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Fountain HouseCreating Community in Mental Health Practice$
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Alan Doyle, Julius Lanoil, and Kenneth Dudek

Print publication date: 2013

Print ISBN-13: 9780231157100

Published to Columbia Scholarship Online: November 2015

DOI: 10.7312/columbia/9780231157100.001.0001

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Issues in Relationships

Issues in Relationships

(p.125) 7 Issues in Relationships
Fountain House

Alan Doyle

Julius Lanoil

Kenneth J. Dudek

Columbia University Press

This chapter analyzes four ethical issues arising from member–staff relationships at the Fountain House. The first is about the boundaries in recovery relationships: where conventional social workers often distance themselves from the patients, no such distance exists at the Fountain House. The culture of the Fountain House is in meeting these patients in all domains of their lives. The second issue illustrates the usual method in dealing with psychotic patients: by making physical gestures that will calm the patient, by avoiding any discussion of the past, and by focusing on controlling the situation. The third issue considers dependent patients who have already lost their sense of self-efficacy. The staff have to constantly judge whether or not a given expression of dependency remains necessary at the moment. The last issue is about what circumstances will permit the exclusion of patients from the Fountain House. Patients are often excluded due to attendant behaviors over which they have control.

Keywords:   member–staff relationships, Fountain House, self-efficacy, psychotic patients, dependent patients, social workers, dependency, exclusion

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