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<title>Integrative milieu model</title>
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<span id="openzim-page-title" class="mw-page-title-main"><span class="mw-page-title-main">Integrative milieu model</span></span>
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<p>The <b>integrative milieu model</b>, developed by <a href="Kevin_F._McCready" title="Kevin F. McCready">Kevin F. McCready</a>, is an alternative treatment regime to the medical model of <a href="Psychiatry" title="Psychiatry">psychiatry</a> for treating people suffering from psychological distress.
</p><p>A central part of the <a href="Anti-psychiatry" title="Anti-psychiatry">anti-psychiatry</a> movement, being a close friend of <a href="Peter_Breggin" title="Peter Breggin">Peter Breggin</a> and a board member of the International Center for the Study of Psychiatry and Psychology, McCready based his model on the idea that human psychological suffering is not caused by a physiological disease or a chemical imbalance, but by a compromise to a person's humanity. He believed that the <a href="Biological_psychiatry" title="Biological psychiatry">biomedical model of psychiatry</a> was a compromise to a person's humanity, stripping its patients from elements he considers to be a necessary and natural part of human life experience. This model of treatment combined elements from <a href="Psychodynamic" class="mw-redirect" title="Psychodynamic">psychodynamic</a> theories, particularly the theories of <a href="Carl_G._Jung" class="mw-redirect" title="Carl G. Jung">Carl G. Jung</a>, <a href="Humanism" title="Humanism">humanism</a>, and <a href="Existentialism" title="Existentialism">existentialism</a>.<sup id="cite_ref-medsfree1_1-0" class="reference"><a href="#cite_note-medsfree1-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup>
</p><p>The integrative milieu model's approach is one which attempts to create a new community for its participants to interact within. This community is based on four main ideas:
</p>
<ul><li>The milieu must be a therapeutic container which allows an intensive exploration of the personal and collective psyche. It must therefore have a structure which maintains continuity and a sense of security.</li>
<li>The professionals who work to maintain the structure of the container must be flexible to allow for the expected and the unexpected expression of self which comes in such an environment.</li>
<li>The integration of all aspects of the human experience must be not only allowed to be expressed and explored, but must be encouraged to be expressed and explored. This means that all aspects of humanity must be made part of the integrative milieu, including such things as play, art, music, discussion, and intimacy.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></li>
<li>A respect for the human being's sense of self-direction. All patients within the milieu are expected to behave in a responsible, respectful manner. McCready believed that the expectations which are part of a community's fundamental philosophy play a significant role in the corresponding behavior of those who are part of the community.<sup id="cite_ref-medsfree1_1-1" class="reference"><a href="#cite_note-medsfree1-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup></li></ul>
<div class="mw-heading mw-heading2"><h2 id="Integrative_milieu_day_treatment">Integrative milieu day treatment</h2></div>
<p>McCready developed a day treatment program based on the integrative milieu model. It is a continuous program, with open enrollment. Most group therapy situations have a beginning phase, during which all clients who are participating in the group begin and an ending phase, until which all group members are encouraged to maintain regular attendance; and all group members complete their treatment at that time. However, in a continuous program, new group members may join the group at any time and group members complete their treatment and terminate therapy at any time they are ready, which means there is a staggered enrollment. The schedule of the program was intentionally set up in such a manner that one started the day light, gradually went deeper, and finally returned to a lighter level before the end of the day. The groups were set up to run for fifty minutes each. All groups would have one therapist moderating. The groups would include not only traditional <a href="Psychodynamically" class="mw-redirect" title="Psychodynamically">psychodynamically</a>-oriented psychotherapy groups, but also groups designed for artistic expression, recreation, discussion of dreams, discussion of specific topics selected by the group, and general community goal and feedback groups.
</p><p>All clients enrolled in the integrative milieu also receive individual psychotherapy from one of the staff psychotherapists. This therapy is psychodynamic in orientation, but adheres to the principles of the integrative milieu model.
