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Results for “Milieu Therapy”

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At least 19 recordsLinked to original sources
PubMed1976

A comparative evaluation of two day hospitals. Goal attainment scaling of behavior therapy vs. milieu therapy.

Previous attempts at program evaluation of partial hospitalization programs have consisted largely of descriptive and anecdotal reports of programs and patient characteristics. There have been no comparative or experimental studies of the effectiveness of differing day treatment programs. In the current study, Goal Attainment Scaling, a goal-oriented program evaluation system, was used with 56 randomly selected partial hospitalization patients who attended two day hospitals: one program was based on behavioral-educational methods, and the other was an eclectic program based on the concepts of a therapeutic community. Patients attending the behavioral-educational program showed greater attainment of their therapeutic goals than did the patients involved in the eclectic program. The greater effectiveness of the behavioral-educational day program increased from the 3-month follow-up to the 2-year follow-up.

Adolescent↗
PubMed2000

The milieu and milieu therapy in adolescent mental health nursing.

The milieu is a well discussed concept in the mental health nursing literature; so too is milieu therapy. Nevertheless, despite evidently clear understandings of the milieu's significance, and of its therapeutic potential, little published mental health nursing research focuses on these areas of practice. As a result, within the specialty, theoretical conceptualizations of the milieu remain unchallenged and theory development remains in its infancy. Findings from an inquiry into the practice of adolescent mental health nursing demonstrate the: (1) nature, (2) construction, (3) maintenance, (4) function, (5) therapeutic effects, and (6) outcomes of the milieu. Through these findings, present theoretical conceptualizations of the milieu are examined and expanded, and a beginning theory of the adolescent milieu, and of milieu therapy, is presented.

Adolescent↗
PubMed2000

Inpatient treatment of severe disruptive behaviour disorders with risperidone and milieu therapy.

OBJECTIVES: To evaluate the therapeutic impact of adding risperidone to milieu therapy of latency-aged inpatients with severe disruptive disorders. METHODS: The charts of 90 latency-aged patients consecutively admitted to a psychiatry ward were reviewed retrospectively. Fifteen of these patients received risperidone treatment, were nonpsychotic, and did not suffer from pervasive developmental disorder (12 male, 3 female; mean age 9.99 years, SD 1.76). Their scores on the Children's Global Assessment Scale (CGAS) were compared at admission, before risperidone treatment, and at discharge. RESULTS: All subjects were diagnosed with a disruptive behavioural disorder. Ten (66.67%) had additional learning difficulties, and 13 (86.7%) had pathological personality traits. The characteristics of the sample suggested borderline pathology or multiple complex developmental disorder. Following a mean of 38 days after admission (SD 22.3), the patients received risperidone for a mean of 46 days (SD 28.2) before being discharged. The mean maintenance dose of risperidone was 1.27 mg daily (SD 0.36). Mean CGAS scores increased from admission (21.9, SD 7.0) to before risperidone treatment (26.8, SD 7.6, P < 0.0001) and to discharge (50.3, SD 5.3, P < 0.0001). Only 2 patients had documented side effects. CONCLUSIONS: Low-dose risperidone used adjunctively to milieu therapy led to statistically and clinically significant additional improvement in the functioning of hospitalized latency-aged children with severe behavioural disorders. Low-dose risperidone is a safe and effective adjunct to milieu therapy for treating this population in inpatient settings. Prospective randomized controlled trials are needed to confirm these findings.

Adolescent↗
PubMedDate not supplied

Milieu therapy: a therapeutic loophole.

TOPIC: The confusion over, and ultimate demise of, milieu therapy. SOURCE: Literature review. GOAL: To chronicle the conceptual problems and other events leading to the decline in the use of milieu therapy. CONCLUSION: Inpatient nurses would do best to leave the concept of milieu therapy behind and focus on clarifying how specific nursing interventions are operationalized and tied to patient outcomes.

Humans↗
PubMedDate not supplied

Milieu therapy: a review of development of this concept and its implications for psychiatric nursing.

Milieu therapy has long existed as an effective treatment modality for the mentally ill. It has also been a significant aspect of psychiatric-mental health nursing practice for several decades. This article reviews the history of milieu therapy and the role that psychiatric-mental health nursing staffs have in its implementation. The authors suggest strategies for milieu management and future implications for milieu therapy.

Forecasting↗
PubMed2000

[Milieu therapy for patients with dementia. Appropriate, regular stimulation by pleasant experiences].

