Mental Health Nursing Psychiatric Nursing Dr. Rahul Sharma Associate Professor H.O.D. of Mental Health Nursing Ph. D Coordinator Seedling School of Nursing, Jaipur National University, Jaipur

1. Dr. Rahul Sharma
Associate Professor
H.O.D. of Mental
Health Nursing
Ph. D Coordinator
Seedling School of
Nursing,
Jaipur National
University,
Jaipur

2. Introduction
• The word “ Milieu “ is French word which means
“middle”.
• The English translation of the word is sorrounding or
environment
• In psychiatry, therapy involving the milieu or
environment may be called as Milieu therapy,the
therapeutic community or the Therapeutic
environment.

3. Definition
• A scientific structuring of the environment in
order to effect behavioral changes and to
improve the psychological health and
functioning of the individual.
- Skinner(1979)

5. Goals
• To change maladaptive behaviour into adaptive behaviour.
• Provide conducive (stress free) environment in which the
client can feel free to talk and be aware about his feelings,
impulse and behaviour.
• Minimize prolongation of hospital stay.
• Promote early recovery.
• To enable the client to actively participate in his daily living
activities and will be actively involved in community activities.

6. • Staff members will help the client to take their own decision
to solve their problems, assist in planning and implement
the community activities to solve the problems at large
levels.
• To improve the self esteem by allowing the client to take
their own decision and taking opinion to solve resident
problems.
• To promote group and social interaction, every member in
the group will be aware of their roles , limitations and
responsibilities.
• To promote self confidence, independence and to have self
control over their personal activities.

7. BASIC ASSUMPTIONS
Skinner outlined 7 basic assumptions on which a therapeutic
community is based:-
• The health in each individual is to be realized and
encouraged to grow
All individual are considered to have strength as well as
limitations.These healthy aspects of the individual are
identified and served as a foundation for growth in the
personality and in thre ability to function more actively in all
aspects of life.

8. Every interaction is an opportunity for
therapeutic intervention
The ideal situation exists for client to
improve communication and relationship
development skills.

9. The client’s own his/her own Environment
Client’s makes decision and solves problem
related to government.
In this way , personal needs for autonomy as well
as other needs are fulfilled.

10. Each client owns his/her own behaviour
Each individual within the therapeutic
community is expected to take
responsibility for his/her own behaviour.

11. Peer pressure is a useful and powerful tool
Behavioural group norms are established
through peer pressure , feedback is direct and
frequent , so that behaving in an acceptable
manner to the other member of the community
becomes essential.

12. Inappropriate behaviour are dealed with as
they occur.
Individual examine the significance of their
behaviour ,looks at how it affects other people and
discuss more appropriate way of behaving in a
certain situation.

13. Restrictions and punishments are to be
avoided
Destructive behaviour casually be controlled with
group discussion, however if anindividual require
external control ,temporary isolation preferred
over lengthy restrictions or other harsh
punishments.