Milieu therapy is a unique form of mental illness treatment involving significant changes to a person’s lifestyle and living environment. These changes are meant to improve the efficacy of cognitive behavioral therapy, motivational interviewing and other types of psychotherapy.
- The word “milieu” means environment.
By manipulating a patient’s environment within an in-patient, group setting, milieu therapy supports the ability of patients to learn new coping skills and interaction insights that can be utilized and generalized into all aspects of their lives. The goal of milieu therapy is improved self-esteem, a growing sense of independence and patient autonomy outside the therapeutic environment.
Milieu Therapy Examples
Milieu therapy is based primarily on behaviorism, a provocative theory of human motivation and the illusion of free will, developed by B. F. Skinner during the 1950s. Skinner later defined milieu therapy as a way to “scientifically structure an environment to induce behavioral changes for improving the psychological functioning and health of individuals”.
Behaviorist Concepts Shaping Milieu Therapy
Operant Conditioning–shaping behavior by exposing patients to situations in which they are compensated in some way for their behavior. In milieu therapy, patients are praised and complimented for using positive coping and relationship skills to deal with incidences of interpersonal friction.
Group Conformity–people are prone to conforming to similar behaviors and beliefs held by a group of individuals, especially when they interact consistently with this group. By participating in group-based milieu therapy, patients are more likely to learn and utilize behaviors conducive to being able to live independently.
Additional Milieu Therapy Concepts
- Patients own their environment. They make their own decisions and solve problems without guidance from the therapist overseeing such a community.
- Individuals participating in milieu therapy are expected to take responsibility for their words and actions. They are not allowed to blame their mental health issue for consequences of unproductive behavior.
- When patients cause problems due to inappropriate behavior, the therapist gathers the community together to examine how this type of behavior impacts others. A discussion regarding more acceptable ways for resolving personal and interpersonal dilemmas is also encouraged.
- In addition to treating mental illness, milieu therapy techniques are used to help children with a severe autistic spectrum disorder learn how to communicate more effectively. Milieu speech therapy focuses on teaching children new behaviors and skills within natural environments.
Treating Schizophrenia With Milieu Therapy
The therapeutic experience underlying milieu therapy extends beyond the treating acute symptoms with medication or one-on-one counseling. Instead of focusing on psychopharmacology to help people with schizophrenia deal with abnormal thought processes and perceptions, milieu therapy provides holistic, patient-centered resolutions that foster living skills and increased independence.
Long-term residential treatment programs often integrate milieu therapy since these types of programs sustain consistent communities. By interacting and bonding with others who have also been diagnosed with schizophrenia, patients (along with the guidance of a professional milieu therapist) learn concrete, valuable behavioral and emotion-regulating skills that nurture their self-esteem and self-identity in ways psychotic medications cannot by themselves.
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