</p><p>Programs currently in existence include:<sup id="cite_ref-medsfree1_1-2" class="reference"><a href="#cite_note-medsfree1-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup>
</p>
<ul><li>Associated Psychological Health Services</li>
<li>Sequioa Psychotherapy Center and</li>
<li>the Insight Center.</li>
<li>Spectrum (Victoria, Australia) is a further example of an integrative milieu model and has been treating people with borderline personality disorder using this approach since 1999.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></li></ul>
<div class="mw-heading mw-heading2"><h2 id="References">References</h2></div>
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</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20100716193002/http://www.medsfree.com/Environment.htm">"Creating an Empathic Environment"</a>. Medsfree.com. Archived from <a rel="nofollow" class="external text" href="http://www.medsfree.com/Environment.htm">the original</a> on 2010-07-16<span class="reference-accessdate">. Retrieved <span class="nowrap">2010-08-01</span></span>.</cite></span>
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</style><div id="Psychotherapy184" style="font-size:114%;margin:0 4em"><a href="Psychotherapy" title="Psychotherapy">Psychotherapy</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Schools</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Psychodynamic_psychotherapy" title="Psychodynamic psychotherapy">Psychodynamic</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Adlerian" class="mw-redirect" title="Adlerian">Adlerian therapy</a></li>
<li><a href="Analytical_psychology" title="Analytical psychology">Analytical therapy</a></li>
<li><a href="Mentalization-based_treatment" title="Mentalization-based treatment">Mentalization-based treatment</a></li>
<li><a href="Psychoanalysis" title="Psychoanalysis">Psychoanalysis</a></li>
<li><a href="Transference_focused_psychotherapy" class="mw-redirect" title="Transference focused psychotherapy">Transference focused psychotherapy</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Behavioral_psychotherapy" class="mw-redirect" title="Behavioral psychotherapy">Cognitive and <br>behavioral</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Clinical_behavior_analysis" title="Clinical behavior analysis">Clinical behavior analysis</a>
<ul><li><a href="Acceptance_and_commitment_therapy" title="Acceptance and commitment therapy">Acceptance and commitment therapy</a></li>
<li><a href="Functional_analytic_psychotherapy" title="Functional analytic psychotherapy">Functional analytic psychotherapy</a></li></ul></li>
<li><a href="Cognitive_behavioral_therapy" title="Cognitive behavioral therapy">Cognitive behavioral therapy</a>
<ul><li><a href="Cognitive_therapy" title="Cognitive therapy">Cognitive therapy</a></li>
<li><a href="Dialectical_behavior_therapy" title="Dialectical behavior therapy">Dialectical behavior therapy</a></li>
<li><a href="Mindfulness-based_cognitive_therapy" title="Mindfulness-based cognitive therapy">Mindfulness-based cognitive therapy</a></li>
<li><a href="Rational_emotive_behavior_therapy" title="Rational emotive behavior therapy">Rational emotive behavior therapy</a></li></ul></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Humanistic_psychology" title="Humanistic psychology">Humanistic</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Emotionally_focused_therapy" title="Emotionally focused therapy">Emotionally focused therapy</a></li>
<li><a href="Existential_therapy" title="Existential therapy">Existential therapy</a></li>
<li><a href="Focusing_(psychotherapy)" title="Focusing (psychotherapy)">Focusing</a></li>
<li><a href="Gestalt_therapy" title="Gestalt therapy">Gestalt therapy</a></li>
