The document discusses the key elements of a therapeutic milieu, which is defined as the special environment where young people and practitioners interact. The five elements that make up a therapeutic milieu are the physical, emotional, social, cultural, and ideological elements. Each element aims to meet core needs of safety, inclusion, and affirmation for young people. Practitioners must consider all elements to create an environment that supports the growth and well-being of young people.
1. 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
2. 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
4. 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
5. CULTURAL
IDEOLOGICAL
Healing Spaces By: Michael Burns
10
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
6. 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
8. 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.
9. 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,
10. 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
15
So that young people can…
11. 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
16
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
12. 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
13. 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
19
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
14. 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
15. 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
22
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
16. 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
17. 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
25
Complete the Socrative quiz on the ideological element. After
you’ve completed it, do not close it, wait for the ‘next activity’
FRANK8108
19. 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
35
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Elements of a Therapeutic Milieu
Week 2
20. 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 ?
21. 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;
23. 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
10
PHYSICAL ELEMENT
This element involves the concrete physical setting of the child
24. (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
25. 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
27. 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
28. 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
29. 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
15
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
30. 16
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
31. 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
32. 19
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
33. 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
22
34. 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
35. 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 &
36. maintain an ideologically safe, inclusive & affirming
environment
25
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
37. 29
31
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
38. 35
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}
Therapeutic Activities: Icebreaker & Activity Design
Assignment 25%
Due: Class #8 – on the day of your class at 11:59pm.
This assignment must be submitted online via Blackboard.
Please ensure you upload a .doc, .docx, or .pdf file.
Instructions:
1. Use the template to complete your Icebreaker and Activity
Design.
2. Complete the template by writing in complete sentences,
except when you are making a list. For example, you can use
point form when listing the procedure/materials required for
your icebreaker.
3. Marks will be deducted for spelling, grammar, flow.
4. Please be thorough in your responses and rationale.
5. If you are using information that you find on the internet or
any other resource, you must provide the link to the source.
Failure to do so is considered academic misconduct and may
result in a grade of 0.
What are icebreakers?
· Icebreakers are used to facilitate introductions, energize
members, increase motivation, build group cohesion and
introduce topics while creating a safe and comfortable
environment for the group or individual
· Therapeutically, icebreakers assist the CYC-P to create a
39. therapeutic milieu, establish rapport and build trust with
children and youth they work with
What is an Activity?
· An activity is developed by the CYC-P after assessing the
needs of the young people they are working with
· A therapeutic activity is more extensive than an icebreaker, as
it is meant to achieve goals beyond facilitating introductions or
energizing the group
ICEBREAKER PLANNING SHEET
Student Name:
Student ID:
Name of the Icebreaker:
Brief description of the icebreaker:
Procedures and steps for the CYC/Facilitator (in numbered
format) STEP BY STEP INSTRUCTIONS:
Describe and outline the teachable moments and questions for
the CYC/Facilitator to ask:
Identify the goals of the Icebreaker for children/youth (What do
you want your Icebreaker to accomplish? What is the purpose of
your Icebreaker?) Identify at least 2 goals.
List of Materials (if any) required
Budget and rationale
Anticipated length of time and rationale
Identify the appropriate developmental age range for the
Icebreaker. Briefly explain using knowledge and experience
40. from Child Development.
Describe 1 modification you might make if the activity does not
go as planned or if there are participants requiring
modifications.
Reference, Resource or Web Link
ACTIVITY PLANNING SHEET
Student Name:
Student ID:
Name of the Activity/Type:
Brief description of the activity:
Procedures and steps for the CYC/Facilitator (in numbered
format) STEP BY STEP INSTRUCTIONS:
Describe and outline the teachable moments and questions for
the CYC/Facilitator to ask:
Identify the goals of the Icebreaker for children/youth (What do
you want your activity to accomplish? What is the purpose of
your activity?) Identify at least 2 goals.
List of Materials (if any) required
Budget and rationale
41. Anticipated length of time and rationale
Identify the appropriate developmental age range for the
activity. Briefly explain using knowledge and experience from
Child Development.
Describe 3 modifications you might make if the activity does
not go as planned or if there are participants requiring
modifications.
Reference, Resource or Web Link
Icebreaker Rubric (10%):
Criteria
Exceeds Expectations
Meets Expectations
Approaching Expectations
Does not Meet Expectations
Activity Plan
All sections are completed (even if not applicable). The
icebreaker is clearly outlined so that another CYC-P could
facilitate it without any issues.
[8 points]
All sections are completed (even if not applicable). Another
CYC-P could facilitate the icebreaker with few issues.
[5-7 points]
All sections are completed, but some areas are unclear and may
be confusing to another CYC-P.
[3-4 points]
Some sections are missing and/or are confusing/hard to follow.
[0-2 points]
Spelling, Grammar and Formatting
Free of spelling, grammar, or formatting issues.
[2 points]
There are 1-2 spelling, grammar, or formatting issues.
[1 point]
42. There are more than 2 spelling, grammar, or formatting issues.
[0 points]
TOTAL
/10
Icebreaker Rubric (15%):
Criteria
Exceeds Expectations
Meets Expectations
Approaching Expectations
Does not Meet Expectations
Activity Plan
All sections are completed (even if not applicable). The
icebreaker is clearly outlined so that another CYC-P could
facilitate it without any issues.
[12 points]
All sections are completed (even if not applicable). Another
CYC-P could facilitate the icebreaker with few issues.
[8-11 points]
All sections are completed, but some areas are unclear and may
be confusing to another CYC-P.
[5-7 points]
Some sections are missing and/or are confusing/hard to follow.
[0-4 points]
Spelling, Grammar and Formatting
Free of spelling, grammar, or formatting issues.
[3 points]
There are 1-2 spelling, grammar, or formatting issues.
[1-2 points]
There are more than 2 spelling, grammar, or formatting issues.
[0 points]