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.
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John G. Gunderson (1978) studied this question.