<li><a href="Logotherapy" title="Logotherapy">Logotherapy</a></li>
<li><a href="Person-centered_therapy" title="Person-centered therapy">Person-centered therapy</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Art_therapy" title="Art therapy">Art therapy</a></li>
<li><a href="Dance_therapy" title="Dance therapy">Dance therapy</a></li>
<li><a href="Feminist_therapy" title="Feminist therapy">Feminist therapy</a></li>
<li><a href="Music_therapy" title="Music therapy">Music therapy</a></li>
<li><a href="Narrative_therapy" title="Narrative therapy">Narrative therapy</a></li>
<li><a href="Play_therapy" title="Play therapy">Play therapy</a></li>
<li><a href="Reality_therapy" title="Reality therapy">Reality therapy</a></li>
<li><a href="Systemic_therapy_(psychotherapy)" class="mw-redirect" title="Systemic therapy (psychotherapy)">Systemic therapy</a></li>
<li><a href="Transactional_analysis" title="Transactional analysis">Transactional analysis</a></li>
<li><a href="List_of_psychotherapies" title="List of psychotherapies">List</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Integrative_psychotherapy" title="Integrative psychotherapy">Integrative</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Eclectic_psychotherapy" title="Eclectic psychotherapy">Eclectic psychotherapy</a></li>
<li><a href="Multimodal_therapy" title="Multimodal therapy">Multimodal therapy</a></li>
<li><a href="Transtheoretical_model" title="Transtheoretical model">Transtheoretical model</a></li></ul>
</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Approaches</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0;background:transparent;"><div style="padding:0 0.25em">
<ul><li><a href="Brief_psychotherapy" title="Brief psychotherapy">Brief psychotherapy</a></li>
<li><a href="Counseling_psychology" title="Counseling psychology">Counseling</a></li>
<li><a href="Online_counseling" title="Online counseling">Online therapy</a></li>
<li><a href="Telephone_counseling" title="Telephone counseling">Telephone therapy</a></li>
<li><a href="Residential_treatment_center" title="Residential treatment center">Residential treatment</a></li>
<li><a href="Self-help" title="Self-help">Self-help</a></li>
<li><a href="Support_group" title="Support group">Support group</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Research</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Clinical_formulation" title="Clinical formulation">Clinical formulation</a></li>
<li><a href="Clinical_pluralism" title="Clinical pluralism">Clinical pluralism</a></li>
<li><a href="Common_factors_theory" title="Common factors theory">Common factors theory</a></li>
<li><a href="Psychotherapy_discontinuation" title="Psychotherapy discontinuation">Discontinuation</a></li>
<li><a href="History_of_psychotherapy" title="History of psychotherapy">History</a></li>
<li><a href="Practitioner%E2%80%93scholar_model" title="Practitioner–scholar model">Practitioner–scholar model</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Techniques</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0;background:transparent;"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Behaviour_therapy" title="Behaviour therapy">Behaviour therapy</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Aversion_therapy" title="Aversion therapy">Aversion therapy</a></li>
<li><a href="Chaining" title="Chaining">Chaining</a></li>
<li><a href="Contingency_management" title="Contingency management">Contingency management</a>
<ul><li><a href="Shaping_(psychology)" title="Shaping (psychology)">Shaping</a></li>
<li><a href="Stimulus_control" title="Stimulus control">Stimulus control</a></li>
<li><a href="Token_economy" title="Token economy">Token economy</a></li></ul></li>
