Philadelphia Association households

Domain III · Humanistic, existential & experiential · R. D. Laing, David Cooper, Aaron Esterson · 1965 · London

What it is

This is not a manualised therapy. It is a named institution's residential practice: small shared houses in North London where people in serious emotional distress live together, run the house themselves, meet several times a week with non-resident house therapists, and are each in individual…

Format

• Format: self-referral or referral by someone else, by phone or email to the PA office; the office puts the applicant in touch with a house therapist, who explains the process and talks with them by phone or in person; there is an application form.
• Format: the applicant may attend a few house meetings before a decision. In the 2005 account, applicants came to a Thursday meeting and then visited several times, and the group reached "yes", "no" or "come back next week". Whether the final decision rests with residents, therapists or both today…

Who practises it, and how they are trained or regulated

• Staffing: house therapists do not live in; the PA settled on a team of two therapists per house (2005 account); recent named house therapists include Paul Gordon and others at Freegrove Road. Supervision and the PA training/Study Programme sit behind the work; the programme describes its path as phenomenological.
• What a practising therapist can use: (a) referring a client to a PA house; (b) working as the individual therapist of a resident; (c) training as or acting as a house therapist; (d) borrowing the model for a supported-living or crisis-house setting. The PA's fullest account of current practice is Paul Gordon's book An Uneasy Dwelling (2010), which is drawn on only through the publisher's description and contents;…

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• one therapist becoming the house's charismatic centre; splits between the pair played out in the house.
• residents staying because there is nowhere to go; abrupt departures, including families removing a resident (reported at Archway).
• splitting between individual and house therapists; therapy lapsing (a condition of residence); dual roles if a house therapist is also someone's individual therapist.
• residents left to hold acute risk alone overnight; burnout in residents who sit with others. Risk flag: the out-of-hours gap in a non-staffed house; see Harm account.
• abrupt stopping of antipsychotics or other medication; group pressure against medication as "giving in"; a staff member giving a sedative informally (one Archway account describes a tranquiliser…

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.