THERAPEUTIC CAMPS

 
 
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Therapeutic camps belong to outpatient therapy. Patients can take part in them when they are already involved in the network of various outpatient groups, can live in a hostel and participate in rehabilitation activities. They go away when they know many other participants and the style of the treatment. When the camp is over, the patients continue their previous therapy. This arrangement gives the patients a strong sense of security. The camp is not a one-off, short social experience, but an element in the diversified, long-term care programme.
The first camps were organised in the seventies for the patients who had undergone treatment in inpatient wards. The outpatient ward did not exist at that time, neither did any developed post-hospitalisation care system. At that time the camps focused on psychotherapy. The subjects of analysis were the dynamics of a large group and international competition. The minutes of the group meetings were kept, and the meetings were daily supervised. The work in the kitchen was of much importance. It meant the preparation of three meals for all the participants, the shopping in the nearest town and transporting food. The camp required from the patients a great deal of physical effort, the more so that they took sports such as football, volleyball, and swimming. In the eighties the first performance was staged as a parody of a community meeting. Since then theatrical play and exercises have been purposefully used as they provided entertainment and other forms of therapeutic activity, besides psychotherapy.
During the next camps the creative element of common theatre play or the production of a film have always been used. The patients are not only cast in particular roles, but they also are the authors of the screenplay. Working on films has opened up new opportunities in therapy, which during the camp, due to its objectives and its limited duration, does not touch the deep, interior problems of the patients. Nevertheless, the topics of the screenplays, the played and even the unplayed roles could always treat on subjects that were subjectively important for individual participants. At such times therapy can become more intense, and the discovered themes and problems can be elaborated on when the camp is over, that is during individual meetings in outpatient care. In practice this means that through tasks and play the therapy can be deepened as a process which is stretched in time and which changes its intensity, depending on the stage of the illness.
In our comprehensive outpatient care system therapeutic camps are used as one of the forms of therapy and rehabilitation of schizophrenic patients. After many years we perceive them as a great opportunity to build social bonds and social competence, and so to have impact on the essence of schizophrenic disorders. The work on the task and social training in natural environment, that is various behavioural techniques and the creative atmosphere serve this purpose. It seems that the special feature of a therapeutic camp is a chance to remove therapy to a non-institutional context and to remove the therapeutic environment so that the ascribed roles resemble those of real social life. The camp appears to transgress the widespread stereotype of treatment and to a degree it imitates scouts or sports camps. Thanks to creative tasks, it facilitates closer collaboration and more reciprocity between the team of therapists and the patients, as compared with other forms of treatment.
The factors that especially shape the special character of the therapeutic environment are: the structure of the camp, activity, the accessibility of the therapists and patients, the atmosphere, and Nature. These factors are, on the one hand, to increase the sense of safety in the group, and on the other hand to motivate the participants to put more effort into their own activity and to display more of it. During the camp the significance of the group increases due to the participation in a common task which has to be fulfilled in a given time. The patient then can feel less dependent on the care system, but rather to rely on his group mates, with whom he/she works on the task, then plays and rests. The special character of the therapeutic camp results also from the increased, as compared to other forms of therapy, individuality of activities, because
- as the interpersonal relations are strengthened, there is more interaction and physical activity in the group (dance, sports, swimming) - the whole person gets involved physically, emotionally and intellectually.
The most important task for the therapeutic team is to maintain this intensity at the optimum level and not to forget at the same time that it is possible to achieve this intensity just because the therapeutic camp is just one element in the comprehensive treatment programme for schizophrenic patients.

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