Therapeutic Milieu

No.	Competency Item	NAC	DEV	COM	DTE	EXC
	Demonstrate knowledge of therapeutic milieu:
BF-02-01	Historical development of milieu therapy
BF-02-02	Definition of therapeutic milieu
BF-02-03	Basic assumptions
BF-02-04	Current uses
BF-02-05	Goals of therapeutic milieu
BF-02-06	Provide for basic needs, including structure
BF-02-07	Provide safety, support and control
BF-02-08	Promote interpersonal interaction and involvement
BF-02-09	Provide for validation needs
BF-02-10	Provide for containment in least restrictive setting
BF-02-11	Differences between milieu therapy and therapeutic community.
	Demonstrate knowledge of and ability to provide for high quality environment:
BF-02-12	Provide for conducive surroundings
BF-02-13	Provide for privacy needs
BF-02-14	Provide for comfort, taking note of factors including noise levels, safety, lighting, temperature, location and physical comfort
BF-02-15	Provide routines that are reasonable and flexible
BF-02-16	Provide appropriate levels of staffing
BF-02-17	Provide least restrictive environment appropriate to individual needs
BF-02-18	Promote positive atmosphere that is affirming and accepting of the uniqueness of individuals
	Demonstrate skilled use of verbal interventions:
BF-02-19	Demonstrate timing
BF-02-20	Demonstrate caring
BF-02-21	Respect boundaries and personal space
BF-02-22	Demonstrate ability to de-escalate.
	Provide elements of caring:
BF-02-23	Appreciation of individual and what makes them unique
BF-02-24	Acceptance of the individual
BF-02-25	Constant efforts to understand how the person thinks and feels
BF-02-26	Establishment of therapeutic norms to talk, disclose information, give and receive feedback and to give comfort and support
BF-02-27	Establishment of relationships that are healthy, nurturing and respectful
BF-02-28	Means to deal effectively with manipulation
BF-02-29	Ability to separate personal issues from patient issues.
	Demonstrate knowledge and ability to promote involvement:
BF-02-30	Promote interpersonal and interactional skills
BF-02-31	Match expected level of involvement with individual abilities
BF-02-32	Promote coping behaviours
BF-02-33	Make use of various strategies such as groups, role play, free expression, support groups and work experience programs
BF-02-34	Demonstrate knowledge and ability to provide for validation.
	Demonstrate knowledge and ability to provide for safety, support and control:
BF-02-35	Provide individuals with protection from themselves if suicidal, homicidal, or self-mutilating
BF-02-36	Provide various levels of observation, as ordered
BF-02-37	Provide an environment that is supportive without excessive demands
BF-02-38	Facilitate growth and intimacy
BF-02-39	Balance concern for individual with that for the group as a whole.
	Demonstrate knowledge and ability for appropriate use of containments:
BF-02-40	Teaching of appropriate expression through one-to-one and group interventions
BF-02-41	Ability to provide for containment that is timely and matched to symptoms including verbal interventions, time out, seclusions, medication and restraints, and ability to set limits
	Understand the use of milieu therapy across practice settings such as:
BF-02-42	In-patient
BF-02-43	Community treatment settings
BF-02-44	Community residential settings
BF-02-45	Psychosocial settings.
	Demonstrate knowledge and ability to participate in a therapeutic community, including:
BF-02-46	Use of therapeutic milieu outside of medical model
BF-02-47	Group decision making
BF-02-48	Flattening of hierarchy
BF-02-49	Permissiveness
BF-02-50	Reality confrontation
BF-02-51	Social context as curative factor
BF-02-52	Mutual self help
BF-02-53	Open communication.