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Aug 9, 2022 · These studies looked at several therapeutic milieu concepts, such as therapeutic communication, patient satisfaction, nurse involvement, ward design and structure, and a mixture of therapeutic...
Abstract: Several researchers have employed milieu therapy to address the communication needs of children with autism spectrum disorder (ASD). Thus, the purpose of this review is to examine milieu therapy, particularly, the environments and individuals involved in the training and the effectiveness of milieu therapy with children
interpersonal skills • Focus on the context in which care is delivered in the care environment • Work with persons’ beliefs and values, engagement, sympathetic presence, shared decision making and holistic care • Expected outcomes, which are the results of effective person-centred nursing and include
Mar 1, 2009 · Milieu therapy consistently increases communication and generalizes to other settings, while maintaining over time; however, milieu therapy does not analyze connections to challenging behaviors and few studies have focused on teachers in the classroom or peers.
- Abstract
- Background
- Method
- Findings
- Discussion
- Implications and Conclusions
The term “milieu therapy” (MT) is commonly used in clinical literatures, often without a clear or operational definition (Delaney, 1997; Wilmer, 1981). Generally speaking, MT refers to the treatment of people in intentionally designed physical and interactional environments, where commonplace interactions around a range of everyday events provide o...
The origin of the term MT is often attributed to early innovators in the residential treatment of children, Fritz Redl (1959) and Bruno Bettelheim (1950). Some also credit August Aichhorn (1935), whose work on wayward children informed Redl and Bettelheim (Zimmerman, 1994). These pioneers in the field of MT worked directly with emotionally disturbe...
Data Collection
This article synthesizes findings from two ethnographic studies of mental health programs that report providing MT. Each study was conducted in compliance with its respective institutional review board protocol for the protection of human subjects. At each site, data were collected only from consenting adults. Participants were never observed covertly, and all people present had the right to discontinue participant observation at any time. Pseudonyms are used for both organizations, and parti...
Data Analysis
During ethnographic data collection the authors each identified emerging themes. In the iterative process of theory building typical of ethnography (Thorne, 2000), identified themes were independently checked through ongoing interviews with key informants at both sites. For example, at UHS, the first author routinely observed workers using the term “milieu” to refer to shared living areas of the program (for example, the dormitories, dining room, and recreation spaces). To refine her understa...
“Everything Is Clinical”
Workers at both sites commonly described MT as fundamentally concerned with the creation and maintenance of a physical and social environment in which everything—from everyday, casual interactions to the physical contents of the space—had the potential to affect therapeutic change. During a mandatory orientation for new workers at UHS, Edie, the director of compliance, advised, In an interview conducted months later, dormitory counselor Melanie echoed Edie’s insistence that even apparently qu...
Milieu as Therapeutic Agent
Community Club workers often described the milieu itself as having a kind of agency, or ability to produce change, that both exceeded and supported workers’ individual efforts to intervene therapeutically. In other words, workers believed that the milieu as a whole—including clients, workers, and the physical environment—produced collective effects. Community Club workers stressed their belief that membership in the social network of the program was essential to treatment. A worker named Char...
A Context for Modeling and Practicing Desired Behaviors and Affect
Community Club workers frequently reported that the milieu provided an opportunity for members to practice new behaviors that could then be transferred to so-called “natural settings.” Community Club workers intentionally designed its rooms to have numerous areas in which members could gather and participate in informal social activities. The most frequently discussed element of informal social programming was the second-floor lounge, where loosely arranged chairs encircled a pool table. Memb...
The high degree of overlap in the accounts and practices of workers in two very different programs that reported using MT suggests that a coherent understanding of MT may be operating among contemporary mental health workers. Significantly, in neither site did workers view MT as a euphemistic catch-all term for nontherapeutic activities between dis...
We conducted an exploratory ethnographic study of two mental health organizations that report using MT. We examined workers’ perspectives on their approach to practice and integrated those perspectives with observations of actual practice. Some limitations of this study should be noted. First, it is important to consider that the two organizations ...
- Yvonnes Smith, Matthew C. Spitzmueller
- 2016
overall improvement in communication. In a similar respect, milieu therapy researchers have not addressed aberrant behaviors. The purpose of the current study was to examine the effects of an intervention that combined FCT and milieu therapy for intervening with children’s communication and
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two effective strategies [i.e., milieu therapy and functional communication training (FCT)] to replace aberrant behavior with functional communicative skills in the individual’s natural environments with parents as change agents. The following research questions were addressed: 1. Does the implementation of a modified milieu therapy
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