MILLEU THERAPU for B.Sc. nursing students.

Details description of milleu therapy or therapeutic community

1. DEFINITION A scientific structuring of the environment in order to effect behavioral changes and to improve the psychological health and functioning of the individual (Skinner, 1979).

2. Basic Assumptions/ PRINCIPLES The health in 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 behavior. Peer pressure is a useful and a powerful tool. Inappropriate behaviors are dealt with as they occur. Restrictions and punishment are to be avoided.

3. Conditions That Promote a Therapeutic Community Basic physiological needs are fulfilled. The physical facilities are conducive to achievement of the goals of therapy. A democratic form of self-government exists. Responsibilities are assigned according to client 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 treatment.

4. COMPONENTS Daily community meetings Patient government or ward council Staff meetings or review Living and learning opportunities

5. Advantages of Therapeutic Community Patient develops harmonious relationships with other members of the community. Gains self-confidence. Develops leadership skills. Learns to understand and solve problems of self and others. Becomes socio-centric. Learns to live and think collectively with the members of the community.

6. Disadvantages of Therapeutic Community Role blurring between staff and patient. Group responsibility can easily become nobody's responsibility. Individual needs and concerns may not be met. Patient may find the transition to community difficult

7. Role of the Nurse Providing and maintaining a safe and conflict free environment through role modeling and group leadership. Sharing of responsibilities with patients. Encouraging patient to participate in decision making functions. Assisting patients to assume leadership roles. Giving feedback. Carrying out supervisory functions.