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There are now more than 1000 therapeutic communites world wide. Yet the fervour which heralded the approach has cooled. Nick Manning tells the story of the therapeutic community movement. Against this background he provides a new analysis of the leading British community, the Henderson Hospital, and examines the development of community based therapeutic communities in Australia by the Richmond fellowship. A statistical evaluation of the effectiveness of the latter is provided. Considerable attention is paid to recent sociology, psychology and critical theory as a basis for reinvigorating therapeutic community work in the changing context of the 1990s is provided.