Sunroom

Ward sunroom, 1986

A Unique Program

Throughout its 81-year history, there was one program implemented at Oak Ridge that can be described as truly unique to the division. Between roughly 1963 and 1977, half of the patient population at Oak Ridge were engaged in what became known as "the Oak Ridge program." While the other half of the division were engaged in a token economy program, those on E, F, G, and H-wards participated in a therapeutic community model whereby patients directed their own treatment.

Therapeutic Communities

The general concept behind a therapeutic community is a shift in power - instead of staff dictating to patients the parameters of the treatment program, the responsibility is given to the patients themselves. Patients determine their own rules for the ward and give out punishments to those within their group who deviate from these parameters. Patients are further encouraged to speak freely of their feelings or emotions, without fear of repercussions. Therapy is considered to be continually taking place throughout the waking hours rather than being relegated to specified blocks of dedicated time.

Therapeutic communities were initially developed towards the end of the Second World War for use with injured soldiers. Promoted most prominently by Dr. Maxwell Jones, a British psychiatrist, the model was adopted into a number of mental hospitals and correctional facilities in the post-war era. The therapeutic community as described by Jones became increasingly encouraged for use with those patients who were suffering from psychopathic personality disorders.

Throughout much of the 1960s and 1970s, the general concept of the therapeutic community formed the backbone of treatment for half the population at Oak Ridge. The programming went through four general phases, growing from a model that was closely aligned to Jones’ work at the Henderson Hospital in the UK to a unique progam that would draw international attention to Penetanguishene. 

Ward Council meeting

Ward Council meeting, 1963

Phase One: The Therapeutic Community comes to Oak Ridge

Elements of the therapeutic community model first began to appear at Oak Ridge in the early 1960s. Superintendent Dr. Barry Boyd inaugurated a new ward structure where patients elected from amongst themselves a Council of 12, which included a Chairman and Vice-Chairman. The Ward Councils held meetings every two weeks during which time they would discuss the policies of their respective wards. Staff maintained the ultimate power to approve or disapprove any final decisions, but generally the Ward Council could anticipate moderately free range. The intention was to provide patients with an opportunity to make their own decisions and to take responsibility for those decisions.

Boyd gave a few examples of the rulings made by these initial Ward Councils in a paper published in the early 1960s:

"One Ward Council recently discussed the problem of dangerous weapons smuggled onto a ward. After much argument, they passed a motion that if patients became aware of such a weapon it was their duty to confiscate it, or to report it to the staff. Another ward decided that patients should intervene only to save the life of a volunteer or a student nurse, but not the life of another patient or staff!" (Boyd, 1962-1963, p. 345).

The new structure was radically different from the authoritarian model that characterize traditional institutionalization. Boyd discussed the change as a way to transform the institutional environment such that it would positively benefit patients and model for them the responsibilities they would have upon release back into the community. He wrote: 

“most hopeful treatment…lies in their exposure over time to a social environment which will change their self-picture, their values, and their attitudes towards responsibility” (Boyd, 1963)

The environment at Oak Ridge in the early 1960s was primed for these new ideas. Legislative changes had only recently seen the first Oak Ridge patients held on Lieutenant Governor’s Warrants to be discharged. For the first time in its three decades, the indeterminate sentencing for many Oak Ridge patients would have a potential ending. With patients determining their own ward policies and helping to facilitate psychotherapy sessions amongst themselves, the therapeutic community also had the added practical benefit of being relatively low cost.

Drs. Elliott Barker and Barry Boyd

Drs. Barker & Boyd, ca. 1990

Phase Two: The Social Therapy Unit

The therapeutic community formed the basis of what came to be known at Oak Ridge as the Social Therapy Unit (STU). Founded in September of 1965, the STU would grow to occupy four of the eight wards of the Oak Ridge building and operated in parallel to the Activity Therapy Unit (ATU) which occupied the other half of the building.

Emphasis throughout the course of the STU's history was on enabling communication. The premise was held that mental illness, and particularly personality disorders, grew from an inability on the part of the individual to adequately communicate their thoughts both to themselves and to others. There were three key components that were believed to help counter this issue: (1) verbal dialogue among the patients; (2) the active involvement of the patient in the direction and application of treatment; and (3) total immersion within the programming.

