the negative symptoms of serious mental illness, all necessary to achieving the goal of successful readjustment to general community life and avoiding re hospitalization a person must identify and attach to a place in addition to having a interpersonal attachment with a caring case manager or mentor. An interpersonal attachment with a mentor alone is not sufficient. Not only because it incorrectly assumes that the general community can alleviate the isolation endemic to the illness, but also because the case manager has no opportunity, place or program tools to help a client, form relationships with others or increase the self efficacy and self esteem required for effective treatment and general community adjustment.
According to place theorist Marc Aug’e the argument between Place and what he calls non- place reflects the struggle between community, attachment, belonging emotional identification and a feeling of security represented by place and rugged individualism, isolation, impersonality and insecurity represented by non- place. Unfortunately as he looks at our culture he see’s non- places growing in popularity. Aug’e work on place is reminiscent of the early sociologists, such as Tonnies, Durkheim a Weber who studied this very same social dynamic as battle between community and individualism. Durkheim actually tied the decline of community support with an increase in suicide rates.
Practice Element Two: Choice is a humanistic value and principle that underlies all practices in adult transformational places. For example, deciding on if, how and when to be involved offers members a sense of personal autonomy and empowerment, vital for successful change.
Fountain House and most naturally occurring formative adult organizations, offer choice to their memberships. Although many activities in any type of formative organization require non voluntary adherence to its rules the degree to which choice is allowed within that context will contribute to the success of the members involvement. Certainly becoming involved or not is the potential members decision. The assumption being that the potential member will make choices that are in their self interest and that since the place functions in the self interest of its membership, the potential member will voluntarily agree to the involvement. This is not always true, even though they believe that membership is in their best interest they may be fearful or lack the motivation to act. In such situations strong outreach activities do not negate the place’s commitment to voluntary involvement
Practice Element Three: The allotted time for transformation to happen is determined by the individual, not the place
Some places that claim a transformative function, set time limits for membership.
This practice is instituted because their leadership believes that a time limit will expedite involvement and speed up the transformative process. This may or may not be true in a school setting or any transformative place whose membership are already motivated to change but not in a transformative place in which its members have varying levels of motivation or levels of functioning. Some non- place transformative organizations or agencies involved with a population similar to Fountain House offer their services to potential members who are already functioning on a high level. This allows them to claim success for a greater number in a shorter period of time. At Fountain House the level of motivation and functioning that members have at the onset of membership and their readiness to change are the dynamics that controls time, not some arbitrary policy created by the place. In a family children differ in their readiness to take on responsibility and these differences are generally respected by parents.
Practice Element Four : Lack of selectivity can create diversity and mutual self help among the membership which gives members an opportunity to participate by helping each other.
Since Fountain House is an intentionally created community it accepts all adults who suffer serious mental illness. Lack of selectivity requirements, in practice means that the membership will be composed of people with different levels of functioning, intelligence, talents, etc. Diversity in a voluntary adult community creates the opportunity for its members to help each other as well as the community itself. The degree to which this mutual self help happens goes a long way in determining effectiveness in creating change.
Practice Element Five: Membership is guaranteed regardless of the amount of participation at a given point of time.
Although a high level involvement by members is valued by formative and transformative organizations, the membership title is maintained regardless of that level. While some family members are very involved, others are only around for special occasions and holidays. In religious groups all levels of involvement and devotion are tolerated. In communities people take on varying levels of responsibility and in educational institutions a student can devote as much time as they want to course work or extra curricula activity.
Practice Element Six: The rights of the membership are guaranteed
All Naturally occurring formative entities that work with adults utilize a leadership group to provide its service, maintain a long term continuity of care and guarantee its institutional survival. Whether they’re called priests, teachers, community leaders, staff or department heads, these people are given power over the lives of their members. Recognizing human frailty, most naturally occurring formative entities provide a mechanism to check arbitrary decision making and the abuse of power by their leadership. At Fountain House the rights of the membership are guaranteed in a written set of rules called the standards. For example one of these standards states that ” a members desire to try ways triumph’s staff’s evaluation of their readiness.
