I think it important to quote some passages of this text for the considerations and reflections that can be drawn from them:

".......Our best educators were very different one from the other in terms of education, previous experience and interests, and they came from different professions. They included: an elementary school teacher, a social worker, a sacristan, a trainer and a director of a reformatory, wardens (male and female) of a detention centre, an employee at an institution for public welfare, a prison social worker......; we think that the kind of vocational training they received and their previous experience have a relative importance in comparison with their ability to assimilate experience and respond in a precise and spontaneous manner to the events of life." Later Winnicot adds: ".....Our present children's homes are not suitable for those children who are generally physically healthy and need prolonged treatment by educators expressly selected for this aim.......Moreover, the nurses who work in children's homes are not right for the assignment because of the kind of vocational training they received, and many paediatricians tend to be closed-minded when it comes to psychology" (D.W. Winnicott, "Deprivation and Delinquency" - The Winnicott Trust, 1984)

The first question that comes to my mind is this: is then a natural selection that limits itself to receiving those who are naturally endowed with these qualities better, or is training necessary?

Furthermore, Freud himself spoke about three impossible activities: educating, governing, analysing (S.Freud, "Terminable and Interminable Analysis", Complete works - Vol II - Boringhieri, Turin.)

Occasionally one sees T.C. workers who, as their experience and knowledge increase, seem to lose the sponteneity with which they were first gifted. Should one conclude then that training tends to change what is natural into something artificial? I think it is more realistic to acknowledge that today we have at our disposal knowledge and instruments of such a degree of complexity that we must make allowance for these. Thus it seems to me that the question becomes: how should this knowledge and these intruments be used to enrich people rather than make them arid, to preserve naturalness and sponteneity in those who possess these qualities and to enable those who do not to acquire them?

In my paper I wish to avoid expounding upon abstract theories about the training of Community workers, finding it easier to make hypotheses based on what Community experience has taught me through daily practice, the successes and failures, the patients I worked with and for, their various destinies and the heritage of reflections, comparisons, and differences of opinions with the colleagues who shared this experience with me.

In order to better understand what I have to say it is necessary to bear in mind the particular context in which the Italian T.C. and the vocational schools operate, and their criteria.

In Italy, in fact a strong Community culture does not yet exist, as it does in England. The few original experiences that were inspired by those of the English and the French came to an end around the period 1965 - 1975, while, in the '80's, as a result of the reform of the 180 law, a number of initiatives sprang up, some of them interesting (unlike others which are Communities in name but not in fact.)

The need for the training of Community workers encounters some difficulty as a result of the lack of clear theoretical models and of a sufficiently consolidated historical and cultural background. To further complicate the problem there is also the fact that most Communities accept a variety of types of patients, including those with serious pathologies (border-line, serious narcissistic disorders, but especially psychotics), and a certain number of patients who, having been discharged from a mental hospital, continue to need appropriate residential care, bringing with them the added complication of the effects of many years spent in a mental asylum. While on the one hand this does not allow for easy improvisation or simplistic solutions, on the other it finds most of the Community staff unprepared.

To return to myself: my experience in T.C. has developed in various directions. At the beginning (1971-1976) it involved a Community for young psychotic patients which followed a psychodynamic model, then, in 1983, a Community project for chronic psychotic patients which sought to create an integrated model of treatment. Subsequently I worked in a private mental hospital; currently I am the supervisor of a group of workers in a Community for adolescent patients. Over the last year I have also led larger groups of workers in an ex-mental hospital managed by a religious organisation engaged in transforming their wards into T.C's for chronic psychotic patients.

My feelings about my curriculum are ambivalent. On the one hand I tend to regard some of my experiences critically as they ended as a result of administrative problems or destructive institutional dynamics; on the other hand I maintain a theoretical interest and the wish to continue spending part of my time in T.C's. Thus, in effect, I continue to be involved with them, although from a more marginal position. I do not know if my persisting in this interest is due to an insufficient loss elaboration or to a narcissistic wound which still drives me to seek for gratification; it however provides me with an introduction to the things I want to say about the ability of those who wish to work in, or have been working in T.C's for some time. It brings us face to face with the questions of motivation (or vocation) and subsequently with the selection of personnel. In my opinion every discussion about the training of T.C. workers starts here, whether we are talking about the case of a primary choice (probably at a young age) or of a change of profession, or of a simple case of job opportunity.

Even though I do not think that one becomes a Community worker because of a natural gift, but rather as a result of good training and sufficient practical experience, nevertheless I believe a certain kind of motivation is necessary, though it is not in itself a guarantee of suitability.
While clarity about one's motives is useful to anyone making a choice it is indispensible for the so-called "Assistance professions"1, especially one like T.C. work, because of the intensity of relational involvement and the facility with which defence mechanisms come into play and at the same time are put to the test. It is not a question of selecting an "elite" for an exclusive activity suitable only for the chosen few, but of contributing firstly to helping the candidate to know and understand himself better so that he may evaluate whether T.C. work is a suitable choice for one of his personality and make-up, so that the reality of it does not become too frustrating and conflictual.

Curiosity about the psychotic's world is not enough, nor is a vague vocation to take care of others, nor the wish to support the rights of the socially marginalised classes. These may all provide a driving incentive, but they are not sufficient to avoid the risk of dangerous wishful thinking. The search for gratification through taking care of others does not always coincide with the gratification of the patients, who are at the same time object and subject of their own therapy in a T.C.

