Comprehensive exams for Mental Health Q 210
Nurse Sarah ensures a therapeutic environment for all the clients. Which of the following best describes a therapeutic milieu?
A. A therapy that rewards adaptive behavior.
B. A cognitive approach to change behavior.
C. A living, learning or working environment.
D. A permissive and congenial environment.
Correct Answer: C. A living, learning or working environment.
A therapeutic milieu refers to a broad conceptual approach in which all aspects of the environment are channeled to provide a therapeutic environment for the client. The six environmental elements include structure, safety, norms; limit setting, balance, and unit modification. A therapeutic milieu is a structured environment that creates a safe, secure place for people who are in therapy. It is the therapeutic environment that supports the individual in their process toward recovery and wellness. This milieu involves not just the provision of safe physical surroundings, but also of supportive therapists and staff.
Option A: Behavioral approach in psychiatric care is based on the premise that behavior can be learned or unlearned through the use of reward and punishment. The behavioral approach is a form of therapy that focuses on current behaviors and problems, along with what changes can be made to remove behaviors that are causing difficulties. The core of the behavioral approach is that people learn from their environment and problems are caused by learned behaviors that aren’t effective. The goal of this approach to therapy is to reinforce behaviors that are effective while working to eliminate behaviors that aren’t wanted or are causing conflicts or problems.
Option B: Cognitive approach to change behavior is done by correcting distorted perceptions and irrational beliefs to correct maladaptive behaviors. Cognitive theory is an approach to psychology that attempts to explain human behavior by understanding your thought processes. For example, a therapist is using principles of cognitive theory when they teach you how to identify maladaptive thought patterns and transform them into constructive ones.
Option D: This is not congruent with therapeutic milieu. The use of a therapeutic milieu is part of what is formally known as milieu therapy. This emerged in response to earlier approaches to community care which took a more custodial approach to treatment. People who were in inpatient or community care settings were provided basic care but rarely allowed to participate in their own treatment. Eventually, the idea of the therapeutic community emerged in which all dimensions of the individual’s environment have the potential to have therapeutic benefits.