Practice Element Seven: Inactive members are always welcomed back
Practice Element Eight: Transformational places reach out to members in times of trouble
Practice Element Nine: The greater the consensus the more empowered the membership
The members of Fountain House and all adult transformative and formative places have a voice in all decisions affecting them and the activities they participate in. Consensus in a formative place is the result of expressed personal opinion that is consistent with established goals, beliefs and values. In order for consensus to be reached open communication and information sharing is crucial.
Practice Element Ten: Needing the help of the membership improves its efficiency, legitimates membership, motivates participation and facilitates a sense of belonging.
When a formative and transformative place recognizes and relates to their members need to be needed, organizational efficiency and survivability are improved. It also motivates participation, confers dignity and puts the focus on the strengths of the membership. The subsequent participation by the membership then makes their sense of identity and belonging evident, substantial and legitimate, which in turn gives the place its supportive power.
Relating to this need in children is neglected and is a detriment in their socialization
Practice Element Eleven: The leadership in a transformational place function as generalists
Specialists offer skills that are needed in a transformative and formative place but the teachers the parents the staff, the department heads, the leaders, who function as the bearers of goals, beliefs, values and practices must be generalists. The generalists are the mentors, motivators, supporters, coaches and organizers who labor side by side with the membership and need their support
Practice Element Twelve: Transformational places are geographic and emotionally impactful. A non- place is not and therefore can not offer the support and protection necessary for success. ”
When looking for a good existential definition of place it is best to utilize the words of two place theorists who say it well. “A sense of place can sustain identity, provide connection to a personal and collective past thereby offering an emotional center which is rooted and anchored in meaning and value”(9 Ritbe ) “place proclaims the importance of the bonds between people, it is a physical and social location which denotes feelings of belonging and a sense of rootedness, it provides a pathway for negotiating the complexities of living.” (10 Casey). In a recent article by Dana March, analyzing place as possibly being involved in the etiology of severe mental illness, place was defined as “a reservoir of risk or resilience. As a reservoir, place consists of the natural and built environment, physical structures, and material resources that shape experience within a designated geographic location. The physical and social architecture of place both shapes and reflects relationships among individual inhabitants, social groups and social structures and institutions. Place thus harbors the dynamics of power varies by culture and changes over time. Given these characteristics, the study of social pathways requires consideration of place, since both risk and protective factors accumulate therein” It was Dr. March’s conclusion that if specific places could be found that explained etiological causation of severe mental illness it could provide clues for places that could assist in the amelioration of the problems faced by people with severe mental illness.
Practice Element Thirteen: Most space in effective adult transformational places are shared by the leadership and membership.
An adult formative and transformative place is more impactful the more that opportunity exist for the membership and leadership to interact. Spacial separation of leadership from adult membership intensifies the we -they feeling that interferes with the formation of significant relationships a key factor in the transformational process.
Practice Element Fourteen: The members need to be needed must related to in real and concrete ways.
As discussed in rule ten, the need to be needed is a key element in creating a transformational place. This requires creative practices and a willingness by leadership to involve their memberships in important activities . Finding ways to operationalize structures to accommodate a members need to be needed is crucial to their identification and sense of belonging with the place. When children are expected to participate in the work of the family and students are asked to contribute to the educational processes of their institution, they benefit from a heightened sense of belonging and a concurrent feeling of relevance.
Practice Element Fifteen: Participating in the work of the community legitimates membership and can be used to help members learn and change as long the work is voluntary and of benefit to both the member and the community.
Practice Element Sixteen: A transformational place exists in a general community and must maintain open boarders with that community. Isolation and segregation is cult like or a misguided attempt to protect membership
Practice Element Seventeen: The work, the organizational structure and the relationships function to facilitate the transformation of the membership. They are designed to help members develop or regain self worth, purpose and confidence.
Practice Element Eighteen: Employment in the general community is an important step in the formative or transformative process.
Practice Element Nineteen: Transformative places help their members achieve their health, vocational, educational and social goals.