The patient population on the wards of the STU was made up primarily of younger men in their late teens to early twenties, many of whom were being held at Oak Ridge on Lieutenant Governor Warrants. Primary diagnoses on the wards was a mix of personality disorders - especially psychopathy - and schizophrenia. The men also generally had higher verbal abilities than their counterparts on the ATU, a basic requirement for the communication-focused programming.

Arrival of Dr. Elliott Barker

Although influenced through the efforts of many individuals at Oak Ridge, the STU was defined primarily by the vision held by two individuals: Superintendent Dr. Barry Boyd and a newly hired psychiatrist, Dr. Elliott Barker.

Dr. Elliott Barker came to Oak Ridge in 1965. He and his wife, Julie Barker, arrived in Penetanguishene fresh from a tour that had taken them to institutions around the world. Their trip included stops at Jones' famous therapeutic community at the Henderson Hospital in the UK as well as new experimental programming among the correctional populations at the Herstedvester Institution in Denmark and the Central Peking Prison in China. The Barkers likewise made visits to the philosopher Martin Buber and some of the more prominent voices of the antipsychiatry movement, including R. D. Laing and David Cooper.

Barker was actively recruited by Boyd, who believed that the psychiatrist shared his vision for a "new" Oak Ridge. Continuing the Ward Councils that Boyd had initiated several years earlier, together they began to add to the programming.

STU Programming

Barker and Boyd began their efforts on G Ward. Group psychotherapy sessions held in the sunroom and smaller sessions of two or three patients (called "dyads" and "triads," respectively) formed part of an intensive schedule, often comprising between 80-100 hours a week. There was also a component of the token economy system in which patients could earn - or lose - "privileges" for their behaviours.

In its fully established form, the intention was for patients to move through the STU from H-Ward to E-Ward, with G- and F-Wards constituting the bulk of the specialized programming features. Over the years the Ward Councils were continued and additional patient committees were developed in order to involve them in all aspects of the programming including medication, punishment, and group assignment decisions.

View into room through bars with 4 men inside

Three patients inside patient room, ca. 1960s

Patients on MAP program

Patients cuffed together on MAP program, 1967

Phase Three: The Oak Ridge Experiment Comes into its Own

The Social Therapy Unit at Oak Ridge really took on its own identity beginning the year after Barker’s arrival. The components of the program – group psychotherapy sessions, committee, and Council meetings – became compulsory. These sessions encouraged confrontation among the patients in order to push individuals to contribute more. The sessions ranged from supportive to anxiety arousing. Patients who refused attendance were forcibly brought to all sessions and prevented from leaving. Any patient who was deemed at risk of suicide or self-harm was physically handcuffed to another patient who became responsible for ensuring their safety – and continued participation in the programming. There was little recreational diversion of any sort provided for the patients on these wards, the STU was all-encompassing.

Ward Programming

When first admitted to the STU, a patient would enter on H-Ward. Here they would be indoctrinated into the vocabulary and psychological concepts of the STU program. As the years progressed, this ward became increasingly strict - patients were not permitted to speak to one another or to staff outside of scheduled times. H-Ward also included the MAP program - Motivation, Attitude, and Participation - which was used as a punishment or "time out" for those who did not comply with the STU's overall programming.

Patients moved from H-Ward into the therapeutic portions of the program offered on G- and F-Wards. The therapy offered on G and F-Wards was psychotherapeutic in nature, inspired by a mixture of Martin Buber's philosophy of dialogue, Maxwell Jones' therapeutic community model, and R. D. Laing's views on psychosis. The wards constituted a total and continuous therapeutic environment which forced patients to continuously discuss, explain, and evaluate their behaviours, psychoses, and previous criminal actions. 

The final step in the four-ward system was E-Ward. Patients were considered to be successful graduates of the STU programming upon arrival at E-Ward and found themselves in preparation for anticipated release from Oak Ridge. This ward featured the greatest amount of autonomy for the patients and it was the only of the four wards were patients worked in the Vocational Services area.

