1. Therapeutic Environments

2. THE 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.”

3. THE DIMENSIONS OF THE THERAPEUTIC ENVIRONMENT
Relationship Dimension
Foundation of work with youth
Relationship serves as a means of behavioural intervention
Builds assets in youth ( modeling etc.)
Direct impact on personal development (opportunity for LSIs, direct counseling etc.)
Encouragement is the cornerstone of an effective relationship
Encouragement reinforces effort as well as outcome
Staff to staff, staff to youth, youth to youth

4. THE DIMENSIONS OF THE THERAPEUTIC ENVIRONMENT
Personal Development Dimension
Encourages potential
An environment that supports growth
Awareness of and support to meet developmental tasks
Goal orientation
Strength based approach

5. THE DIMENSIONS OF THE THERAPEUTIC ENVIRONMENT
System Maintenance and Change Dimension
Appearance, order, routine and structure
Daily expectations
Staff vs. resident control
Responsiveness to change
Management of client movement – short -term placements
The issue of turnover! Burnout and its consequences.
The system of discipline
Emotional neutrality
Encouragement
Logical Consequences

6. DISCIPLINE WITHIN A THERAPEUTIC ENVIRONMENT
Emotional Neutrality
Easier said than done!
Depersonalizing behavior
Dealing with issues without engaging in power struggles
Conscientious effort to control both verbal and nonverbal behaviors when confronted with client misbehavior
Helping defuse client anger by forcing staff to depersonalize their interventions
Important to remember that client/staff conflict is almost always a lose-lose proposition for staff
Choosing your battles wisely!

7. DISCIPLINE WITHIN A THERAPEUTIC ENVIRONMENT
Encouragement
Encouragement 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.

8. DISCIPLINE WITHIN A THERAPEUTIC ENVIRONMENT
Logical Consequences
Behavior is followed by a consequence.
Logical consequences accomplish discipline without jeopardizing relationships.
Emotional neutrality ensures no judgment or anger involved
Logical consequences “make sense”.
Categories of consequences:
Natural
Logical
Punishment

9. THE 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 behaviors
Eliminate punishment
The way in which an agency structures the measures taken to correct misbehavior directly correlates with how therapeutic the environment is for children and youth.

10. This presentation was prepared and has been shared by Nancy Brown Brunton, Professor, CYW Program.