Milieu therapy

the milieu therapy is a hospital therapy. its made by the hospital to improve the patient health.

1. milieu therapy MR. KULTHE VIKRANT R M SC NURSING

2. INTRODUCTION . The milieu therapy in that the word milieu is the French for “Middle”. The English translation of the word is SURROUNDINGS OR ENVIRONMENT. In psychiatry, therapy involving the milieu or environment , may be called milieu therapy. The therapeutic milieu is an environment that is structured and maintained as an ideal, dynamic settings in which to work, with client. The milieu therapy include safe physical surrounding, all the treatment team members, and other client.

3. PURPOSES OF MILIEU THERAPY Correct the redefine perception of stressors. Correct the maladaptive behaviour. Develop adaptive coping. Acquire interpersonal and stress-management skill. Manipulate the environment so that all aspects of clients hospital experiences are considered therapeutic. Client is expected to learn adaptive coping, interaction and relationship skill that can be generalized to other aspects of his or her life. Achieving client autonomy.

4. PRINCIPLES OF MILIEU THERAPY To promote a fundamental respect for individual.(staff and client) To use the opportunities for communication between client and staff for maximum therapeutic benefit. To encourage client to cut at a level equal to their ability and to enhance their self-esteem. To promote socialization. To provide the opportunities for clients to be part of unit management. Individuals are held responsible for own action.

5. Client is expected to learn adaptive coping, interaction and relationship skill that can be generalized to other aspects of his or her life. Achieving client autonomy. Peer pressure is utilized to reinforce rules and regulations. Team approach is used. Group discussions and temporary seclusions are favored approaches for acting out behaviour. The nurses, function is to act in way that consistently promote these goals.

6. DISRIBUTION OF POWER The milieu therapy approach involves ‘flattening’ the control hierarchy so all participants have a voice in decision making. This process may include the whole population of the treatment unit, or a governing council may take the final decision based on input from various smaller groups of clients and staff members.

7. 2. OPEN COMMUNICATION. In the therapy, treatment decisions are often made by the client themselves , who therefore need information to make effective decision. It is not necessary to communicate personal information but clients and staff need to be aware of individual treatment goals to ensure everyone is working towards the same goals.

8. 3.STRUCTURED INTERACTION It’s a interaction approach is that all staff members approach the client in a consistent manner, acknowledging specific diagnostic areas, therapy shortening treatment time.

9. 4.WORK- RELATED ACTIVITIES Frist, clients need to choose the type of work they wish to perform. Second, work activity should be geared towards developing skills that will be useful in actual job situation. Thirds, a variety of activities provide the opportunities to test different areas for future job interest .

10. 5.COMMUNITY AND FAMILY INVOLVEMENT IN THE TRETMENT PROCESS Clients are kept in their usual environment, for example a day treatment centre, or halfway house, and continue most of their routine activities while receiving treatment.

11. 6. ADAPTATION OF THE ENVIRONMENT TO MEET THE DEVELOPMENTAL NEED To develop his full potential an individual must have an environment adapted to his current need. Adapting the environment to meet these multiple needs is challenging due to the extension of milieu therapy to all age group and the inclusion of family members with individuals of varying ages within the treatment milieu.

12. COMPONENTS OF MILIEU THERAPY 1) MAINTAINING SAFE ENVIRONMENT : Dispose of all needles safely and out of reach of client. Do not allow smoking. Restrict or monitor the the use of matches and lighters. Keep away sharp instrument from patient. Identify potential weapons e.g. mop handles, hammers. Do not leave medicines unattended or unlocked. Be aware of items that are harmful if ingested, e.g. mercury in monometer.

13. 2) THE TRUST RELETIONSHIP One of the key to therapeutic environment is the establishment of trust. Trust is the foundation of therapeutic relationship, and limit settings and consistency are its building blocks.

14. 3) BUILDING SELF-ESTEEM Set and maintain limits. Accepts the clients as a person. Be non-judgmental at all times. Structures the clients time and activities. Initially provide the client with task, responsibility and activities. Allow the client to make his own decisions whenever possible.

15. 4) LIMIT SETTINGS State the expectation or limits as clearly, directly and simply as possible. The consequence that will fallow the clients exceeding the limits also must be clearly stated at the outset. The consequence should immediately follow the clients exceeding's the limits and must be the consistent, both over time and among staff

16. Advantages of milieu therapy Its create different type and attitude and behaviour of client because the environment like home. Patient learn the making decisions which improve his self confidence. Its develop a leadership skill. It becomes the sociocentric. Its help to learns the live and think collectively with the members of the community.

17. DISADVANTAGES OF MILIEU THERAPY Role blurring between staff and patient. Milieu therapy is limited to only hospitalise patient. Requires continuous open communication among all staff and clients. Group responsibility can easily becomes nobody’s responsibility. Low client-to-staff ratio.

18. ROLE OF NURSE IN MILIEU THERAPY: A nurse participate in the design and or renovation of the settings can greatly affect the therapeutic physical environment. The nurse responsible for making the referrals, encouraging clients participation. The coordinate all team member is involve in team The nurse may interpret the need of the client population for design expert with knowledge of colour.