Defining the therapeutic processes in psychiatric milieus

Clinicians are increasingly required to justify the costs of milieu therapy. The current variety of milieu types and their competing claims of efficacy can make this a vexsome problem. This paper attempts to conceptualize five major therapeutic processes which commonly exist in a broad range of milieus, independent of size, length of stay, staffing and philosophy. It is hoped these will help provide a reasonable and clear means of developing and explaining therapeutic milieu programs.