The target group includes caregivers of demented persons at home and in institutions. The aim is a synopsis of different ways to cope with behavioural disturbances by milieu-therapy for demented persons. Appeals are made to their remaining resources, thus getting them more joy and less frustration by less excessive demands. Less boring activities avoid to feel under-challenged. More activity during day-time provides better sleep at night.--Consequently there are less behavioural disturbances with less stress for caregivers thus enabling them to keep the patients longer at home, leading to lower health costs. Behavioural disturbances of demented persons should always be treated by milieu-therapy achieving a response rate of up to 60%. With application of adjuvant medication, e.g. geriatric neuroleptics, a rate of 70% is within reach. Milieu-therapy is optimal for the prevention of behavioural disturbances. The better the adaptation of milieu-therapy to the individual patient's deficits and lifestyle and to the lifestyle of his caregiver, the better the effect.

Aged↗
PubMedDate not supplied

Why are the results of milieu therapy for schizophrenic patients contradictory? An analysis based on four empirical studies.

The results of milieu therapy with psychotic patients have been highly conflicting because of unrecognized differences among the wards investigated. Our own research indicates that for psychotic patients in short- and intermediate-term wards: A beneficial milieu has a low perceived level of anger and aggression and a high level of support, practical orientation, and order and organization. Confronting group therapy is detrimental and individually oriented milieu therapy beneficial. Community groups may become anti-therapeutic pseudo-groups. Extensive use of confrontational groups may contribute to a detrimental ward atmosphere. A high mean age of patients may contribute to a favorable low level of aggression. A high percentage of psychotic patients, a high number of patients, and a high staff turnover may lead to a detrimental atmosphere. On this basis we tried to change the milieu on a 26-bed therapeutic community ward which proved to have pseudo-groups and a detrimental ward atmosphere. The amount of compulsory group activities was reduced, the groups made more task-oriented, the amount of individually oriented milieu therapy increased, and the number of beds reduced. At re-evaluation the ward atmosphere had improved considerably.

Age Factors↗
PubMed1992

Milieu therapy for short stay units: a transformed practice theory.

Milieu therapy is an interdisciplinary treatment approach widely applied in psychiatric settings. Current short stay inpatient trends indicate a need to adapt the approach so that it remains useful for nursing practice in those settings. This report presents basic historical milieu concepts with their relationships to patient outcome; current short stay patient needs, outcomes, and nursing actions are developed and linked with the historical concepts. The resulting transformed theory can be seen as an adaptation of the classic approach, tailored to short stay settings, with short-term goals and a clarified role for the nurse in the milieu.

Hospitalization↗
PubMed1978

Milieu therapy with the adolescent sociopath.

This paper defines sociopathy, presents current research experimentation being conducted and findings as to its causes and treatment. Also presented is a description of a milieu therapy program for the adolescent sociopath. Both preventive and active treatment methods in this program are discussed. The value of the milieu therapy approach is shown in its attempt to keep the adolescent sociopath engaged in constructive activities and relationships in order to overcome antisocial behavior patterns. With the failure of individual therapy alone to reinforce normal living patterns and overcome lack of socialization functions in the adolescent sociopath, a more comprehensive and effective approach is required. Such an approach is described in which the following are stressed: 1) prevention of incarceration, 2) prevention of rejection by parents, peers and teachers, 3) active treatment of hyperkinesis and specific learning disabilities, 4) utilization of "sponsors," and 5) multiple therapist (family, group, individual) programs.

Adolescent↗
PubMed1975

Introduction of intensive milieu therapy in a traditional psychiatric unit.

In spite of a growing interest in clinical psychiatry to experiment with new treatment programs, not least in the field of milieu-therapy, the effect of these programs on the behavior of patients and staff are rarely subjected to systematic evaluation. So the progress in the field is hampered by a lack of clearly defined behavioral data which lends itself to critical analysis, and generally speaking is based on rather loose clinical impressions which make scientific verification difficult the present describes an admittedly crude attempt at systematic evaluation of what happened to staff's and patients' behavior when a relatively intensive milieu-therapy program was introduced in a traditional psychiatric unit, using relatively simple but clearly defined parameters of change in behavior over time. Certain hypotheses about what would happen in terms of group behavior if the new program worked according to its intentions were tested, and generally speaking the conclusion was that the program developed successfully as far as this could be measured by the selected parameters. Data about the patients' evaluation of the effect of the treatment program on themselves, and how this relates to attitudes towards own mental disorders and expectation towards psychiatric treatment at admission to the clinic, as well as social background and group behavior, is analysed, and wil be published in a subsequent paper. So the present paper should be considered as a preliminary report, mainly focusing on certain methodological aspects.

Adult↗
PubMed1980

A reevaluation of milieu therapy for nonchronic schizophrenic patients.

Until recently almost all the controlled research on milieu therapy for schizophrenic patients involved nonintensive milieus and chronic patients. Under these circumstances the effectiveness of milieus was not evident. Recent studies have suggested that intensive milieus significantly benefit nonchronic patients. These studies have indicated the importance of defining what ingredients can make a milieu therapeutic. The existing research evidence is surveyed, and the nature of what some of these ingredients might be described.

Antipsychotic Agents↗