In Italy there has been no particularly thorough research, nor are there any important publications on the criteria of suitability for this kind of work. Selection methods are for the most part empirical; though the most common method is what I would call "Do it Yourself" or "internal promotion", the candidate usually enters through one or two interviews with the director of the Community and a period of apprenticeship of variable length. Both, more than helping the candidate to clarify his or her ideas, serve to help the Community identify major areas of unsuitability, and more importantly to establish the degree of affinity with the theoretical orientation of the said Community, its methods and pace of work; and the extent of positive feeling that is established with the candidate. Thus selection is based for the most part on questions of empathy and on subjective criteria. This is also true in the case of the candidate being interviewed by the staff as a group, rather than by an individual. The arrival of a new member of staff is communicated (not always) to the patients, in a Community meeting, as a foregone conclusion about which little discussion is possible.

There are further complications if the establishment is run by the public health service. Here the hiring of a worker involves going through a series of bureaucratic mechanisms (public examinations, educational qualifications, seniority, limitations imposed by trade union and administrative legislation etc) that make the evaluation of motivation even more difficult. In recent years the urgent demand for residential and semi-residential structures and the resulting proliferation of heterogenous institutions has emphasised the need for regulation regarding the character, educational qualifications and training needed for those wishing to enter the field. As a result several public, private and university schools have been established, with different theoretical orientations (generally health or psycho-social) and different rehabilitative methodologies (mostly cognitive-behavioural). To the characteristics and limitations of these schools I will return later in more detail. It is however important to bear in mind that the regulations governing the Communities and the training of personnel are decided for the most part by regional or national bodies run by the National Health Service, which means that there is a tendency to view the problems from a medical point of view. This explains the requirement for a high number of nurses in structures like Therapeutic Communities which should not need them, and the application of hygiene and sanitary regulations as quality indicators for environments whose primary concern is their patients' mental health. Lastly it explains the inclusion in the curriculum of subjects which are more suitable to a medical student than for a worker in a Therapeutic Community.

In a very recent contribution to a book that will shortly be published in Italy2 Aldo Lombardo expresses the opinion that at the base of a candidate's interest in Therapeutic Communities is the unconscious drive to protect internal parental figures. In favour of this hypothesis he quotes the conclusions of R.Websby, D.Menzies, B. Dolan, and K. Norton on the most frequent psychological types in T.C. (A survey of psychological types in a Therapeutic Community" from The International Journal for Therapeutic and Supportive Organizations Vol.16 - No. 4, 1995); and O. Khaleelee on the tests to identify motivation and the possibilities of professional development for those wishing to become Community workers. ("The defence mechanism test for the selection and development of staff" from The International Journal for Therapeutic and Supportive Organizations Vol.15 - No.1, 1994). The first points out that among staff members and residents are personality types that may be described as intovert-intuitive, while the second emphasises the existence of an unconscious identification with a damaged maternal or paternal image that generates the need to repair, or the unconscious identification with a deprived or damaged individual that makes him want to make him feel better.

I find these analyses very convincing and think that starting from these data we can propose some goals:

- bring the candidate to a better understanding of his/her motives
- prepare a method to enable this to happen
- make it possible for him, once he has reached a sufficient understanding and acceptance of his problems, to manage them with his own egotic resources, or to change his choice.

How can all this be included in a training programme?

If I consider the experience of many Community workers I know and my own, I can roughly describe two models. It is possible to add a third, which was very important in my own personal experience, but as I do not consider it training in the strict sense of the word, I prefer to discuss it separately.

The first training model may be described as "do-it-yourself" or "internal promotion", where everything depends on the subject's initiative, on his personal powers of observation, on imitation mechanisms and identification with Community leaders. This model bases itself on direct, practical learning and attaches less importance to theoretical training, (even if it does not exclude it) and prefers the acquisition of knowledge by assimilation, day by day, from the practices and the way of life of the Community. The risks incurred by such a model may include:

- the creation of a monoculture, partially or completely closed to comparisions with other views and methods, especially in those Communities where the weakness or lack of theoretical equipment and the vagueness of its aims are compensated for by the charismatic personality of its leader. (A.Orsenigo, contribution to "The Therapeutic Community between Myth and Reality", see note 2)

- a sometimes fedeistic acceptance by the Community workers of the theoretic model which is practised in the Community. This accentuates the ideological dimension and prevents a confrontation with reality, especially in moments of crisis.

- the occurrence of dependence mechanisms within the staff and, inevitably, between staff and patients, which last are obliged to adapt to the prevailing cultural climate and the resulting way of life.

The second model of training privileges the acquisition of theoretical knowledge, sometimes considerable, in a separate context, which is often disconnected from an effective experience in a Community. This type of training also presents some risks:

- The predominately two-way character of traditional teaching does not provide any incentive to work, grow and learn in a group. This type of training tends to inhibit the possibility of making multiple relationships and does not contribute to the development of abilities such as autonomy, taking responsibility, and dealing with complex ideas. The traditional relation between teacher and student may develop a sort of dependence on an authority who provides the solutions to problems and tells us what to do. (A.Orsigeno, see note 2)

- a marked separation between the interpretation of phenomena occurring in the Community and the concrete methodology to deal with them.

- The development of rational and intellectual defences when faced with the problems of emotional involvement in the Community environment.

- The limitations of a merely theoretical training in relation to the development of insight and awareness of one's role as a Community worker.

It is important to remember that the strength, invasiveness and sometimes contradictoriness of the experiences involved in the relationships with patients are such that vocational training and the technical and human abilities of the individual worker alone are not always sufficient to cope with them. Here enters the importance of the role of the group as a container and a support and as a tool for the working out of the emotions and cognitive functions of the individual worker. (A.Correale, "The field and its organisers in the initial phases of therapy with seriously ill patients" Paper presented at the Centro di Psicoanalisi Romano on 12.02.94)

Now I would like to examine a particular aspect of training that some consider a precondition or obligatory part of, or a natural result of every Community worker's training. I refer to psychoanalysis. In fact I personally know some Communities where only those who have already undergone, or are in the process of undergoing, psychonalysis, (either individual or group) are accepted. I personally do not consider this either a mandatory requirement or a guarantee of quality, even if I think individual and group analysis a fundamental requisite for self-knowledge and for the maturation of every individual. I think that such a course should be based on free choice, which may well be stimulated by various
circumstances, including those connected with one's work, but should not be conditioned by any implicit institutional presciption or by compliance with the working group's guidelines.

