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Lecture 5 Community and Mental Health Nursing-NUR 472 Milieu — The Therapeutic Environment.

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Presentation on theme: "Lecture 5 Community and Mental Health Nursing-NUR 472 Milieu — The Therapeutic Environment."— Presentation transcript:

1 Lecture 5 Community and Mental Health Nursing-NUR 472 Milieu — The Therapeutic Environment

2 Milieu, Defined  Milieu is the French word – in English translation, the word milieu means “surroundings, or environment.”  Milieu therapy is the treatment of mental disorder or maladjustment by making substantial changes in a patient's immediate life circumstances and environment in a way that will enhance the effectiveness of other forms of therapy.  Milieu therapy, or therapeutic community, is defined as a scientific structuring of the environment to effect behavioral changes and to improve the psychological health and functioning of the individual.

3 Milieu Therapy  Client makes decisions and solves problems related to government of the unit.  Destructive behaviors can usually be controlled with group discussion. However, if an individual requires external controls, temporary isolation is preferred over lengthy restriction or other harsh punishment.

4 Goals of milieu therapy  Manipulate the environment so that all aspects of client’s hospital experience are considered therapeutic.  Client is expected to learn adaptive coping, interaction and relationship skills that can be generalized to other aspects of his or her life.  Achieving client autonomy

5 Principles of milieu therapy  To promote a fundamental respect for individuals (both clients and staff).  To use opportunities for communication between client and staff for maximum therapeutic benefit.  To encourage clients to act at a level equal to their ability and to enhance their self esteem( autonomy is reinforced)  To promote socialization.  To provide opportunities for clients to be part of unit management.

6 Principles of milieu therapy(cont.)  Individuals are held responsible for own actions.  Peer pressure is utilized to reinforce rules and regulations.  Team approach is used.  Group discussions and temporary seclusions are favored approaches for acting out behavior.  The nurses function is to act in ways that consistently promote these goals.

7 The Program of Therapeutic Community  The treatment plan is directed by an interdisciplinary team.  Disciplines may include psychiatry, psychology, nursing, social work, occupational therapy, recreational therapy, art therapy, music therapy, dietetics, and the clergy.  The plan is formulated by the team.  Team members of all disciplines sign the plan and meet regularly to update the plan as needed.

8 Role of the Nurse  Through use of the nursing process, nurses manage the therapeutic environment on a 24-hour basis.  Nurses have the responsibility for ensuring that the client ’ s physiological and psychological needs are met.  Nurses are also responsible for  Medication administration  Development of a one-to-one relationship  Setting limits on unacceptable behavior  Client education


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