example of the assignment
Elements of a Therapeutic Milieu
Week 2
The Therapeutic Milieu
“The special environment where the young person and practitioner] interact in the process of growth and change” (Burns, 2006 p.2)
A place of teaching, healing, rehabilitation and recovery
The space “in between” young people and practitoners
What are some examples of places practitioners and young people are together ?
Milieu examples
Schools
Offices
Hospitals
Court rooms
Community centers
Residential
Group/foster home
Relationships*
3 Core needs in a Hierarchy
SAFETY
INCLUSION
AFFIRMATION
Safety
SAFETY
physical, emotional and psychological safety
protection from physical harm and threats
protections from emotional and social threats
Safety: (a) looks at physical, emotional & psychological safety; (b) protection from physical harm & threats & © protection from emotional & social threats
INCLUSION
Beyond safety needs, the need to feel loved & included by others (peers, family & society) is critical.
Everyone needs to feel that they are special & cherished.
Inclusion
II. Inclusion: Beyond safety, needs, the need to feel loved & included by others (peers, family & society) is critical. Everyone needs to feel that they are special & cherished. As children grow & develop, the group that they reference & which has the greatest influence on their feeling of being included, changes
AFFIRMATION
When safety & inclusion needs are met, children need to feel a sense of worth or self-esteem
Support and encouragement from others, empowers one to feel the same way about themselves
Affirmation
III. Affirmation: When safety & inclusion needs are met, children need to feel a sense of worth & self-esteem & the therapeutic milieu contributes significantly to that feeling of self-worth … hence affirmation is attained
The ultimate goal
AFFIRMATION
INCLUSION
SAFETY
The 5 Elements OF THE THERAPEUTIC MILIEU
PHYSICAL
EMOTIONAL
SOCIAL
CULTURAL
IDEOLOGICAL
Healing Spaces By: Michael Burns
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PHYSICAL ELEMENT
This element involves the concrete physical setting of the child (i.e., the backyard of a group home, a school classroom, a child’s bedroom, the agency van, etc.)
This milieu has a profound conscious & unconscious effect on its inhabitants
Physical environments include furnishings that are appropriate size or the space that accommodates a wheelchair
EMOTIONAL ELEMENT
This element involves the emotional makeup of the child (i.e., his/her temperament, his/her emotional experiences, his/her sensory experiences, etc.)
This also involves the communal emotional experiences of each individual child & adult who inhabit the therapeutic setting, their ability to express emotions appropriately & the level of acceptance & tolerance for emotional expression that exists within that milieu
The emotional environment is often a very dangerous & exhaustive place
Yet as CYW’s, displaying sensitivity & understanding helps in promoting a sense of emotional security
SOCIAL ELEMENT
This elements includes the social interactions that take place within the therapeutic setting that the CYW & child are involved in together
It is the therapeutic environment where children & professionals interact for the therapeutic benefit
All human beings are social creatures & the minute-to-minute interactions of the social environment influence safety, inclusiveness & affirmation needs in children & youth
Relationships develop one-to-one with practitioners, between peers & relationships between children & their family & community can be brought into OR rejected by the milieu the child is engaged in
CULTURAL ELEMENT
Measured or defined by the level of acceptance and celebration of differences, not only of the cultures represented by the children ther but also the attitidue and level of acceptance of all human exceptionalities
Perception of diversity
Prejudice, SES
IDEOLOGICAL ELEMENT
This element includes the body of ideas, beliefs & attitudes that each individual within the milieu deems important & essential to their well-being
This also includes the principles & practices of the agency, governmental body or group that provides the treatment & care for those within the milieu
This also addresses the need to understand & challenge treatment theories & practices so that they are truly in the best interests of the children &/or youth
The
Physical
Milieu
Safety
Inclusiveness
Affirmation
The
Emotional
Milieu
Safety
Inclusiveness
Affirmation
The
Ideological
Milieu
Safety
Inclusiveness
Affirmation
The
Social
Milieu
Safety
Inclusiveness
Affirmation
The
Cultural
Milieu
Safety
Inclusiveness
Affirmation
The Therapeutic Milieu
The
Physical
Element
Safety
Inclusiveness
Affirmation
The safe practices within the environment are consistently identified and addressed
Proactive- the likelihood/ risk for threats and harms are low
- Space/ layout
Dangerous substances & objects
Education- do people know how to keep themselves physically safe?
The child feels like they belong when in the space
They feel comfortable, and a sense the concern for their well being
Room temperature
Lighting
Colours
Smells
Noise levels
Durable furniture
Young people should play a role in the development, design, and creation of the space. They should see themselves somehow reflected
Artwork
Achievements
Decision making process
People take pride in the things the help create
You feel pride when you’ve created and others notice/ appreciate
Focuses on the physical concrete setting and the things that can be felt/seen through the senses within it.