In Therapeutic Communities training is often of a clinical type, sometimes acquired through privately undertaken and costly courses of treatment. These are often based on two-way relationships which tend to confirm the idea that the therapeutic relationship is also fundamentally two-way. Moreover these private courses often contribute to the development of a strong professional identification with psychotherapists and psychoanalysists. The result is a professional identity that is unsuitable to this specific kind of work. It may also encourage fantasies of becoming a T.C. psychotherapist or induce feelings of inadequacy because of the difference in the kind of work. (A.Orsigeno, see note 2) Moreover not all Communities are psychoanalytically orientated and this emphasises the separation between institutional and personal points of view.

Undoubtedly psychotherapeutic experience can contribute to a non-intellectual awareness of the contact with mental suffering, to the acquisition of a capacity for empathy with the profound sufferings of the patient and to the recognition and control of contratransfert feelings (A. Ferruta, "The Therapeutic Community between Myth and Reality; see note 2), but I do not believe that it is the only way to reach this goal.

In other words I do not think that only psychoanalysts and people who have been analysed are the only peole who should be allowed to work in a Community. I will go on to expound on how training could encourage the acquisition of these capabilities, regardless of whether or not one has had a course of psychotherapy.

Focus on Motivation

Every community, in spite of the characteristics which distinguish them one from the other, should, within their particular culture and methodology, allow for the opportunity, time and space to reflect on the behaviour of the community worker, as an individual and as a member of the group. The existence of an effective tradition of enquiry could also be useful for the assessment of new candidates, including their motivations. I am by no means proposing a kind of vivisection of the candidate on the part of the group, but simply a preliminary period of observation without committment, which has as its sole aim the opportunity for the candidate to participate in all aspects of Community life, and to reflect on his motives (unconscious identification, reparation of needs, narcissistic and omnipotent traits in his personality), aided in this by the whole staff.

This first contact with the Community way of life, without claiming to be an aptitude test, could reduce the number of candidates who without any training or with a heterogenous basic training that has no correlation with the specific work of the Community, tend to refer to their own family, scholastic, or work experience, or to their own ideological inclinations, reproducing in their relationships with staff and patients unresolved personal problems. This is particularly frequent in Communities which house mainly psychotic patients, who are particularly adept at awakening and stimulating problematical areas of the personality regarding sexuality, aggressivity, relationships with authority etc. (A.Orsenigo, "Therapeutic Community Work", Nuova Italia Scientifica, Rome 1992).

Such an approach to professional experience would offer those who have no experience in this field a first encounter with group work, a working method which is characteristic of all Communities.

There is no doubt that the Community worker's professionalism is distinguished by the fact that it is collective, connected to a team, to an environment and to a collective know-how. In a Community, (it does not matter which) each intervention is characterised less by individual ability than by the therapeutic and rehabilitative capacity of the group as a whole, and of its environment. This is one of the essential characteristics of the community worker, which distinguishes him from others such as, for example, the psychotherapist or the psychiatrist who has the personal responsibility of his patient in a dyadic relationship. (C. Kaneclin, A.Orsenigo, "Therapeutic Community Work, Nuova Italia Scientifica, Rome 1992)

A no less important question is whether or not it may be useful to provide the candidate with a tutor, or whether the staff group may be able to perform this function. I think it is necessary to distinguish between those who have some practical experience or some knowledge of what happens in groups, and those who have come to psychiatric work with no previous experience at all.

My personal training experience and my current experience as a group supervisor of community workers makes me believe that, at least in the second case, the presence of a tutor would be very useful. It is not a question of establishing a privileged relationship, or one of dependence but of mediating the impact of the group dimension and helping the candidate to contain his anxieties and emotions when these become too strong.

Speaking of these things I am inevitably taken back to the time when, just after graduating and filled with lofty ideals, I was accepted as a trainer in a Community for young psychotics. On one occasion I was entrusted with the task of taking a small group of patients out shopping. A fight broke out between some of the patients and I was physically involved in separating them. I was very upset by what had happened and when I got back to the Community naively expressed my doubts to a member of the staff, a very nice psychiatrist with many years of experience. "Was I right to intervene? Should I have kept out of it? Were there any 'magic words' which would help to avoid such a situation? Was there anything I should or could have done?" The psychiatrist, who was usually very pleasant and spontaneous, answered very seriously that he couldn't help me by explaining how I should or could have behaved, but that I would learn through experience and by learning to recognise and control my emotions. It was true, but it left me feeling terribly alone and more anguished than before. It was experiences like this that I believe encouraged me to start psychoanalytic treatment, which I had thought about doing for some time.
Psychoanalysis was useful to me in that it made me realise that it wasn't a way to become a Superman, capable of facing any situation, ignoring one's own emotions, but rather an experience that, among many other things, helps one to recognise one's own feelings and, when needed to accept one's limits.

I think that an observation period, prior to the beginning of training proper, may achieve two goals:

- for the candidate - a greater awareness of his motivations and the opportunity to compare his expectations with the reality
- for the Therapeutic Community - the opportunity to evaluate the advisability of letting the candidate begin training at that particular time of his life.

