1. Milieu-therapy with children and youth -The organization as therapist
ERIK LARSEN
Professor emeritus
Specialist in clinical psychology
Tartu, March, 3rd 2017
Milieu-therapy with children and youth
-The organization as therapist

2. INTRODUCTION
This lecture will focus on the concept of milieu-therapi and how this form of psychotherapy can be imlimented.
Different levels of milieu-therapeutic work will be discussed and the importance of defining the therapeutic task will be emphesized.
The evailable resources in milieu-therapeutic work will be presented, and the role of the milieu-therapist will be presented.

3. Introduction continues
Finally the characteristics of children and youth who need milieu-therapi will be presented and commented.

4. THE CONCEPTS SERVICE
MILIEU-THERAPY
ORGANIZING
DEVELPOMENT/CHANGE

5. THE MILIEU –THERAPEUTIC HOUSE
Basic models, theories and concepts
Room for investigations and reflections
Conference and meetings
Supervision
Dialogues amongst colleagues
Everyday milieu-therapeutic life
The milieu –therapeutic field of power

6. Organizational culture - definition
Basic values and basic assumptions that are som important for the organization that new members are socialized to them.
Examples of basic values are curiousity and generousity.
Examples of basic assumption are the importance of supervision and a good dialogue among colleagues.

7. THE MUTUAL RELATION BETWEEN THE TASK, THE WAY OF ORGANIZING AND PROFESSIONAL KNOWLEDGE
THE PRIMARY MILIEU –THERAPEUTIC TASK
THE MILIEU-THERAPEUTIC ORGANIZATION
PROFESSIONAL KNOWLEDGE THAT MAKES IT POSSIBLE TO SOLVE THE TASK

8. RESOURCES IN WORKING WITH THE PRIMARY MILIEU –THERAPEUTIC TASK
The milieu- therapeutic territory
The milieu- therapeutic time
The availability in the role as milieu -therapist

9. THE MILIEUTHERAPEUTIC ORGANIZATION
The formal organization
The dynamic organization

10. MILIEU-THERAPY IN A SYSTEMORIENTATED PERSPECTIVE
The milieu –therapeutic organization
The personelsystem
The clientsystem
The system of children or youth
Milieu-therapists
Milieu –therapeutic leadership

11. THE ROLES IN MILIEU –THERAPEUTIC WORK
The formal roles
The dynamic roles

12. THE INTEGRATED MILIEU –THERAPIST ROLE
Formal qualifications
Formal education
Developmental psychology
Organizational understanding
Family comprehension
Knowledge about activities
Informal gualifications
„Life`s school“
One`s basic family
One`s actual family
Professional experiences
Interests and hobbies
Being personally suitable
The value as model, the ability for empathy
Good communication
Can handle critics
Not easily insulted
Formal experiences
One`s own therapy
Supervision
Reflections with colleagues

13. INTEGRATED, DESINTEGRATED AND POORLY INTEGRATED YOUTHS
They can understand the connections between feelings, thoughts and behavior
DESINTEGRATED YOUTHS
They have temporarily lost their ability to see these connections
POORLY INTEGRATED YOUTHS
These youngsters do not understand the connections between feelings, thoughts and behavior
There youngsters commute between their longings for attachment and contact and their anxiety for attachment and contact
They lack concepts for „ their inner life“
They have an unclear picture of their self-esteem
They have an unclear boundary between fantasy and reality
They have fixed „pictures of reality“ and these fixed Pictures are not investigated
They basically strive with the theme of survival

14. FIGHT
FLIGHT
FREEZE

15. THANK YOU