Commentary:Recognizing the value of the milieu in therapeutic residential care for children and youth

ABSTRACT

Therapeutic residential care differs markedly from other forms of out-of-home care for children and youth. Support for the view that therapeutic residential care needs to be a milieu approach that leverages all interactions in the living environment to achieve a beneficial emotional and behavioral experience for children and youth is presented. A therapeutic milieu has the advantage of maintaining focus on what is in the best clinical interest for a child by aligning and coordinating all interactions and activities. We provide a rationale for a milieu-based foundation for therapeutic residential care that consists of five elements: care, treatment, nurturing, teaching, and order. Attending to milieu as defined will provide a sound foundation upon which effective and well-implemented treatment can be fully expressed.

KEYWORDS:

• Therapeutic residential care
• therapeutic milieu
• children and youth

Acknowledgments

We are grateful to Martha Holden, Sigrid James, Jim Whittaker, Lisa Holmes for discussions and suggestions that have greatly added to the content of this article.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.