Duquesne University Duquesne Scholarship Collection Electronic Theses and Dissertations Winter 12-18-2020 The Haven: A Clinical Ethnography of a Farm-Based Therapeutic Community Monica Lawson Follow this and additional works at: https://dsc.duq.edu/etd Part of the Clinical Psychology Commons Recommended Citation Lawson, M. (2020). The Haven: A Clinical Ethnography of a Farm-Based Therapeutic Community (Doctoral dissertation, Duquesne University). Retrieved from https://dsc.duq.edu/etd/1939 This Immediate Access is brought to you for free and open access by Duquesne Scholarship Collection. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Duquesne Scholarship Collection. THE HAVEN: A CLINICAL ETHNOGRAPHY OF A FARM-BASED THERAPEUTIC COMMUNITY A Dissertation Submitted to McAnulty College and Graduate School of Liberal Arts Duquesne University In partial fulfillment of the requirements for the degree of Doctor of Philosophy By Monica A. Lawson December 2020 Copyright by Monica A. Lawson 2020 THE HAVEN: A CLINICAL ETHNOGRAPHY OF A FARM-BASED THERAPEUTIC COMMUNITY By Monica A. Lawson Approved November 16th, 2020 ________________________________ ________________________________ Daniel Burston, PhD Lori E. Koelsch, PhD Associate Professor of Psychology Associate Professor of Psychology (Committee Chair) (Committee Member) ________________________________ Kevin R. Smith, PhD Adjunct Associate Professor of Psychology (Committee Member) ________________________________ ________________________________ Kristine L. Blair, PhD Leswin Laubscher, PhD Dean, McAnulty College and Graduate Chair, Psychology School of Liberal Arts Associate Professor of Psychology Professor of English iii ABSTRACT THE HAVEN: A CLINICAL ETHNOGRAPHY OF A FARM-BASED THERAPEUTIC COMMUNITY By Monica A. Lawson December 2020 Dissertation supervised by Daniel Burston, PhD Therapeutic communities are communal spaces where individuals live for an extended period in hopes of recovering from personal crises, or while coping with severe mental illness. They provide a humanistic alternative to inpatient hospitalization. Although they are seldom studied, even less is known about farm-based therapeutic communities in the United States, where communal work is viewed as central to recovery. This dissertation examines the experience of living and working at the Haven. Originally conceived as a farm-based community where suffering individuals could experience reprieve from the demands of the “working world,” and heal by living in community, recent changes in the mental health field require the Haven to provide more clinical services to residents to remain viable. This transition has evoked a collective identity crisis for the Haven. iv After four months of ethnographic participant observation and 50 interviews with current and former residents and staff, it became evident that the Haven’s work program, formerly its primary treatment modality, was no longer sufficient to meet residents’ needs. In fact, residents overwhelmingly requested more clinical services. However, the Haven has embraced a medical model approach to the provision of clinical services, which is at odds with its humanistic history and aims. This fact is likely the cause of many staff members’ wariness regarding the growing clinical programming. This approach reduces residents’ agency, autonomy, and implicitly reduces the role of non- clinical staff as well. This dissertation explores the evolution of these changes and provides suggestions for how to reorient the Haven towards a restoration of community, revitalization of the work program, and an existential-humanistic orientation consistent with the values of the Haven’s original vision. v DEDICATION Interviewer: Do you identify as having a mental illness? Resident: I don't believe in the psycho-medical-mental complex. Psycho medical mental health process.... or the psychiatric complex. So yes, I have things wrong. Yes, I am different from most people and some of those things are faults. I think wherever you look [though] you can see that in everybody. *~* Staff Member: I want to thank you and appreciate folks like you, taking the time out of your life and part of your profession to come to a [this] place and offering your time. It gives me hope that, you know, my voice doesn’t have much of a voice here, but maybe it has a voice out there somewhere.” This dissertation is dedicated to the all of the individuals who look to, or reach for, the mental health system in times of distress, especially in light of the times the mental health system has failed us. In particular, I want to dedicate this project to the residents of the Haven who participated in my study. Thank you for sharing your time, lives, and thoughts with me. In the spirit of the above participants, every single one of us suffers distress and has unique ways of expressing and