NCJ Number
72431
Date Published
1980
Length
13 pages
Annotation
Twelve milieu variables are identified in a residential treatment program for children; they illustrate the difficulties of clinically assessing milieu factor impact upon the treatment process.
Abstract
Seven meanings of the term 'therapeutic milieu' are cited to point out the conceptual confusion in its use. The crucial element of a milieu artificially created for the purpose of treating children is the social structure, including role distribution of the adult figures, the 'pecking order' among the patients, and the communications network. Next in importance are primary values, routines, rituals, and behavioral regulations, and the impact of the group process. Dominant trait clusters of individual patients, attitudes and feelings of the staff, the impact of behaviors received by a child in a day's time, are also important factors, as are activity structure and the nature of constituent performances. Affecting the milieu further is the influence of 'space, equipment, time, and props' upon utilization of time by the professional staff. Impacts of the 'outside world', i.e., factors outside the treatment process, are also to be considered, along with adult assistance given to disturbed children for coping with their environment, including social interaction with other children. The final factor is the mechanisms for insuring continuing sensitivity of the changing needs of patients during different phases of the treatment process. Rather than studying the components of the milieu per se, isolated milieu ingredients should be observed as they 'hit' the child in a specific setting during a specified activity. In this way, the actual experience that a concrete situation in a given setting produced in the child may be traced. Three references are provided.