Milieu Therapy Therapeutic Community Introduction The psychiatricmental health

Milieu Therapy – Therapeutic Community

Introduction • The psychiatric-mental health nurse provides structures, and maintains a therapeutic environment in collaboration with the patient and other health care clinicians. ” Standard Vb of the American Nurses Association Standards of Psychiatric– Mental Health Nursing Practice

Milieu, Defined • Milieu therapy, or therapeutic community, is defined as “a scientific structuring of the environment to effect behavioral changes and to improve the psychological health and functioning of the individual. ” • Within therapeutic community setting, the patient is expected to learn adaptive coping, interaction, and relationship skills that can be generalized to other aspects of his or her life.

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

Conditions that Promote a Therapeutic Community • Basic physiological needs are fulfilled. • The physical facilities are conductive to achievement of the goals of therapy. • A democratic form of self-government exists. • Unit responsibilities are assigned according to patient capabilities. • A structured program of social and work-related activities is scheduled as part of the treatment program. • Community and family are included in the program of therapy in an effort to facilitate discharge from the hospital.

The Program of Therapeutic Community • A treatment plan is directed by an interdisciplinary team. • The plan is formulated by the team. • Team members of all disciplines sign the plan and meet weekly to update the plan as needed. • Disciplines may include psychiatry, psychology, nursing, social work, occupational therapy, recreational therapy, art therapy, music therapy, dietetics, chaplain’s service and family. • The core team members are the psychiatry, nursing and social workers to have a treatment team meeting.

Role of the Nurse • Through use of the nursing process, nurses manage therapeutic environment on a 24 -hour basis. • Nurses have the responsibility for ensuring that the patient’s physiological and psychological needs are met. • Nurses are also responsible for – Medication administration – Development of a one-to-one relationship – Setting limits on unacceptable behavior – Recognizing positive behaviors – Client education