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BF: Psychiatric Care BF-02: Therapeutic Milieu
No. Competency Item NAC DEV COM DTE EXC
  Demonstrate knowledge of therapeutic milieu:          
  • 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:          
  • 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:          
  • 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:          
  • 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:          
  • 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:          
  • 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:          
  • 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:          
  • 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:          
  • 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.
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