Milieu Therapy

Milieu means environment or surroundings. Milieu therapy is the treatment of mental disorder or maladjustment by making substantial changes in a patient's immediate life circumstances and environment in a way that will enhance the effectiveness of other forms of therapy. The objective or goal of milieu therapy is to use the environment or manipulate the surroundings to make client's hospital experience be therapeutic. Having a therapeutic community setting, client is expected to learn about adaptive coping skills, interaction and relationship skills and to develop autonomy.
Milieu therapy is a scientific planning by structuring an environment in order to effect behavioral changes and to improve the psychological health and bring individual to its maximum functioning.

Bettleheim coined the word milieu therapy in 1948 that used in children during that time but as time goes by, milieu therapy evolved to better hospital integration and community psychiatry with different structure therapeutic activities that are effective and efficient for the treatment or rehabilitation regimen.

Basic assumptions:
Skinner created seven basic assumptions on which a therapeutic community is based:

• The health in each individual is to be realized and encouraged to grow.
• Every interaction is an opportunity for therapeutic intervention
• The client owns his or her environment
• Peer pressure is a useful and a powerful tool
• Inappropriate behaviors are dealt with as they occur
• Restrictions and punishment are to be avoided.

Principles of Milieu Therapy:

• To promote a fundamental respect for individuals
• To use opportunities for communication between client and staff for maximum therapeutic benefit.
• To encourage clients to act at a level equal to their ability and to enhance their self-esteem
• To develop social skills and improve relationships.
• To provide opportunities for clients to be part of unit management.
• To be responsible to their own actions.
• Peer pressure is utilized to reinforce rules and regulations.
• Team approach is emphasized.
• Group discussions and temporary seclusions are favoured approaches for acting out behavior.
• The nurses function is to be therapeutic as well to achieve these goals.