Milieu Therapy

MILIEU THERAPY
PRESENTED BY:
ANUSIKTA PANDA
ROLL NO-1988015
MSC NURSING 1ST YEAR
OBJECTIVES: At the end of the class the students will able
to-
• Define milieu therapy
• Elaborate the historical overview
• Identify different purposes and goals of milieu therapy.
• Explain the principle
• Classify different components
• Differentiate advantages and disadvantages
• List the qualities of nurses in milieu therapy
DEFINITION
Milieu therapy:
A scientific structuring of the environment in order
to effect behavioral changes and to improve the
psychological health and functioning of individual
(Skinner, 1979).
Cont....
Milieu therapy or therapeutic community approach
attempts to make the maximum use of –
i.The social system and its constituents (i.e. the patient,
his relatives ,neighbors
ii.Personnel and the hospital community (i.e. psychiatric,
nurse, psychologist, social worker, other patients) to
modify the patient’s behavior so that he may manage his
life and his personal relationship in a more constructive
manner.
HISTORICAL OVERVIEW
• Milieu therapy came into its own during the 1960s through
early 1980s.
• The term “milieu therapy” was coined in Germany in the
early 1900s to describe a new hospital treatment for
psychiatric patients.
• It was first called activere behandlugen-more active
therapy-and later, milieu therapie.
Cont.....
• Its founder, P. Pinel, created a revolution in his time by urging
that the mentally ill be treated compassionately and with
understanding.
• During this period, psychiatric patient provided sufficient time to
implement programs of therapy that were aimed at social
rehabilitation.
• This basic approach was used in a psychiatric setting by bringing
more interaction between the staff and patient and was called
THERAPUTIC COMMUNITY by Maxwell Jones(1953).
GOAL OR PURPOSES:
To minimize the anti therapeutic environment for the patient in
the ward. For example , telling other nurses that he is always sad let
him stay in the bed only
To minimize prolongation of hospitalization by helping in early
recovery.
To minimize maladaptive behaviour. Creating an environment
where maladaptive behaviour is discouraged.
To provide a free and favourable climate in which the patient can
talk and gain awareness of his own feelings, impulses and behaviour
PRINCIPLES
The patient is involved in his own therapy.

Decision making ability improves the self
confidence of the patient.
It provides an environment of free
communication.
Reduce hospital authoritativeness.
The patient is also directed to focus his
attention not only on his own needs but also
on the needs of other patients.
Cont.....
In a mental hospital or psychiatric ward, patients are away from

society. So they feel isolated. Milieu therapy reduces social isolation
and dehumanization of a large hospital.
It attempts to reduce the feeling in the patient about the supreme
power of the doctor.
Through the nurse sets limits and has various roles to play, still
the patient considers his part of milieu in which he is living. The
nurse needs to be consistent in setting limits.
COMPONENTS OF MILIEU THERAPY
ADVANTAGES AND DISADVANTAGES
ROLE OF NURSE IN MILIEU THERAPY
Nurses are involved in all day-to-day activities of client
care.
Nurses have input into therapy goals and participate in the
regular updates and modification of treatment plans.
Assessing physical status is an important nursing
responsibility that must not be overlooked in a psychiatric
setting that emphasizes holistic care.
Reality orientation for clients who have disorganized
thinking or who are disoriented or confused is important in
the therapeutic milieu.
Cont.......
Nurses should ensure that clients have written schedules

of activities to which they are assigned and that they arrive
at those activities as scheduled.
Some clients may require an identification sign on their
door to remind them which room is theirs.
On short-term units, nurses who are dealing with
psychotic clients usually rely on a basic activity or topic
that helps keep people oriented.
Cont....
The nurse control and set the limitations of the group.
Through the use of the nursing process, nurses manage the
therapeutic environment 24hour.
Nurses have the responsibility for ensuring that the clients
psychological needs are met. 
Nurses are also responsible for- 
a)Medication of administration 
b)Development of a one-to-one relationship. 
c) Setting limits on unacceptable behavior. 
d)Client education
PATIENT EDUCATION POINTS
BIBLIOGRAPHY
• Kapoor bimla, textbook of psychiatric nursing,

kapoor publising house, 2nd edition, page no 98-102.
• Ahuja nirja, a short textbook of psychiatric, jaypee
publication, 17th edition, page no 396-398.
• https://www.google.com/search?q=milieu+therapy
• https://en.wikipedia.org/wiki/Milieu_therapy
• https://www.slideshare.net/kulthevikrant/milieu-
therapy-111938631

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MILIEU THERAPY

The patient is involved in his own therapy.

In a mental hospital or psychiatric ward, patients are away from

Nurses should ensure that clients have written schedules

• Kapoor bimla, textbook of psychiatric nursing,

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