responding to that distress. As patients, clients, researchers, and mental health professionals, may we continue to advocate and work for a more humane and person-centered model of care that does not strip individuals of autonomy and humanity. vi ACKNOWLEDGEMENT I want to express immense gratitude to the Laurel County Public Library, in London, Kentucky. When I decided in November 2019 to move back to my hometown to focus on the dissertation after internship, I had no idea that the looming pandemic would shut down the very place I was depending on to write. Thankfully, the library reopened this summer and created a “WiFi patio,” where I practically lived from July 24th, 2020 until late fall. As someone who does not have internet access at home, the library is (and was) an invaluable resource, and this dissertation would not have been completed without their space and support. Throughout the writing process, staff came to speak with me and even offered me office supplies to help with the task. As the weather turned cooler, and without a place with reliable internet to hold a progress meeting and defense, the library graciously let me use their board room for both events, during a pandemic. I am an ardent supporter of public libraries and cannot sing the praises of the Laurel County Public Library enough. Thank you for your support throughout this process, and throughout my childhood. It’s been such an amazing experience to complete this dissertation at the place where I spent so many weekends as a kid, devouring books, and planting the seeds for this day. Thank you for being my haven. Kay Chai, there are no words to adequately express the importance and vitalness of our friendship throughout this long, and oftentimes, painstaking process. From ODL celebrations, to “never getting it all back,” and all of the chaos of life as a graduate student. I am indebted to your friendship and am grateful that Duquesne allowed our paths to cross. There I met a friend for life. I love you so much and am tremendously vii grateful for your support and love. WE DID IT. Now let the healing begin. Jack Jessup, thank you for the years of friendship and for many wonderful hikes, and bike rides throughout Pittsburgh and beyond. You’ve been a part of my PhD journey from the very beginning and listened tirelessly to me discuss this project over and over again. Thank you for listening, your great insights, and for providing me with the apt name, The Haven, for this therapeutic community. Most importantly, thank you for the laughter, support, and friendship that helped me maintain some sanity through this long and intense journey. I’m glad we survived 2016! ;) You can now call me Dr. Monica. Elizabeth Bennett, FINALLY! I finally finished the program! We did it as well! Thank you for all of the coffee dates, knowing looks, and support in graduate school and beyond. I am so grateful for our friendship and look forward to ongoing years of connection and collaboration. Amanda Harris, my longtime friend, thank you for always believing in me and cheering me on, especially when times were difficult and felt hopeless. I am so grateful for our years of friendship, and I hope post-PhD life means more time together. I’m so happy you are here to see this day with me! I love you so much, and I can’t wait for Vegas! Thank you for your fierce feminism. You are a light this world needs. Judy Harrison, it breaks my heart that you are not alive to see this day. You have been my number one support and cheerleader since my mother died. I can’t say thank you enough for everything you’ve done for me, and how you’ve believed in me through all that I have faced. Thank you for all of the “Dr. Lawson” pep talks and being the mother I needed, when my mother passed. I miss you every day. To my family, your support during the months I wrote my dissertation was viii invaluable. I cannot describe in words the gifts you provided during these last few months. Dad, thank you so much for providing me a place to live and work after my internship. After struggling for two years to work part time jobs, a fulltime internship, and try to write my dissertation, I knew the only way this project would ever be finished, is if I could devote myself to fulltime writing, and this was impossible as long as I had to pay rent. Not only did you give me a place to live for the last six months, you invested in ways to make the house more conducive to writing, when I was unable to work at the library. Thank you for the added LED lighting, and supporting me in having a quiet and private place to work. Also, thank you for valuing my work. Though our work looks very different, I so appreciate your acknowledgement that my writing time was important and necessary. Ali, you may not realize it, but all the hours I spent writing and not being able to hang out with you left me feeling sad too.