What Is a Milieu Therapist?


Milieu therapy is a form of treatment that involves patients who live in community environments and are under the care of trained medical personnel. In this highly structured setting, emphasis is placed on the social aspects necessary to healing. A milieu therapist is a health care professional with a background in psychiatry or social work who provides counseling and treatment to patients in the therapeutic community.


  • Milieu therapy has been practiced since the early 1900s and provides an opportunity for patients to learn the valuable skills of human interaction and behavior. In French, milieu means “middle place,” which describes this type of therapy. Patients are not isolated and studied; nor are they running unchecked. They live together in controlled environments that promote healing. The milieu therapist oversees this process.


  • A milieu therapist typically must possess a minimum of a bachelor’s degree, preferably in the health care, social work or psychology fields. Some positions may require advanced degrees, specialized course work, precise experience in a certain field or a combination of these.


  • It is the job of the milieu therapist to maintain a safe and nurturing environment for those in his care. Specific job duties might include assessing patients, developing treatment plans, facilitating group therapy, monitoring patient behavior and interaction, staging interventions, evaluating patient progress, meeting with families, consulting with community agencies and supervising employees.


  • The most commonly seen milieu therapy settings are alcohol and drug rehabilitation centers and centers for children with psychological disorders. While there is no one specific type of milieu therapist, those with backgrounds in either addiction treatment or child psychology have an advantage finding work in the field.


  • The monetary benefits of working as a milieu therapist depend entirely on the type of setting in which the therapist works. A state-funded hospital or local clinic might pay less than a private hospital or a generously funded institution. At nonmonetary benefit is the milieu therapist’s opportunity to watch her patients grow and evolve in a group setting as they learn new social skills and begin to heal old wounds. Throughout the therapeutic process, a milieu therapist who works with children often has frequent contact with the children’s families. Seeing young patients and their families adopt new beneficial patterns of behavior is another benefit of this position.

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