Soteria Programme

Click on title to go to section:

Introduction
Publications
Research and Practice
Videos and Presentations
Organisations
Links


Introduction

Soteria is a community service that provides a space for people experiencing mental distress or crisis. Based on a recovery model, common elements of the Soteria approach include primarily non-medical staffing; preserving resident's personal power, social networks, and communal responsibilities; finding meaning in the subjective experience of psychosis by "being with" clients; and no or minimal use of antipsychotic medication (with any medication taken from a position of choice and without coercion).

The original Soteria Research Project was founded by psychiatrist Loren Mosher in San Jose, California in 1971. A replication facility ("Emanon") opened in 1974 in another suburban San Francisco Bay Area city. Loren Mosher was influenced by the philosophy of moral treatment

Soterias were open — they had no restraint facilities for young psychotic patients, mostly at their onset. Loren Mosher, who founded the Soteria experience, showed that treating psychosis also in the acute phase is possible without using restraint methods.

Soteria houses are often seen as gentler alternatives to a psychiatric hospital system perceived as authoritarian, hostile or violent and based on routine use of psychiatric (particularly antipsychotic) drugs. Soteria houses are sometimes used as "early intervention" or "crisis resolution" services.

Soteria or Soteria-based houses are currently run in Sweden, Finland, Germany, Switzerland, Hungary and some other countries.

Back to top


Publications (date ordered)

Soteria: Through Madness to Deliverance Loren R. Mosher, Voyce HendrixXlibris, 2004 Soteria was a community-based therapeutic house for helping people diagnosed with schizophrenia to move forward in their lives. It was based in the US, and developed primarily by Dr Loren Mosher, first author of this book, whose work was strongly influence by R. D. Laing and his developments at Kingsley Hall. The book gives a detailed account of how the Soteria project developed, how it was run, and the main treatment principals. What is particularly unique about Soteria is how rigorously it was evaluated, and there are details of the research projectst in this book. The therapeutic approach used in Soteria was an 'interpersonal phenomenological' approach, similar in many ways to the work of Laing, with an emphasis on helping clients to re-form authentic relationships with those around them and find supportive and loving relationships. From the research that is presented, the approach seems to have been as effective as more medication-based treatments, which is extremely encouraging for the development of treatments for 'schizophrenia'.

Back to top


Research and Practice

A Systematic Review of the Soteria Paradigm for the Treatment of People Diagnosed With Schizophrenia Tim Calton, Michael Ferriter, Nick Huband and Helen Spandler Schizophr Bull. 2008 Jan; 34(1): 181–192 The “Soteria paradigm” attempts to support people diagnosed with schizophrenia spectrum disorders using a minimal medication approach. Interest in this approach is growing in the United Kingdom, several European countries, North America, and Australasia. Aims: To summarize the findings from all controlled trials that have assessed the efficacy of the Soteria paradigm for the treatment of people diagnosed with schizophrenia spectrum disorders. Methods: A systematic search strategy was used to identify controlled studies (randomized, pseudorandomized, and nonrandomized) employing the Soteria paradigm to treat adults and adolescents meeting the criteria for schizophrenia spectrum disorders according to International Classification of Diseases and Diagnostic and Statistical Manual for Mental Disorders criteria. Results: We identified 3 controlled trials involving a total of 223 participants diagnosed with first- or second-episode schizophrenia spectrum disorders. There were few major significant differences between the experimental and control groups in any of the trials across a range of outcome measures at 2-year follow-up, though there were some benefits in specific areas. Conclusions: The studies included in this review suggest that the Soteria paradigm yields equal, and in certain specific areas, better results in the treatment of people diagnosed with first- or second-episode schizophrenia spectrum disorders (achieving this with considerably lower use of medication) when compared with conventional, medication-based approaches. Further research is urgently required to evaluate this approach more rigorously because it may offer an alternative treatment for people diagnosed with schizophrenia spectrum disorders.

