Milieu Therapy: How Does It Work, Conditions Treated By Milieu Therapy, Risks & Disadvantages of Milieu Therapy

What is Milieu Therapy?

Milieu therapy is a type of psychotherapy for treating mental health conditions that use the surroundings to encourage healthier ways of thinking and behaving. It seeks to controls the environment to keep a person safe, improves their ability to learn new mental health skills and encourages attitudes like respect and positivity in them.

It was also described earlier as a humanistic, permissive, living-learning environment(1).

Milieu therapy works on a consistent method i.e. people are surrounded by a safe and structured community and their daily activities and interactions are the means of receiving therapy.

How Does Milieu Therapy Work?

A person undergoing milieu therapy has to spend a significant amount of time in a home-like environment. There he interacts with people and does ordinary activities throughout the day. There may be group sessions or individual therapy sessions that are part of the schedule.

The person establishes the treatment goals and makes decisions for himself. He also would be involved in making decisions for the community.

There are various challenges involved in the course of the day and the person learns new ways of responding to peers and counselors.

The duration of milieu therapy of an individual depends on the program to program.

Guiding Principles Of Milieu Therapy

Structured Physical Environment

The physical environment for milieu therapy is safe and carefully structured. It emphasizes on routines, boundaries, and open communication to build trust faster between the people in the program.

3 Different Types Of Spaces Are Used:

  • Fixed feature space in which the design of the building structure and everything is unmovable.
  • Semi-fixed space in which the objects such as furniture and other physical objects are movable
  • Informal space in which the interpersonal space includes physical distances between people who are interacting socially.

Interdisciplinary Treatment Teams

People undergoing milieu therapy receive care from different healthcare professionals. This helps benefit them from a variety of skill sets and perspectives.

Studies show that interdisciplinary teams help in developing better goals for patients(2). They foster a good learning climate and equality between clients and staff members.

Mutual Respect

The most powerful aspect of this therapy is that everyone in these programs both the therapist and patients deserve respect.

It focuses on creating a supportive environment in which people can talk with each other about their experiences as they go ahead with the day.

Individual Responsibility

People in milieu therapy not only are allowed to make their own decisions but also think for themselves and do things on their own.

It prepares them to emerge as more confident and able to handle stressors in the larger society.

Activities as Opportunities

During the treatment people undergoing therapy are assigned different responsibilities that contribute to their environment functioning. It allows people to choose everyday activities so that they feel comfortable and more productive.

These activities are done to change the perspective and the way of thinking and action that is not considered healthy.

Peer Communication Therapy

Group dynamics play an important role in shaping the behavior of a person. It helps people understand, how their behavior affects other people(3).

While doing activities, interacting, working, and playing in groups, conflicts arise and a person learns new ways to cope and respond to them.

What Conditions Are Treated By Milieu Therapy?

Milieu therapy is used for the treatment of various psychological and behavioral conditions that include eating disorder, behavior disorder, and schizophrenia.(4, 5)

The success of the therapy varies from group to group.

Risks and Disadvantages of Milieu Therapy

Just like any therapy or treatment, milieu therapy also has some problems.

  1. The ratio of staff to patients: When there are not enough caregivers there would be a greater need to control the environment that may lead to an authoritarian communication style. Some nurses and therapists repost being vulnerable to get physically or emotionally hurt by the patients(6).
  1. Adjustment in the outside environment: This is a primary concern of people in milieu therapy as they might have a hard time adjusting outside the treatment settings.

If wanting to go ahead with milieu therapy it is important to find a program that offers support as one move out of the treatment environment into a larger society.

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