It is not a question of making a definitive decision, but of pointing out what the problems could be in embarking on this carreer. It is not always easy to admit one's inadequacies, especially with respect to something one wants to do, but it is surely better that problems, if they exist, emerge, in the most realistic way possible, in order to avoid perhaps more painful disappointment in the future, and also possible unpleasant complications for the Community.

We should never forget that a Therapeutic Community, besides allowing for the maturation of its workers, exists primarly as an institution which provides a service for patients with serious psychopathological disturbances, or existential problems, and because of this should take particular care when selecting or accepting its workers.

I do not claim to have found a method which will act as an infallible filter, and safeguard the Community from unpleasant surprise. I simply wish to underline a problem that I consider of prime importance, in the belief that the Community has the resources to deal with it, both to its own advantage, and to that of the candidate; whether the validity of his motives is confirmed or whether a greater awareness of problematic aspects in his character will encourage him to make another choice.

Participant Observation

The next question to consider is: what kind of training and what kind of learning? I described earlier the split which often occurs between theoretical training and experience on the field and the drawbacks resulting from this split. I do not believe it is necessary to decide which of the two approaches is the most important, but perhaps how much of one or the other may be useful to the candidate, in what way they should be developed in order to be really useful and especially how the two methods can be integrated.

If I were to look back on my own experience of training, which was completely of the "do-it-yourself type", and learning through experience, the first thing I would remember is that little by little I began to hunger for theory, despite the fact that I was working in a highly psychoanalytical environment. As my experience and ability as a Community worker grew, I found that if I asked myself why I did certain things, on the basis of which theoretical model, I could not give myself precise answers. Evidently my training had not been not well balanced. I find that even today, in some of the groups I work with, there is a poverty of theoretical knowledge, and an excess of empiricism. This last is the result of the repetitiveness with which practices which are the norm in certain Communities are carried out, with no reflection on their significance. I have known Communities which, initially inspired by the enthusiasm, charisma and improvisation of their founder, subsequently failed as a result of the scarcity of theoretical and methodological knowledge. But I have also witnessed the opposite: the tendency to attempt to include within preset conditions aspects of reality whose meaning is obvious, and often in strident contrast with the theory that is constructed around them. In both cases there is a loss of the sense of reality as the result of a lack of balance between theory and practice.

I think it is useful to distinguish between basic training for all T.C. workers, and more advanced training that will take into account the specific characteristics of the Community of which the worker is part. Each candidate should be provided with a Basic Theoretical Knowledge, which includes simple but fundamental concepts of psychology, psychiatry, pschyoanalysis and sociology; the study of small and large groups, their dynamics and defence mechanisms; the history of psychiatry, particularly that of T.C.'s; the most commonly used transformation models (psychodynamic, cognitive, behavioural, biological and systemic-familiar) and the different ways in which they are used in the Community. (D. Kennard, contribution to "The Therapeutic Community between Myth and Reality" Raffaello Cortina Ed. see note 2)
I consider important a minimum of knowledge about Systems Theory and its organisation, and also a good knowledge of psychopathology, psychopedagogy and nursing, especially for T.C. workers involved with psychotic patients.

However we are not talking about the passing on of abstract information according to the traditional methods of teaching but of providing incentives for active participation by candidates. How can an effective model for training be realised?

I propose that right from the beginning training takes on simultaneously the characteristics of both work and study groups, i.e. is able to stimulate discussion, research into content, the active participation and integration of the group, and the analysis of group and individual problems, so as to arrive at something different from the traditional relationship between teacher and student. It is not a question of emphasising the group as an ideal, nor of the members losing their individual identities, but rather of creating conditions from the beginning, that will allow for the development of those attitudes which will be indispensible in the reality of Community work, where thinking, the person and the group are normal aspects of work and of transformation. When I speak of the attitudes that are necessary to become a Community worker I am not talking about innate qualities. If it is true that there are people who are more suited than others to this kind of work (as in every human activity), it is also true that the essential attitudes required for this work can be learned through good training, provided that one is willing to move outside one's own preconceptions.

I think that group learning, both of theory and of practice, allows a candidate to develop the attitude of observing what happens around him, of listening to the people around him, of expressing his opinions, of reflecting on his experiences,and above all of considering the group as a container, not only as regards work and study, but also of his own uncertainties, anxieties, aggressiveness etc. According to Bateson it is indispensible that everyone who works in a T.C. should develop the mental attitude (which he calls learning to learn) of attentive observation of the emotional processes which develop inside himself, between him and the patients, between him and the staff, and within the Community as a whole. (G.Bateson "Social Planning and the concept of deutero-learning" in "Towards an ecology of the mind" Adelphi - Milano 1976).

It is clear that no theoretical training course could take the place of direct practical experience, but I believe that some theoretical knowledge, acquired in a dynamic rather than a passive context, contemporaneously with practical experience in the Community, can assist in the development of the correct attitudes. By a dynamic context I mean for example a seminar model, where small goups of students meet regularly to discuss the teacher's lessons, to comment on recommended texts, or to analyse their experiences during their practical training. Various techniques could be used: sensitization to group dynamics, role play, problem solving, psycho-drama etc. In other words my concept of theoretical training is based on a learning group where the student can develop not only his basic theoretical knowledge but can also relate his practical experience to it. I believe, in fact, that both aspects of training should proceed together in such a way that the candidate who is in a study group outside the Community should also be gaining practical experience as a trainee in a Community, so that there is the possibility of continuous feedback between theory and practice.

I would like to be more specific about what I mean by practical training inside the Community. At least at the beginning I do not think the candidate should take on any direct responsibility, or have the right to intervene at his own discretion. The practical part of his training should simply offer him the opportunity to live as a resident and as an observer at the same time, participating fully in Community life and in the various staff meetings. Progressive involvement in meetings, activities, and direct contact with patients will provide him with the means to develop the capacity to learn from experience, which is one of the most characteristic aspects of the T.C.