Soteria – no restraint system in Italy Lorenzo Toresini, NEUROLOGIA CROATICA Vol 56, Suppl 5, 2007 The Soteria experience was founded by Loren Mosher in California at the ‘70ies. Soterias were open – no restraint facilities for young psychotic patients, mainly at their onset. Loren Mosher demonstrated that it is possible to treat psychosis also in the acute phase without utilizing restraint methods. In Italy Franco Basaglia began refusing binding patients at their beds in the Lunatic Asylum of Gorizia in the year 1961. He also abolished any isolation method. From this initiative begun a wide theoretical and practical debate in the whole Italy. Restraint started to be considered as an ethical question, rather than as an objective need of public order in the hospital. The whole psychiatric question was seen as a balance between the right to be cured and the defense of society from the disturbing people. It became clear that until then the defense of the society had been prevailing on the right to cure. Such a huge debate led to the endorsement of a national Reform bill in the year 1978, which provided the gradual but radical dismantling and closure of the psychiatric hospitals all over the Country. This process is still being implemented today. The former Psychiatric Hospitals where everywhere substituted by a range of alternative facilities. Mainly outdoors, open facilities, work facilities a. s. f. For those patients who required a hospitalization there have been opened a number (321) small Acute Hospital Wards. The latter can per low guess no more than 15 beds. Even if not everywhere, in many places (30%) such acute wards are run without restraining any patients. In a few of them the ward is run with the door open. At the end it has become clear how dismantling the structures leads to the dismantling of the illness itself.

Soteria and Other Alternatives to Acute Psychiatric Hospitalization A Personal and Professional Review Loren R Mosher M.D, The Journal of Nervous and Mental Disease 187:142-149, 1999 The author reviews the clinical and special social environmental data from the Soteria Project and its direct successors. Two random assignment studies of the Soteria model and its modification for long-term system clients reveal that roughly 85% to 90% of acute. and long-term clients deemed in need of acute hospitalization can be returned to the community without use of conventional hospital treatment. Soteria, designed as a drug free treatment environment, was as successful as anti-psychotic drug treatment in reducing psychotic symptoms in 6 weeks. In its modified form, in facilities called Crossing Place and McAuliffe House where so-called long-term “frequent flyers” were treated, alternative-treated subjects were found to be as clinically improved as hospital-treated patients, at considerably lower cost. Taken as a body of scientific evidence, it is clear that alternatives to acute psychiatric hospitalization are as, or more, effective than traditional hospital care in short-term reduction of psychopathology and longer- social adjustment. Data from the original drug-free, home-like, non-professionally staffed Soteria Project and its Bern, Switzerland, replication indicate that persons without extensive hospitalizations (<30 days) are especially responsive to the positive therapeutic effects of the well-defined, replicable Soteria-type special social environments. Reviews of other studies of diversion of persons deemed in need of hospitalization to “alternative” programs have consistently shown equivalent or better program clinical results, at lower cost, from alternatives. Despite these clinical and cost data, alternatives to psychiatric hospitalization have not been widely implemented, indicative of a remarkable gap between available evidence and clinical practice.

Back to top


Videos and Presentations

Back to top


Organisations

Soteria Network UK A network of people in the UK promoting the development of drug-free and minimum medication therapeutic environments for people experiencing 'psychosis' or extreme states. Part of an international movement of service users, survivors, activists, carers and professionals fighting for more humane, non-coercive mental health services. People who hear voices, have visions or experience reality in different ways to those around them — and become overwhelmed by their experiences — are often referred to as experiencing 'psychosis'. Soteria UK believe that people can and do recover from difficulties which tend to be categorised under the term psychosis. This recovery can be with, without and sometimes despite psychiatric intervention.

Back to top


Links

Mosher Soteria website: Schizophrenia without anti-psychotic drugs and the legacy of Loren Mosher

Soteria (psychiatric treatment) From Wikipedia, the free encyclopedia

Back to top


 

Leave a Reply

Translate »