Background and Goals: The role of milieu therapy on inpatient treatment has become
more prominent due to the changing landscape of hospital care, with shorter length of
stay, higher patient acuity, and rapid turnover. The modern inpatient unit promotes less individual
psychotherapy with the psychiatrist or therapist, and more milieu and group based
treatment that emphasizes acute stabilization.
Methods: The authors share some of the core domains that provide the basic framework for
milieu treatment within an acute care setting when working with adolescents and transitional
age youth (TAY), with the aim to share clinical considerations for milieu therapy and offer
practical ideas for implementation in clinical practice.
Discussion: The therapeutic milieu and collaboration of an interdisciplinary team has a significant
impact on hospital treatment. Considerations for milieu therapy implementation in
an inpatient unit include developmentally informed concepts related to milieu treatment of
adolescents and TAY patients in a hospital setting.