What is Milieu therapy – Definition, Examples, Activities, Procedure

What is milieu therapy? In milieu therapy, positive change takes place in the community. In addition, they also happen through the community. The community includes a cast of characters. First, they are the healthcare professionals who are providing the treatment. Then, there are the supporting staffs. Finally, there are the other people in recovery.

Milieu therapy takes a unique approach to dealing with people’s substance abuse disorders. The following shows three things. First, it defines the approach and the underlying principles. Second, it defines the ideal candidates for this treatment. Third, it talks about the therapy modalities. Milieu therapy blossomed during the 1960s, 1970s, and early 1980s, when psychiatric inpatient treatment provided sufficient time to implement programs of therapy aimed at social rehabilitation.

The concept of milieu therapy developed from a desire to counteract the negative, regressive effects of institutionalization: reduced ability to think and act independently, an adoption of institutional values and attitudes, and loss of commitments in the outside world.

Care of the clients in the milieu therapy is directed by an interdisciplinary treatment team. They include: Psychiatrist, Clinical psychologist, Psychiatric clinical nurse specialist, Psychiatric nurse, Mental health technician (psychiatric aide or assistant or psychiatric technician), Psychiatric social worker, Occupational therapist, Recreational therapist, Music therapist, Art therapist, Psyhcodramatist, Dietitian and Chaplain.

The therapeutic milieu has long been considered an important healing tool in the treatment of individuals with serious mental illness in day treatment settings. This treatment format focuses on the specific therapeutic factors in the environment that contribute to the success of treatment. Specifically, the milieu is the physical environment, the culture that is created and maintained by the attitudes and behaviors of the staff and clients, the policies and procedures of the program, the rituals and daily programmatic structure and the rules for promoting safety and healing. The combination of these factors results in a “milieu experience” that has a primary goal of both supporting and educating clients about specific treatment issues, coping skills and encouraging participation through a safe, stable, predictable, consistent  positive and caring environment.

What is Milieu therapy - Definition, Examples, Activities, Procedure

What is Milieu therapy

Milieu is a French word that refers to the social environment of the individual. Milieu therapy is a type of treatment that involves changing this environment in the hope that it will encourage a client to develop new coping strategies. Milieu therapy is a form of psychotherapy that involves the use of therapeutic communities. Milieu therapy is based on the theory that the individual can rely on their own inner strengths to change undesirable behaviors. Autonomy and personal responsibility is a key element, but there is also the assumption that social interactions can benefit the individual.

Milieu therapy Definition

The word milieu is French for “middle”. The English translation of the word is surroundings or environment. Milieu therapy is the scientific planning of an environment for therapeutic purposes. The aim is to create the right environment where change can take place. This approach has been used for over a century in the treatment of psychiatric disorders and other behavioral problems.

Milieu therapy Examples

Some examples of the implementation of milieu therapy strategies are structuring a day around work tasks, community meetings, and skills training groups; ensuring that the physical environment is comfortable, inviting, and clean; and planning a recreational event that will encourage high levels of participation and interaction between people. Each of these tasks helps to shape the environment in order to make it conducive to achieving the goals of the individuals receiving services. Various interventions can be used in the therapeutic milieu in either the inpatient or outpatient setting. Interventions that meet the basic needs of the client in the psychiatric–mental health setting are addressed here. Interactive therapies such as crisis intervention, individual and group therapy, and family therapy, as well as special treatment modalities such as psychopharmacology, electroconvulsive therapy, and alternative therapies.

Milieu therapy Activities

One of the key aspects of milieu-based treatment is the opportunity for social interaction. During group therapy or activities, patients are able to take leadership roles and resolve social conflict. Healthy risk taking, such as talking to a new person or sharing feedback with another patient, increases the confidence of the individual.

Milieu therapy Procedure

Members of several disciplines collaborate in the promotion of a therapeutic milieu. Referred to as the psychiatric multidisciplinary treatment team, members include psychiatric–mental health nurses; psychiatric nurse assistants or technicians; psychiatrists; clinical psychologists; psychiatric social workers; occupational, educational, art, musical, psychodrama, recreational, play, pet, and speech therapists; chaplains; dietitians; and auxiliary personnel. The multidisciplinary treatment team participates in regularly scheduled meetings to allow team members to discuss the client’s progress and to review the client’s individualized plan of care. Clients and their family members, significant others, and support persons are invited to participate in these meetings.

The following is a list of educational strategies the nurse can use to promote client education after the client is ready to learn or to share information.

  • Prioritize the client’s needs and focus on everyday issues (e.g., safety vs. nutritional needs).
  • Present specific information (e.g., “Let’s discuss what you should do when you experience what you describe as panic attacks.”).
  • Use simple language and avoid speaking in a monotone.
  • Utilize different educational approaches depending on the client’s ability to relate to the written word, video or audio presentations, or ability to use the Internet.
  • Involve the client’s family members and support persons in the educational process.
  • Educate and reinforce information while providing care.

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