Integration of Psychedelic Drugs

To further encourage communication among the patients on the STU, a range of mind-altering drugs were incorporated into the programming on G- and F-Wards beginning in 1966. In March of that year, G-Ward patients began to receive injections of sodium amytal, a drug best known as a sort of "truth serum." To ward off the sedative properties of the drug, patients were likewise given the stimulant methedrine. In their drug-induced state, the patients would then be interviewed by the other patients. Several months later, scopolamine, a drug with similar properties to sodium amytal that caused confusion and a lowering of inhibitions, was also administered to patients.

A year later, in February of 1967, patients on G-Ward began receiving d-Lysergic acid diethylamide (LSD-25). LSD, colloquially known as "acid," had been used previously in psychiatric experiments in Canada - most notably at the Allan Memorial Institute in Montreal and the Saskatchewan Mental Hospital in Weyburn - as both a potential treatment for alcoholism and as a drug which could provide insight into the mind of a person suffering from hallucinations. 

The Total Encounter Capsule

In 1967 a final alteration was made to the STU programming: the creation of the Total Encounter Capsule on F-Ward. The Total Encounter Capsule was a specially designed 8’ x 10’ windowless chamber at the end of the F-Ward corridor in which all distractions - books, television, music, etc - had been removed. It featured a one-way mirror through which participants inside the Capsule could be continually observed. Bright lights were kept on so that participants could not track the time of day. An open toilet was provided and liquid food was made available to the patients through an entry point in the wall.

The patients of F-Ward entered the Capsule with nothing - not even their clothing - and remained confined within the space together initially for periods of between two to four months and later, for several weeks at a time. The expectation was that once they were free of distractions within the Capsule environment, patients would shed their inhibitions and share their thoughts freely with the group (and those monitoring their progress outside of the Capsule). The administration of mind-altering intravenous drugs was continued, with patients both determining who would receive the injection and when it would be administered. 

Phase Four: The Barker-Maier Handoff

When Barker left Oak Ridge, the STU was continued by psychiatrist Dr. Gary Maier. In contrast to Barker's pressed shirts and more traditional demeanor, the long-haired and often barefoot Maier brought a more free-form approach to the wards of the STU. It would not prove to be a good fit. Maier faced mounting opposition from attendant staff who were concerned about the security risks that an unregulated format posed with their particular patient population.

The breaking point came in 1975 when Maier orchestrated a mass psychedelic trip on one of the wards. A group of 26 men were each injected with 300 mcg of LSD-25. Maier's expressed intention was to encourage a collectively shared experience of self-knowing among a group of diagnosed psychopaths and schizophrenics; instead, it heralded the demise of the decade-old program. Shortly after Maier's group experiment, he received a memo from Superintendent Boyd: 

"Concern has been expressed by other Unit Directors and the Treatment Department Heads as to the direction of recent developments in treatment.... The use of LSD as an experimental and research tool appears to be undergoing some change from the approach originally approved.... I would ask you to gently de-escalate these aspects..." (Boyd, 1975). 

Maier nonetheless continued the program, repeating the mass injection session with 12 patients the following year. But the practice of letting Oak Ridge patients wander the ward while in a psychedelic trance was too much for attendant staff to bear. While Maier accused Attendants of sabotaging the programming, Attendants in turn raised serious security concerns. The events culminated in the Attendants locking the professional staff out of Oak Ridge, Maier included. Ministry officials were dispatched from Toronto to address the situation and, in the end, Maier and his professional staff were transferred out of Penetanguishene.

Dissolution of the Social Therapy Unit

Soon after Maier's departure, the Total Encounter Capsule was dismantled. While efforts were made to continue the remaining components of the STU, the program would be officially dismantled in 1985 following negative criticisms in the Hucker Report review of the division. 

In later years, the Research Department conducted a retrospective evaluation of the STU programming to examine whether patients who had participated in the program and been released from Oak Ridge had lower levels of recidivism. The research revealed that the programming had some benefits to non-psychopathic patients but psychopaths who went through the STU program at Oak Ridge were found to have higher rates of recidivism.