Maybe because my memories of my first experience in Communities are still vivid I consider this first phase of training to be very delicate. While an attitude of willingness to learn on the candidate's part is indispensible, it is also essential that the Community staff are ready and willing to welcome him, help him, and stimulate and support him in his difficulties.
If we consider the whole training period as an opportunity for growth then the Community should develop "good enough maternal care" to facilitate this growth. Obviously I do not mean by this a relationship of dependence but of accompaniment towards a progressive autonomy and an effective participation in the life of the group.

Above all in the initial phase I am in favour of the presence of a tutor, who could be a senior staff member, and who would in a certain sense supervise everything that happens to the candidate in his first months in the Community. His attitude should not be that of a teacher who tells him what he should know and/or do, but rather that of a trainer who observes the trainee's movements, not only what he does but also what he tends not to do, for example not expressing himself, not noticing things, avoiding things. Knowing the rules of the game he tries, without being too directive, to improve the candidate's awareness of what is going on.

I hope that what I have said clarifies my opinions on the aims and methods of the first phase of practical training. It should develop gradually, avoiding the assumption of responsibilities that the candidate may not be ready for, and should be accompanied by constant attention and willingness on the part of the staff. The main objectives of this part of the training should be the development of the capacity to observe, to listen, to express oneself, and to enter into the particular atmosphere of the Therapeutic Community.

What is important is that the traditional models of training for social workers, nurses,and psychiatric workers are avoided. These tend to reproduce the courses adapted to students of medicine, psychology, or psychiatry, with a resulting rough copy which bears no relation to reality. Whoever arrives in a Therapeutic Community, whether nurse or social worker, art therapist or psychologist, psychoanalyst or psychiatrist, has to construct a new professional identity with new theoretical and practical knowledge. Thus it seems convenient, in terms of cost and time, that training should be defined from the beginning according to criteria which are more consistent with the reality of the Community.

When I have doscussed these ideas with colleagues who are well aware of the problems in Communities, or who are trainers, one of the most frequent objections is that the model I have just described risks inhibiting the development of an appropriate sense of belonging, or in other words represents an artificial division between the vocational school outside the community and the community itself. I believe however that this objection owes more to the fear that some charismatic leaders of communities have of opening themselves to comparisons with the outside, and the consequent threat of loss of identity. Undoubtedly an integration between theory and practice reduces some of the excesses of both, entails the construction of a more complex view of the problems (in my opinion more complete), and prevents a counterproductive split between the two components and above all the unjustified supremacy of one over the other.

In fact, I think that the existence of a school outside the Community is both healthy and favourable to the community. What I consider important is a strict interpendence between the theory that the candidate learns in the school and the practical training he has in the community, so that he has the opportunity to evaluate what happens in the community through discussion and comparison with other members of the study group. In this way he can develop theoretical knowledge and concrete attitudes which allow him to think about why and how to behave, and decode both what happens to him and what happens in the community.

To summarise what I think the important features of this initial phase of training are:

- the introduction of the candidate into a study group led by a tutor for the learning of basic theoretical knowledge and for the development of the attitude of learning to learn.
- the use of specific techniques like seminars, role-play, psychodrama, problem solving etc.
- the introduction at the same time of the candidate into a T.C. for practical training, where he will be a resident and an observer, involved in every moment of community life and the work of the staff, under the supervision of a tutor.

Naturally this will involve a relationship of collaboration between the school and the T.C.if they are to realize a programme which will take care of all the candidate's needs. It will involve organisational problems, decisions about the course of studies, evaluation of results, and of the candidates according to agreed criteria, and the continuous exchange of information on the candidate's progress, any difficulties he is having, and on the final assessment. I think it would be an advantage if the study group tutors have had some Community experience.

In my opinion the second phase of training can take place when the candidate begins to understand that particular characteristic of communities which is the sharing of a committment to learn from living and working together (D.Kennard, contribution to "The Therapeutic Community between Myth and Reality", see note 2). It is not always easy to define when this occurs and I believe that only an open, honest evaluation involving tutor, candidate and staff together may suggest when it is opportune to progress to a more advanced phase of training.

Basic Competence

After the first phase of training, whose length could vary (but should not, I believe, be less than 6/8 months) it is necessary to direct the training towards the attainment of adequate competence.

I don't think I'm saying anything new when I describe work in a T.C. as being rich and eventful, characterised by strong personal involvement, more dynamism and less rigidity or predictability than in other types of institutions, for example hospital wards. Generally Community workers are required to carry out a variety of activities: organise activity groups, hold interviews, write reports, conduct meetings, keep the accounts, do the housework, take care of the physical and affective needs of patients, maintaining at the same time the capacity to analyse the situations and keep a record of their reactions to them.

These are all characteristics of a more demanding and complex kind of work than in other services. Even when there is a well defined role distinction among the staff the individual worker is required to perform a variety of organisational tasks. Needs and pressures are often contradictory and emotionally intense, and both the individual worker and the staff, if they are to work effectively as a team rather than as a group of individuals, need to be able to elaborate them, and develop hypotheses and tools to cope with moments of crisis. (C. Kaneclin, A. Orsenigo, "Work in Therapeutic Communities" - Nuova Italia Scientifica, Rome 1992). It can be said that one of the salient characteristics of Community work is the capacity to integrate different abilities and to act within a context which allows for the analysis and processing of what happens in order to give sense to the answers requested by the patients. Often these answers have to be adapted to requests that are as variable, incoherent and multi-form as the psychotic world from which they come, and so they need to be based on flexibility and on the analytic capacity of the whole staff, rather than on rigidly fixed procedureuate what happens in the community through discussion and comparison with other members of the study group. In this way he can develop theoretical knowledge and concrete attitudes which allow him to think about why and how to behave, and decode both what happens to him and what happens in the community.

