2THE THERAPEUTIC ENVIRONMENT OR MILIEU Physical:Psychological:Structure:Relationships:“The one practice that a CYW draws on consistently in their work is that of a therapeutic milieu or environment. An environment that fosters healthy relationship building, routine, consistency and structure is key to working with troubled children and youth.”
3THE DIMENSIONS OF THE THERAPEUTIC ENVIRONMENT Relationship DimensionFoundation of work with youthRelationship serves as a means of behavioural interventionBuilds assets in youth ( modeling etc.)Direct impact on personal development (opportunity for LSIs, direct counseling etc.)Encouragement is the cornerstone of an effective relationshipEncouragement reinforces effort as well as outcomeStaff to staff, staff to youth, youth to youth
4THE DIMENSIONS OF THE THERAPEUTIC ENVIRONMENT Personal Development DimensionEncourages potentialAn environment that supports growthAwareness of and support to meet developmental tasksGoal orientationStrength based approach
5THE DIMENSIONS OF THE THERAPEUTIC ENVIRONMENT System Maintenance and Change DimensionAppearance, order, routine and structureDaily expectationsStaff vs. resident controlResponsiveness to changeManagement of client movement – short -term placementsThe issue of turnover! Burnout and its consequences.The system of disciplineEmotional neutralityEncouragementLogical Consequences
6DISCIPLINE WITHIN A THERAPEUTIC ENVIRONMENT Emotional NeutralityEasier said than done!Depersonalizing behaviorDealing with issues without engaging in power strugglesConscientious effort to control both verbal and nonverbal behaviors when confronted with client misbehaviorHelping defuse client anger by forcing staff to depersonalize their interventionsImportant to remember that client/staff conflict is almost always a lose-lose proposition for staffChoosing your battles wisely!
7DISCIPLINE WITHIN A THERAPEUTIC ENVIRONMENT EncouragementEncouragement builds relationships, relationships effectively modify behavior.Encouragement builds self worth.Encouragement builds intrinsic motivation ( motivation that comes from within).Encouragement assists in building resiliency.Encouragement reinforces effort as well as success.
8DISCIPLINE WITHIN A THERAPEUTIC ENVIRONMENT Logical ConsequencesBehavior is followed by a consequence.Logical consequences accomplish discipline without jeopardizing relationships.Emotional neutrality ensures no judgment or anger involvedLogical consequences “make sense”.Categories of consequences:NaturalLogicalPunishment
9THE THERAPEUTIC AGENCY If an agency aims toward the development of a therapeutic environment or milieu, it is necessary to:Fully develop a system of logical consequences which address both positive and negative behaviorsEliminate punishmentThe way in which an agency structures the measures taken to correct misbehavior directly correlates with how therapeutic the environment is for children and youth.
10This presentation was prepared and has been shared by Nancy Brown Brunton, Professor, CYW Program.