MILIEU THERAPY-THE THERAPEUTIC COMMUNITY

‘Milieu’ is a French word, mean ‘Middle ‘ and surrounding or environment. The therapy which
involves the milieu or environment is called as Milieu therapy or therapeutic community or
therapeutic environments. The members of therapeutic community are usually known as, residents,
clients or members. The concept of therapeutic community was first developed by Maxwell Jones in
1953. Milieu therapy provides a stable and coherent social organisation to facilitate an individuals
treatment. A therapeutic milieu facilitates patients interaction and promotes personal growth.
Milieu therapy is the responsibility of the nurse in collaboration with the patient and other health
care providers.

DEFINITION OF MILIEU THERAPY

The psychiatric mental health nurse structures, provides and maintain a therapeutic environment in
collaboration with the clients and other health care providers

-ANA 2000

A scientific structuring of the environment to bring behavioural changes and to improve the
psychological health and functioning of the individual.

-BF skinner 1979

GOALS OF MILIEU THERAPY

1. Providing a physically and psychologically safe environment.

2. Maximising the highest level of psychological functioning.
3. Identifying acute or chronic physical illness that are affecting psychiatric symptoms.
4. Promoting healthy coping behavioural strategies and symptoms managements.
5. Helping to promote independent activities of daily living.
6. Educating patients and their families about medications and their therapeutic modalities.
7. Establishing collaborative discharge planning with the patients or family and the
multidisciplinary team.

BASIC ASSUMPTIONS OF THERAPEUTIC COMMUNITY

The health in each individual is to be realized and encouraged to grow: All individuals are considered
to have strengths as well as limitations. These healthy aspects of the individual are identified and
serve as a foundation for growth in the personality and in the ability to function more adaptively and
productively in all aspects of life.

Every interaction is an opportunity for therapeutic intervention: Within this structured setting , it is
virtually impossible to avoid interpersonal interaction. The idea situation exists for clients to improve
communication and relationship development skills. Learning occurs from immediate feedback of
personal perceptions.