International Attention for the Social Therapy Unit

The Social Therapy Unit brought people to Oak Ridge. For the first – and really the only – time in the division’s history, Oak Ridge was open to direct public scrutiny. High school and university students were invited to tour the wards and spend the afternoon with the men. Forensic experts from around the world travelled to Penetanguishene to observe the experimental programming in action. The media likewise made the trek and were given free range to film the activity. The BBC, CTV, and the National Film Board of Canada each created documentaries based on the STU between 1966 and 1977. Footage from these years was again re-aired in a CBC television series in 1982 and in a documentary made by Canadore College students around the same period.

This exposure was far from the negative exposé of a radical program. Patients were shown to be actively engaged in the therapy sessions, guiding one another through increasing levels of personal revelation. The images stood in stark contrast to the haunting despair that had been captured in other psychiatric portrayals of the period which included Ken Kesey’s 1962 quasi-fictional account of psychiatric treatment in One Flew Over the Cuckoo’s Nest and Frederick Wiseman’s controversial 1967 documentary, Titicut Follies. The latter comparison is particularly interesting as it, too, was based on a forensic mental health population. Titicut Follies was filmed at the Bridgewater Hospital for the Criminally Insane in Massachusetts. But, as described by historian Richard Weisman, this was where the comparison ended:

“Instead of the disfigured, floridly disturbed, and abused inmates that populated the Massachusetts facility, here [in Oak Ridge] were young, handsome, and intelligent men discussing their violent actions with insight and understanding, and apparently interacting with their peers in a manner that was both honest and compassionate” (Weisman, 1995, p. 266).    

Newspaper coverage was equally prevalent and positive. The Globe & Mail ran a series of articles about the STU from 1967-1968 and again in 1977. Without the benefit of the video camera, one of their reporters went so far as to move into a room on one the wards for a week. Joan Holloban, Globe & Mail medical reporter, thus became the first woman to "live" at Oak Ridge.   

The STU was also reviewed extensively over the years and even considered for integration into other mental health facilities as well as the correctional system. As part of a national evaluation of the penitentiary system in 1977, the Sub-Committee on the Penitentiary System in Canada recommended to parliament that:

“The social therapy technique developed by the Oak Ridge Division of the Ontario Mental Hospital at Penetanguishene is the most promising known for assisting offenders in self reformation. This technique should be introduced into both maximum and medium security institutions immediately…” (MacGuigan, 1977, p. 120, 165).

Mixed Experiences on the STU

The official reports and descriptions of the STU over the years described those entering the programming as "volunteers" – especially the initial draftees on G-Ward. Subsequent research and interviews with patients by historian Richard Weisman has revealed that not all were given an opportunity to form this decision for themselves.

While some patients reportedly thrived in the environment, others argued that it infringed on their basic human rights. In 2001, a class action lawsuit was filed against the government of Ontario as well as Drs. Elliott Barker and Gary Maier on behalf of several patients from the STU program. At the time of publication of this exhibit, a decision had not yet been reached in the case. 

By Jennifer L. Bazar

Page Last Updated: June 4, 2015


References

MacGuigan, M. (1977). Sub-Committee on the Penitentiary System in Canada: Report to parliament. Retrieved from http://www.johnhoward.ca/media/(1977)%20HV%209507%20C33%201977%20(MacGuigan).pdf

Nosanchuk, S. (1999). Revisiting the insanity defence: The capital murder trial of Matthew Charles Lamb. In E. L. Greenspad (Ed.), Counsel for the defence: The Bernard Cohn memorial lectures in criminal law, pp. 67-92. Toronto, ON: Irwin Law.

Watkins, R. E. (1978). Report on visits to the Social Therapy Unit (Oak Ridge), Penetanguishene Mental Health Centre and the Therapeutic Community Unit, Springhill Institution. Canadian PenitentiaryService. Retrieved from http://www.publicsafety.gc.ca/lbrr/archives/rc%20451.4.p68%20w3%201978-eng.pdf

Weisman, R. (1995). Reflections on the Oak Ridge with mentally disordered offenders. International Journal of Law & Psychiatry, 18(3), 265-290.


To Cite this Page

Bazar, J. L. (2015). The Oak Ridge program. In J. L. Bazar (Ed.), Remembering Oak Ridge Digital Archive and Exhibit. Retrieved from https://historyexhibit.waypointcentre.ca/exhibits/show/treatment/or-program