Complete the Socrative quiz on the physical element. After you’ve completed it, do not close it, wait for the ‘next activity’ FRANK8108
The
Emotional
Element
Safety
Inclusiveness
Affirmation
Free of fear of judgment and negative consequences when expressing feelings
Mistakes are welcomed and learned from
Rules/ guidelines are in place to establish respect
Here children can learn about their emotions, how to identify and express them
Young people can learn about how their expression of emotions impact others
Learn how other expressions of emotions impact themselves, thus forming a connection
Adults can be trusted to regulate their own emotions, and respond rather than react
Young people know that their feelings are valid and important. This reinforces and increases one’s sense of self worth and self esteem, their emotional confidence
Emotional intelligence also adds to ability to develop good coping skills and be resilient
Focuses on understanding, expressing and exploring feelings
The Role of the CYC-P
Help to create an environment that encourages emotional expression
Assist young people learn practical and acceptable ways of expressing their emotions
Model appropriate emotional expression
Engage in self-reflective practice to identify their own methods of emotional expression
Educate young people about the importance of expressing their feelings and emotions
Seek out external resources to strengthen counseling skills & techniques
Provide and seek suggestions with team about ways to enhance the emotional value of the milieu
Plan and implement therapeutic activities that help to create & maintain an emotionally safe, inclusive & affirming environment
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So that young people can…
Be aware of what emotions are, where they come from, how they work
Identify different emotions
Able to identify the role & relationship of feelings, thoughts & behaviours
Have different ways for expressing feelings (anger, sadness, anxiety)
Be able to use “I” feel statements
Feel confident in expressing feelings
Be able to actively listen &empathize
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Complete the Socrative quiz on the emotional element. After you’ve completed it, do not close it, wait for the ‘next activity’ FRANK8108
The
Social
Element
Safety
Inclusiveness
Affirmation
Safety from physical and psychological harms are enforced (i.e. laws and policies)
Codes of conduct help young people regulate themselves, and make everyone feel safe
Do no harm, to others, or yourself
Young people feel like they belong and are part of the group
They know that their input is expected, valued and respected
Young people are part of the resolution process
Young people are held in high esteem, and hold each other in high esteem
Youth can perform well because they support, encourage, and defend each other
Not everyone like everyone, but there is still a sense of respect and regard
Appropriate social behaviour is developed
The interactions between young people and practitioners, in various social settings
The Role of the CYC
Assess & learn from other therapeutic settings ways to create positive social environments
Collaborate with caregivers, teachers, etc. to suggest ways to encourage positive social interactions
Encourage practicing social skills strategies outside the therapeutic milieu & to debrief experiences thereafter
Awareness of group dynamics & the developmental process of small & large groups
Must remain loyal & true to the need of the client, the entire group, the policies & procedures of the institution in which they work, the professional association as well as to him/herself
Must utilize behaviour management & group facilitator skills to enhance appropriate social interactions
Provide & seek suggestions with team about ways to enhance the social value of the milieu
Develop rules of conduct & be consistent to ensure cohesiveness
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Complete the Socrative quiz on the social element. After you’ve completed it, do not close it, wait for the ‘next activity’ FRANK8108
The
Cultural
Element
Safety
Inclusiveness
Affirmation
Young people can participate actively in their cultural groups
The goal is to understand and accept similarities and differences
Learn about oppression and stigma and actively fight against it
Understand ones own cultural background and be aware of any cultural biases one may hold
People are curious and interested in learning about other cultures ways of knowing, being and doing
Respects and values differences and encourages participation in cultural practices an events
Cultures are celebrated, using the experiences of those in the group and outside of the group
Members encourage, support and defend each other
Young people feel good about all of who they are
Focus is on the acceptance and celebration of differences
The Role of the CYC-P
Seek the support and guidance of additional experts to enhance the cultural composition of the children &/or youth receiving services
Attend professional development workshops in cultural diversity
Seek additional professional supports if experiences of racism & stigmatization are negatively impacting their work
Model appropriate behaviours of individuals from different cultural backgrounds
Identify culturally inappropriate behaviours & thought patterns
Consider the cultural aspect of activities during the planning stages to ensure that cultural practices are not disrespected
Plan and implement therapeutic activities that help to create and maintain a culturally safe, inclusive & affirming environment
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Complete the Socrative quiz on the cultural element. After you’ve completed it, do not close it, wait for the ‘next activity’ FRANK8108
The
Ideological
Element
Safety
Inclusiveness
Affirmation
Young people can share their ideas and beliefs without fear of exclusion or ridicule
The space is judgment free, all opinions count, all opinions matter
Young people have the right to think, worship, believe and hold sacred whatever they want
The institutions ideologies must also be respected
People are curious and interested in all thoughts and opinions, the differences and similarities
People are encouraged to share their thoughts and opinions
Debates are encouraged with rules and regulations
Criticality means understanding that there are different thoughts and ideas and all are valid
Appreciates that not all thoughts, ideas and beliefs are the same
Strives to unify institutional and individual ideologies, that is that they are in sync and supportive of each other
Young people feel confident in forming and sharing their own thoughts, ideas and beliefs…they can change the world!
The body of ideas, beliefs, and attitudes that people deem important and essential to their well being
The Role of the CYC-P
Uncover, understand & appreciate ideological beliefs & practices of the individual
Heighten awareness of personal ideologies to identify those that may be a hindrance to the therapeutic relationship
Provide opportunities for children &/or youth to share their ideologies with others
Allow children &/or youth to practice appreciation of ideological differences
Identify unjust ideological aspects of the institution
Challenge of rules in a professional manner after consulting with team to identify inconsistencies in ideological policies & practices
Help children &/or youth understand the ideologies of the institution
Plan & implement therapeutic activities that help to create & maintain an ideologically safe, inclusive & affirming environment
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Complete the Socrative quiz on the ideological element. After you’ve completed it, do not close it, wait for the ‘next activity’ FRANK8108
Assess this milieu
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For next class:
There will be the in-class milieu design group assignment (20%)
You will have the class to plan and complete the design
The write up and design is due at 11:59pm the day after class
Be sure to create groups and assign the milieu that each group will be creating
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