<li><a href="Counterconditioning" title="Counterconditioning">Counterconditioning</a></li>
<li><a href="Desensitization_(psychology)" title="Desensitization (psychology)">Desensitization</a>/<a href="Exposure_therapy" title="Exposure therapy">Exposure therapy</a>
<ul><li><a href="Systematic_desensitization" title="Systematic desensitization">Systematic desensitization</a></li></ul></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other individual therapy</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Autogenic_training" title="Autogenic training">Autogenic training</a></li>
<li><a href="Biofeedback" title="Biofeedback">Biofeedback</a></li>
<li><a href="Clean_language" title="Clean language">Clean language</a></li>
<li><a href="Cognitive_restructuring" title="Cognitive restructuring">Cognitive restructuring</a></li>
<li><a href="Emotional_self-regulation" title="Emotional self-regulation">Emotion regulation</a>
<ul><li><a href="Affect_labeling" title="Affect labeling">Affect labeling</a></li></ul></li>
<li><a href="Free_association_(psychology)" title="Free association (psychology)">Free association</a></li>
<li><a href="Homework_in_psychotherapy" title="Homework in psychotherapy">Homework</a></li>
<li><a href="Hypnotherapy" title="Hypnotherapy">Hypnotherapy</a></li>
<li><a href="Modeling_(psychology)" title="Modeling (psychology)">Modeling</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Group_psychotherapy" title="Group psychotherapy">Group psychotherapy</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Co-therapy" title="Co-therapy">Co-therapy</a></li>
<li><a href="Couples_therapy" title="Couples therapy">Couples therapy</a></li>
<li><a href="Family_therapy" title="Family therapy">Family therapy</a></li>
<li><a href="Psychodrama" title="Psychodrama">Psychodrama</a></li>
<li><a href="Sensitivity_training" title="Sensitivity training">Sensitivity training</a></li></ul>
</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">People</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em">
<ul><li><a href="Philippe_Pinel" title="Philippe Pinel">Philippe Pinel</a></li>
<li><a href="Josef_Breuer" title="Josef Breuer">Josef Breuer</a></li>
<li><a href="Sigmund_Freud" title="Sigmund Freud">Sigmund Freud</a></li>
<li><a href="Pierre_Janet" title="Pierre Janet">Pierre Janet</a></li>
<li><a href="Alfred_Adler" title="Alfred Adler">Alfred Adler</a></li>
<li><a href="S%C3%A1ndor_Ferenczi" title="Sándor Ferenczi">Sándor Ferenczi</a></li>
<li><a href="Carl_Jung" title="Carl Jung">Carl Jung</a></li>
<li><a href="Ludwig_Binswanger" title="Ludwig Binswanger">Ludwig Binswanger</a></li>
<li><a href="Melanie_Klein" title="Melanie Klein">Melanie Klein</a></li>
<li><a href="Otto_Rank" title="Otto Rank">Otto Rank</a></li>
<li><a href="Karen_Horney" title="Karen Horney">Karen Horney</a></li>
<li><a href="Harry_Stack_Sullivan" title="Harry Stack Sullivan">Harry Stack Sullivan</a></li>
<li><a href="Fritz_Perls" title="Fritz Perls">Fritz Perls</a></li>
<li><a href="Anna_Freud" title="Anna Freud">Anna Freud</a></li>
<li><a href="Donald_Winnicott" title="Donald Winnicott">Donald Winnicott</a></li>
<li><a href="Wilhelm_Reich" title="Wilhelm Reich">Wilhelm Reich</a></li>
<li><a href="Milton_H._Erickson" title="Milton H. Erickson">Milton H. Erickson</a></li>
<li><a href="Jacques_Lacan" title="Jacques Lacan">Jacques Lacan</a></li>
<li><a href="Erik_Erikson" title="Erik Erikson">Erik Erikson</a></li>
<li><a href="Carl_Rogers" title="Carl Rogers">Carl Rogers</a></li>
<li><a href="Viktor_Frankl" title="Viktor Frankl">Viktor Frankl</a></li>
<li><a href="George_Kelly_(psychologist)" title="George Kelly (psychologist)">George Kelly</a></li>
<li><a href="Rollo_May" title="Rollo May">Rollo May</a></li>