To summarise what I think the important features of this initial phase of training are:

- the introduction of the candidate into a study group led by a tutor for the learning of basic theoretical knowledge and for the development of the attitude of learning to learn.
- the use of specific techniques like seminars, role-play, psychodrama, problem solving etc.
- the introduction at the same time of the candidate into a T.C. for practical training, where he will be a resident and an observer, involved in every moment of community life and the work of the staff, under the supervision of a tutor.

Naturally this will involve a relationship of collaboration between the school and the T.C.if they are to realize a programme which will take care of all the candidate's needs. It will involve organisational problems, decisions about the course of studies, evaluation of results, and of the candidates according to agreed criteria, and the continuous exchange of information on the candidate's progress, any difficulties he is having, and on the final assessment. I think it would be an advantage if the study group tutors have had some Community experience.

In my opinion the second phase of training can take place when the candidate begins to understand that particular characteristic of communities which is the sharing of a committment to learn from living and working together (D.Kennard, contribution to "The Therapeutic Community between Myth and Reality", see note 2). It is not always easy to define when this occurs and I believe that only an open, honest evaluation involving tutor, candidate and staff together may suggest when it is opportune to progress to a more advanced phase of training.

Basic Competence

After the first phase of training, whose length could vary (but should not, I believe, be less than 6/8 months) it is necessary to direct the training towards the attainment of adequate competence.

I don't think I'm saying anything new when I describe work in a T.C. as being rich and eventful, characterised by strong personal involvement, more dynamism and less rigidity or predictability than in other types of institutions, for example hospital wards. Generally Community workers are required to carry out a variety of activities: organise activity groups, hold interviews, write reports, conduct meetings, keep the accounts, do the housework, take care of the physical and affective needs of patients, maintaining at the same time the capacity to analyse the situations and keep a record of their reactions to them.

These are all characteristics of a more demanding and complex kind of work than in other services. Even when there is a well defined role distinction among the staff the individual worker is required to perform a variety of organisational tasks. Needs and pressures are often contradictory and emotionally intense, and both the individual worker and the staff, if they are to work effectively as a team rather than as a group of individuals, need to be able to elaborate them, and develop hypotheses and tools to cope with moments of crisis. (C. Kaneclin, A. Orsenigo, "Work in Therapeutic Communities" - Nuova Italia Scientifica, Rome 1992). It can be said that one of the salient characteristics of Community work is the capacity to integrate different abilities and to act within a context which allows for the analysis and processing of what happens in order to give sense to the answers requested by the patients. Often these answers have to be adapted to requests that are as variable, incoherent and multi-form as the psychotic world from which they come, and so they need to be based on flexibility and on the analytic capacity of the whole staff, rather than on rigidly fixed procedureuate what happens in the community through discussion and comparison with other members of the study group. In this way he can develop theoretical knowledge and concrete attitudes which allow him to think about why and how to behave, and decode both what ar moment. Above all he should maintain an objective viewpoint, bearing in mind the group as a whole, and avoiding as far as possible telling them what to do. He should try to stimulate an analysis of the situation, and use the egotic resources of the group in coming to a solution. For example, the possibility of reorganising the programme for the day, drawing attention to the difficulties involved in the original programme, and bearing in mind the consequences for the individuals and the group.

Another example:

The expert in activities for self-expression could, during his session of art or music therapy, find himself faced with a psychotic crisis, a quarrel, a refusal to do anything, or a hundred other possibilities. Obviously in such cases he must forget his specific professional role and resort to the basic competence that will enable him to cope appropriately.

Plainly these qualities are learned and developed only through direct contact, firstly by observing the staff at work, and then consolidating them with the guidance and support of the staff group. It becomes more and more evident that the way of working in a T.C. is very different from that in a hospital or a professional studio; and also that the theoretical learning involved develops in a very different way from that of traditional scholastic learning.

In this second phase of practical training I think that the candidate should be increasingly involved in the activities and relationships with the patients and take a progressively more active part in organisation and in staff meetings. It is a question of moving from the position of an observer to that of a growing participation in Community life, with opportunities for the candidate to gradually learn to express himself in the group and develop a growing awareness of his feelings and be able to express them in staff meetings. Also in this phase he shouldn't be left to himself but should be able to count on the support of senior members of staff in the analysis, not only of his doubts and difficulties, but also of that which seems to him self-evident and easy.

Little by little, as his experience and familiarity with the patients grow, a fundamental issue of his training will be the difficult but essential discrimination between his personal involvement with the patients and his therapeutic role. This is particularly important when he has to deal with psychotic patients, and the game of projections, splits and projective identifications of which they are masters.

In such a close relational context it is very easy for relationships of collusion to be born, as much between the workers as between the patients, and also between patients and workers. The result is a progressive divestment of the therapeutic role. At the other extreme there is also the possibility that conflicts will arise, with the consequent rejection of the patients and the rigid application of formal therapeutic roles. Who of us can say that they have not fallen at least once into this trap?

Another important aspect of the training is the learning of that function I defined as the patient's "auxiliary ego". This involves standing by him in critical moments and taking up the position of a "mirror" and in this way providing him with possibility of developing insight. It is a very delicate position, because it means avoiding the development of a pathological dependence, but at the same time not expecting a level of autonomy that the patient may not be capable of at a given moment. Particularly with severly regressed and pathological patients T.C. workers need to be able to perform those roles that Recamier called "Ego substitution and integration" (P.C. Recamier: "Le psychanaliste sans divan", Payot, Paris, 1972.) I also believe that with seriously ill patients (read schizophrenics), a good knowledge of psychopathology and the psychodynamics of psychotic states would be extremely useful to Community workers.

