A therapeutic milieu.

Bettelheim, Bruno; Sylvester, Emmy

doi:10.1111/j.1939-0025.1948.tb05078.x

Cited by 71 publications

(15 citation statements)

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“…Attempts to define MT are further complicated by the fact that it is used by a wide range of helping professions and in an array of settings. These include psychiatric nursing ( Mahoney et al, 2009;Thomas, Shattell, & Martin, 2002), substance abuse treatment ( Tims, De Leon, & Jainchill, 1994), community mental health practice ( Dincin, 1975), residential treatment for youths ( Bettelheim & Sylvester, 1948;Crouch, 1998;Redl, 1959;Trieschman, Whittaker, & Brendtro, 1969), and inpatient psychiatry ( Visher & O'Sullivan, 1970). Challenges to the approach have motivated scholars to define MT more precisely by focusing on particular aspects of the construct or particular historical strands of its development ( Gunderson, 1978;Gutheil, 1985).…”

mentioning

confidence: 99%

Worker Perspectives on Contemporary Milieu Therapy: A Cross-Site Ethnographic Study

Smith

Spitzmueller

2016

Social Work Research

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The term "milieu therapy" (MT) is commonly used in mental health literatures. However, because MT has historically encompassed a wide range of practices, it has invited the criticism that it is simply an attractive theoretical packaging of the time clients spend between other specified interventions, such as individual and group therapies. Some have suggested that, because of its conceptual ambiguity, MT should be abandoned altogether. Despite these challenges, MT endures as a common approach to social work practice in a range of clinical settings. This article describes a study that used ethnography to investigate the perspectives of workers from two mental health organizations that claim to provide MT. By analyzing four themes common to both sites, this article brings exploratory empirical findings to bear on the question of what constitutes MT in contemporary mental health organizations. Participants reported that (a) everything in the physical and social milieu has the potential to affect therapeutic change; (b) the milieu itself functions as a therapeutic agent; (c) the milieu provides a context for modeling and practicing desired behaviors; and (d) MT is a principlebased ethos, rather than a set of specific interventions. Implications of these findings for social work research, practice, and funding are discussed.

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confidence: 99%

Worker Perspectives on Contemporary Milieu Therapy: A Cross-Site Ethnographic Study

Smith

Spitzmueller

2016

Social Work Research

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“…Residents' lives were completely organized under the grand plan of the institution (Goffman 1961), which was all-inclusive mental health treatment. This mental health treatment procedure was understood as "milieu treatment" (Aichhorn 1955;Almond 1974;Bettelheim and Sylvester 1948;Hoffman 1982;Robinson et al 1957). Milieu treatment is understood as the "other 23 hours" of treatment, the 24th being the hour of individual therapy (Trieschman et al 1969), which is in contrast to incarceration in juvenile detention facilities, for example.…”

Section: Issues Vs Problems: Varying Accounts Of Treatment Procedurementioning

confidence: 99%

Care, Closeness, and Becoming “Better”: Transformation and Therapeutic Process in American Adolescent Psychiatric Custody

Hejtmanek¹

2016

Ethos

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In the United States, young people are remanded to psychiatric custody for the institutionalized treatment of mental illness, behavior disorders, and emotional disturbances, and forced to participate in this therapeutic system. Anthropological investigations of therapeutic process have focused on individuals actively seeking and engaging in treatment or a therapeutic process. Does transformation require a person fully accept the therapeutic system? Is a coerced therapeutic process still effective? This article engages with these questions by situating the therapeutic process in psychiatric custody for American adolescents. The youth in treatment accept that transformation and even healing take place but locate the etiology and form of this change differently than the official treatment paradigms. This case study illustrates that transformation and therapeutic process as multifaceted, especially in coercive contexts, and the efficacy of the therapeutic process as shaped by the life stage and political contexts of those engaged in the process.

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“…As regards therapy in these severe forms of mental trauma after hospitalization, BENDER (3,1947)) LEVY (20,1937)) POWDERMAKER et al (27,1937), among others, state that in the majority of cases therapy is ineffective, mainly owing to the fact that the therapeutist is unable to establish any emotional contact with the patient, which is a sine qua non of a successful treatment. Other authors like JONSSON of Skii Edeby, Sweden (6, p. 51) and BETTELHEIM & SYLVESTER of Chicago (4,1948) view this treatment more optimistically, finding the prognosis hopeful when the child is first subjected to a regression to earlier infantile stages and then developed along more normal lines. However, this treatment is both expensive and lengthy.…”

Section: Per-bke Orsten and Bke Mattssonmentioning

confidence: 99%