Milieu therapy consists of treatment by means of controlled modification of the client's environment to promote positive living experiences.

1. CONCEPTS AND PRINCIPLES RELATED TO MILIEU THERAPY:
1. Everything that happens to clients from the time they are admitted to the hospital or treatment setting has a potential that is either therapeutic or antitherapeutic.
1. Not only the therapists but all who come in contact with the clients in the treatment setting are important to the clients' recovery.
2. Emphasis is on the social, economic, and cultural dimension, the interpersonal climate, and the physical environment.
2. Clients have the right, privilege, and responsibility to make decisions about daily living activities in the treatment setting.
2. CHARACTERISTICS of milieu therapy:
1. Friendly, warm, trusting, secure, supportive, comforting atmosphere throughout the unit.
2. An optimistic attitude about prognosis of illness.
3. Attention to comfort, food, and daily living needs; help with resolving difficulties related to tasks of daily living.
4. Opportunity for clients to take responsibility for themselves and for the welfare of the unit in gradual steps.
1. Client government.
2. Client-planned and client-directed social activities.
5. Maximum individualization in dealing with clients, especially regarding treatment and privileges in accordance with clients' needs.
6. Opportunity to live through and test out situations in a realistic way by providing a setting that is a microcosm of the larger world outside.
7. Opportunity to discuss interpersonal relationships in the unit among clients and between clients and staff (decreased social distance between staff and clients).
8. Program of carefully selected resocialization activities to prevent regression.
3. NURSING CARE PLAN/IMPLEMENTATION in milieu therapy:
1. New structured relationships—allow clients to develop new abilities and use past skills; support them through new experiences as needed; help build liaisons with others; set limits; help clients modify destructive behavior; encourage group solutions to daily living problems.
2. Managerial—inform clients about expectations; preserve orderliness of events.
3. Environmental manipulation—regulate the outside environment to alter daily surroundings.
1. Geographically move clients to units more conducive to their needs.
2. Work with families, clergy, employers, etc.
3. Control visitors for the benefit of the client.
4. Team approach uses the milieu to meet each client's needs.
4. EVALUATION/OUTCOMES CRITERIA:
1. Physical dimension: order, organization.
2. Social dimension: clarity of expectations, practical orientation.
3. Emotional dimension: involvement, support, responsibility, openness, valuing, accepting.