The further into this phase of training the trainee enters, the more need he has of the emotional and mental support of the whole staff. At this point, the capacity of the team to facilitate growth, the function of which I spoke earlier, is in a certain sense put to the test. They should create an atmosphere in which the candidate feels he can spontaneously speak his mind and voice his emotions, express his resistances and ambivalences; and the staff in turn should perform the role of "ego auxiliary" and "mirror" for him.

In this respect the language used in staff meetings is particularly important, because there is a big difference between working in an environment where people speak spontaneously and naturally and one where people express themselves in a complicated and obscure way. It may seem a trivial point but I am always suspice must forget his specific professional role and resort to the basic competence that will enable him to cope appropriately.

Plainly these qualities are learned and developed only through direct contact, firstly by observing the staff at work, and then consolidating them with the guidance and support of the staff group. It becomes more and more evident that the way of working in a T.C. is very different from that in a hospital or a professional studio; and also that the theoretical learning involved develops in a very different way from that of traditional scholastic learning.

In this second phase of practical training I think that the candidate should be increasingly involved in the activities and relationships with the patients and take a progressively more active part in organisation and in staff meetings. It is a question of moving from the position of an observer to that of a growing participation in Community life, with opportunities for the candidate to gradually learn to express himself in the group and develop a growing awareness of his feelings and be able to express them in staff meetings. Also in this phase he shouldn't be left to himself but should be able to count on the support of senior members of staff in the analysis, not only of his doubts and difficulties, but also of that which seems to him self-evident and easy.

Little by little, as his experience and familiarity with the patients grow, a fundamental issue of his training will be the difficult but essential discrimination between his personal involvement with the patients and his therapeutic role. This is particularly important when he has to deal with psychotic patients, and the game of projections, splits and projective identifications of which they are masters.

In such a close relational context it is very easy for relationships of collusion to be born, as much between the workers as between the patients, and also between patients and workers. The result is a progressive divestment of the therapeutic role. At the other extreme there is also the possibility that conflicts will arise, with the consequent rejection of the patients and the rigid application of formal therapeutic roles. Who of us can say that they have not fallen at least once into this trap?

Another important aspect of the training is the learning of that function I defined as the patient's "auxiliary ego". This involves standing by him in critical moments and taking up the position of a "mirror" and in this way providing him with possibility of developing insight. It is a very delicate position, because it means avoiding the development of a pathological dependence, but at the same time not expecting a level of autonomy that the patient may not be capable of at a given moment. Particularly with severly regressed and pathological patients T.C. workers need to be able to perform those roles that Recamier called "Ego substitution and integration" (P.C. Recamier: "Le psychanaliste sans divan", Payot, Paris, 1972.) I also believe that with seriously ill patients (read schizophrenics), a good knowledge of psychopathology and the psychodynamics of psychotic states would be extremely useful to Community workers.

The further into this phase of training the trainee enters, the more need he has of the he staff. Through the numerous meetings and moments of contact the staff will be able to provide a continuous feed-back on everything the trainee is doing. In order for this feed-back to be as full and as useful as possible the candidate should immerse himself fully in the daily life of the community, accompanying the various members of staff as an active observer, becoming progressively more involved, and taking on small responsibilities. In particular it is important that he develops a group outlook, which will be a prerequisite for a fruitful participation in the many meetings of small and large groups. It is only through direct contact, in interaction with others, that one can test one's own emotions, find ways of expressing oneself, and train oneself to pick up the thread that always binds group events. Staff meetings allow for the development of these capacities.

In respect of the above, as I said before, many people believe that a personal course of therapy is indispensible. I personally believe that in order to achieve a satisfactory attitude for working well in a group regular group training workshops could form part of the theoretical training programme. These would include a certain number of group sessions with an external trainer, combined with theoretical sessions dedicated to reflection, discussions and the reading of relevant texts (Bion, Foulkes etc). In other words I think that this particular aspect of training should be somewhere between a study group and a therapy group and its objectives should take into account both the practical experience and the theoretical knowledge that the trainee is developing. It is possible that as a result of this experience some trainees may decide to undertake individual or group analysis. What I think is important is that this request comes about freely and spontaneously.

In this second phase of training the trainee needs to deepen his theoretical knowledge, the learning continuing to take place in groups. He will also develop his knowledge related to themes and circumstances stimulated by the practical aspect of his training.

An aspect often neglected is writing. In Communities there is a lot of talk, sometimes too much, but hardly anything is written. I do not know if this is the result of a scarcity of theoretical knowledge or because of a kind of vanity. I believe however that the habit of writing down one's observations and reflections may be a useful complement to the act of thinking. Asking candidates to write a report on particular aspects of their experiences, to present in this way a clear and thorough communication to their colleagues, besides initiating a useful habit, may also provide a stimulus for discussion and comparison within the group.

The common goal of both aspects of training, practical and theoretical, should be to reduce the gap between thinking and acting, seeing them as a circular rather than a linear process. The first favours a continuous dialetic exchange, a reciprocal interaction and a possible alliance. (A.Orsenigo, see note 2).

To summarise the goals of the second phase of training, which could last from 8 to 12 months:

- the full immersion of the candidate in Community life, as an active observer, accompanying the various members of staff and being delegated small responsibilities.
- continuous supervision by the whole staff
- deepening of basic theoretical knowledge; development of new knowledge stimulated by experience; analysis and information exchange between members of the study group; workshops and the study of small and large groups.

