Tuesday, 22 September 2009

Soterias House Alaska opens, (non drug psycho-social treatment approach)

I am publishing this email from Jim Gotstein in full as the content is great news!
Jim mentions psychiatrist Loren Mosher who was one of our speakers in the first APRIL conference in 2001. Loren Mosher resigned from the Americal Psychiatric Association as he felt they were controlled by the pharmaceutical industry.

From: Jim Gottstein [] Sent: 24 July 2009 19:14To:

Subject: [PsychRights] Soteria-Alaska Opens With Two Residents

Hello,I wanted to let you know that Soteria-Alaska has opened its doors on a partial basis with two residents, pending receipt of its license, which will allow it to take more.
This is a milestone six years in the making.

For those that don't know about Soteria, Soteria-Alaska is a replication of the original Soteria House in San Jose California. The original Soteria-House was the brain-child of Loren Mosher, psychiatrist of beloved memory who tragically passed away in 2004.

There is also no doubt that the original Soteria House's success depended on marvelous Alma Menn, its administrator, and Voyce Hendrix, its House Manager. The original Soteria House proved that outcomes for people diagnosed with schizophrenia could be dramatically improved if a psychosocial approach was used instead with neuroleptics used as a last resort and stopped as soon as possible when they were used.

The Soteria-Alaska website at has quite a bit of information on this as does the PsychRights web page at

While I co-founded Soteria-Alaska in 2003, I left the board in October of 2007, and this achievement can be squarely credited to god-send Susan Musante, Soteria-Alaska's Executive Director, and Dr. Aron Wolf, a well-respected long-time Alaska psychiatrist, who early in his career worked at the famous Chestnut Lodge. Susan has assembled a terrific staff of people for Soteria-Alaska, including house manager Bill Miller, and they have also been instrumental in pulling this off.

Soteria-Alaska has been lucky to have been able to consult with marvelous Alma Menn, who is so terrific with conveying how Soteria House actually worked in practice. It is anticipated that Voyce Hendrix will also be available for consultation as things go forward.

Dr. Mosher and Luc Ciompi, who ran Soteria-Berne in Switzerland for many years developed the following Soteria Critical Elements, which guide Soteria-Alaska:


1. FACILITY: a. Small, community based b. Open, voluntary home-like c. sleeping no more than 10 persons including two staff( 1 man & 1 woman) on duty d. preferably 24 - 48 hour shifts to allow prolonged intensive 1:1 contact as needed

2. SOCIAL ENVIRONMENT: a. respectful, consistent, clear and predictable with the ability to provide asylum, safety, protection, containment, control of stimulation, support and socialization as determined by individual needs b over time it will come to be experienced as a surrogate family

3. SOCIAL STRUCTURE: a. preservation of personal power to maintain autonomy, diminish the hierarchy, prevent the development of unnecessary dependency and encourage reciprocal relationships b. minimal role differentiation ( between staff and clients) to encourage flexibility of roles, relationships and responses c. daily running of house shared to the extent possible; "usual" activities carried out too maintain attachments to ordinary life - e.g. cooking, cleaning, shopping, art, excursions etc.

4. STAFF: a. may be mental health trained professionals, specifically trained and selected nonprofessionals, former clients, especially those who were treated in the program or a combination of the three types b. on the job training via supervision of work with clients, including family interventions, should be available to all staff as needed

5. RELATIONSHIPS: these are central to the program's work a. facilitated by staff being ideologically uncommitted ( i.e. to approach psychosis with an open mind) b. convey positive expectations of recovery c. validate the psychotic person's subjective experience of psychosis as real by developing an understanding of it by "being with" and "doing with" the clients d. no psychiatric jargon is used in interactions with these clients

6. THERAPY: a. all activities viewed as potentially "therapeutic" but without formal therapy sessions with the exception of work with families of those in residence b. in-house problems dealt with immediately by convening those involved in problem solving sessions

7. MEDICATIONS: a. no or low dose neuroleptic drug use to avoid their acute "dumbing down" effects and their suppression of affective expression, also avoids risk of long term toxicities b. benzodiazapines may be used short term to restore the sleep/wake cycles

8. LENGTH OF STAY: a. sufficient time spent in program for relationships to develop that allow precipitating events to be acknowledged, usually disavowed painful emotions to be experienced and expressed and put into perspective by fitting them into the continuity of a person's life

9. AFTER CARE: a. post discharge relationships encouraged (with staff and peers) to allow easy return ( if necessary) and foster development of peer based problem solving community based social networks b. the availability of these networks is critical to long term outcome as they promote community integration of former clients and the program itself

James B. (Jim) Gottstein, Esq.President/CEOLaw Project for Psychiatric Rights406 G Street, Suite 206Anchorage, Alaska 99501USAPhone: (907) 274-7686)

Fax: (907) 274-9493jim.gottstein[[at]]

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