<li><a href="Virginia_Axline" title="Virginia Axline">Virginia Axline</a></li>
<li><a href="Carl_Whitaker" title="Carl Whitaker">Carl Whitaker</a></li>
<li><a href="Albert_Ellis" title="Albert Ellis">Albert Ellis</a></li>
<li><a href="Silvano_Arieti" title="Silvano Arieti">Silvano Arieti</a></li>
<li><a href="James_Bugental" title="James Bugental">James Bugental</a></li>
<li><a href="Joseph_Wolpe" title="Joseph Wolpe">Joseph Wolpe</a></li>
<li><a href="Virginia_Satir" title="Virginia Satir">Virginia Satir</a></li>
<li><a href="Aaron_Beck" title="Aaron Beck">Aaron Beck</a></li>
<li><a href="Salvador_Minuchin" title="Salvador Minuchin">Salvador Minuchin</a></li>
<li><a href="Paul_Watzlawick" title="Paul Watzlawick">Paul Watzlawick</a></li>
<li><a href="Haim_Ginott" title="Haim Ginott">Haim Ginott</a></li>
<li><a href="Ogden_Lindsley" title="Ogden Lindsley">Ogden Lindsley</a></li>
<li><a href="Paul_Watzlawick" title="Paul Watzlawick">Paul Watzlawick</a></li>
<li><a href="Arthur_Janov" title="Arthur Janov">Arthur Janov</a></li>
<li><a href="Eugene_Gendlin" title="Eugene Gendlin">Eugene Gendlin</a></li>
<li><a href="R._D._Laing" title="R. D. Laing">R. D. Laing</a></li>
<li><a href="Jean_Baker_Miller" title="Jean Baker Miller">Jean Baker Miller</a></li>
<li><a href="Otto_F._Kernberg" title="Otto F. Kernberg">Otto F. Kernberg</a></li>
<li><a href="Nathan_Azrin" title="Nathan Azrin">Nathan Azrin</a></li>
<li><a href="Irvin_D._Yalom" title="Irvin D. Yalom">Irvin D. Yalom</a></li>
<li><a href="Arnold_Lazarus" title="Arnold Lazarus">Arnold Lazarus</a></li>
<li><a href="Lorna_Smith_Benjamin" title="Lorna Smith Benjamin">Lorna Smith Benjamin</a></li>
<li><a href="Marsha_M._Linehan" title="Marsha M. Linehan">Marsha M. Linehan</a></li>
<li><a href="Vittorio_Guidano" title="Vittorio Guidano">Vittorio Guidano</a></li>
<li><a href="Les_Greenberg" title="Les Greenberg">Les Greenberg</a></li>
<li><a href="William_Richard_Miller" title="William Richard Miller">William R. Miller</a></li>
<li><a href="Steven_C._Hayes" title="Steven C. Hayes">Steven C. Hayes</a></li>
<li><a href="Michael_White_(psychotherapist)" title="Michael White (psychotherapist)">Michael White</a></li>
<li><a href="Jeffrey_Young_(psychologist)" title="Jeffrey Young (psychologist)">Jeffrey Young</a></li>
<li><a href="Peter_Fonagy" title="Peter Fonagy">Peter Fonagy</a></li></ul>
</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Associations</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0;background:transparent;"><div style="padding:0 0.25em">
<ul><li><a href="Association_for_the_Advancement_of_Psychotherapy" title="Association for the Advancement of Psychotherapy">Association for the Advancement of Psychotherapy</a></li>
<li><a href="Association_for_Applied_Psychophysiology_and_Biofeedback" title="Association for Applied Psychophysiology and Biofeedback">Association for Applied Psychophysiology and Biofeedback</a></li>
<li><a href="Association_for_Behavioral_and_Cognitive_Therapies" title="Association for Behavioral and Cognitive Therapies">Association for Behavioral and Cognitive Therapies</a></li>
<li><a href="Association_for_Behavior_Analysis_International" title="Association for Behavior Analysis International">Association for Behavior Analysis International</a></li>
<li><a href="European_Association_for_Psychotherapy" title="European Association for Psychotherapy">European Association for Psychotherapy</a></li>
<li><a href="Society_for_Psychotherapy_Research" title="Society for Psychotherapy Research">Society for Psychotherapy Research</a></li>
<li><a href="World_Council_for_Psychotherapy" title="World Council for Psychotherapy">World Council for Psychotherapy</a></li></ul>
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