Specific Competence

Once the candidate has attained a satisfactory familiarity with the Community, and a certain degree of autonomy, he could move on to the last phase of training, i.e. the development of the specific abilities which may define his role. In T.C.'s there is a wide variety of professional roles in operation. Some may be based on previous professional training, others on experience matured in a specific Community. We could list them, but for reasons of space it may be more useful to describe those areas of activity most frequently found.

- Area of Psychotherapy (group or individual psychotherapy carried out inside or outside the T.C.)
Here we are talking about specific therapy, as distinct from that carried out by every Community as part of its global activity. Not everyone agrees about the usefulness of specific psychotherapy sessions carried out inside or outside the Community. Nevertheless it is clear that anyone who performs such an activity as a psycho- therapist should have the requisite recognised qualifications. However my paper is not stricly concerned with this question.

- Pharmacotherapy(which is still used in some Communities):
Evidently in this case the specific competence belongs to the physician or psychiatrist. It would be interesting to discuss the use of psychotropic drugs in T.C., but time and space do not allow me to.

- Area of Artistic Activities for self expression (music, drawing, painting, sculpture,etc):

- Are of Verbal and Non-verbal activities for self expression (theatre, mime, and psychodrama, which is sometimes included in the area of psychotherapy)

- Area of Ludic activites

- Area of Handcraft Activities

- Area of Rehabilitation and Social Reinstatement activities
The delimiting into a distinct area of rehabilitation activities is a controversial point, as in general is the clear-cut distinction between therapy and rehabilitation. As has been noted many patients, especially psychotics, need to acquire abilities more than to recuperate those they have lost. The question deserves more thorough examination. Meanwhile I would like say that I believe too rigid a distinction between the two may be arbitary and more useful to the staff than to the patients. Many of the above listed activities have in fact a double function, both therapeutic and rehabilitative, so that what appears to be specific to one, may be useful to the other, and vice versa.

However, all these activities differ from the bulk of the work in T.C.'s that we describe as Basic Competence. This could on the other hand be described as "Area of activities adapted to the particular way of life of the specific Community, and its inhabitants." They include all the activities connected with daily domestic life, but not only. Bearing in mind the different educational and cultural backgrounds of the candidates, their training should provide three objectives, according to the Community where they do their practical training:

- a general, elementary understanding of the various activities and their therapeutic and rehabilitative functions.
- the development and improvement of his capacities in those activities for which the candidate seems to have a particular aptitude.
- the testing of the real capabilities of those candidates who have already had specific training e.g. in art, handcraft etc.

In effect, in every study or work group there will be those who have some qualifications e.g. artistic, handcraft etc, and those who do not. Those without need to be taught the basics about the various activities and their function in relation to the patients and to the Community as a whole, so that they can get an idea of in which direction they might like to go. At the same time real training should be given to those who have an obvious aptitude in one or the other direction; while those already in possession of a qualification need to have their effective competence tested by the leaders of the groups, the staff and by the candidate himself.

The study group could, among other things, be used by the trainees as a testing ground. For example the candidate who would like to become an expert in self expression could practise on the study group. When I insist on the importance of integration between the T.C. as the environment for practical training and the school as the place where theory and conceptualization are learnt, I do not mean juxtaposition or overlap, but a reciprocal influence one on the other.

The last phase of the training should aim towards the attainment of reasonable autonomy on the part of the trainee, and his involvement in the daily management of Community life. This means having a clear awareness of the goals for which the Community exists, i.e. the services it supplies to its internal clients (its patients) and external (families, public bodies etc).

Even though the analysis of the interpersonal dynamics, wishes, pains, and conflicts between T.C. workers and patients represent one of the most important characteristics of the staff's work, we must not forget that it is all related and subordinate to what is useful to the patients. Otherwise the T.C. may unconsciously transform itself into a nursing home for its workers, and an inexaustible source of work for consultants and supervisors. (A.Orsenigo, see note 2). From experience I believe that as soon as T.C. work becomes a burden, and staying close to a patient becomes an exhausting effort or, at the other extreme, activities are performed without any clear idea of their usefulness to the patient, it is time to sound the alarm bell. In a well-known article by Monica Meinrath and Jeff Roberts ("On being a good enough staff member" I.J.T.C., 1982 - vol , no. 1) particular strategies were taken into consideration, based on the hypothesis of a collusion between the concentration of too much energy on the patient and the neglect of one's own needs as a therapist and as a person. I think also that when burn-out happens it is necessary for the T.C. to rethink itself and review its own organisation in relation to its goals.

By the end of this last phase of training (after a period of 8 - 12 months) the following minimum objectives should have been achieved:

- the acquisition of a minimum knowledge about the specific areas in which the candidate shows the greatest aptitude.
- the opportunity for practical training in these areas
- a good level of autonomy and of integration with the patients and the staff.

It is very probable that during the training there may occur a change of orientation, smaller or greater shortcomings or lack of motivation. To each of these the school and the Community should know how to provide appropriate support, further improvement, analysis of difficulties and, if necessary, reflection on the motives and personal inclinations of those who, in the light of experience, turn out to be more suited to a different kind of job.

I realize that what I have described is easier to write about and to read than to do. In fact, given the complexity of the subject, the heterogeneity of points of view and the multiplicity of the objectives, I do not know how possible it may be to contain within definite schemes the guidelines for a T.C. worker's training. What has made me reflect on these questions is largely my own experience, which has taught me that superficiality, eclectism, vain ambition and excessive rationality are obstacles to the work of Therapeutic Communities. If my attitude towards training may seem somewhat uncompromising, it is because I have learnt not to lose touch with the needs, the deficiencies and the interests of the patients, either in Communities or elsewhere.