The integrative milieu model, developed by Kevin F. McCready

Kevin F. McCready

Kevin F. McCready was a clinical psychologist in Fresno, California. He was the founder and director of the San Joaquin Psychotherapy Center and the non-profit Recovery for Emotionally Abused Children ....

, is an alternative treatment regime to the medical model of psychiatry

Psychiatry

Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...

 for treating people suffering from psychological distress.

A central part of the anti-psychiatry

Anti-psychiatry

Anti-psychiatry is a configuration of groups and theoretical constructs that emerged in the 1960s, and questioned the fundamental assumptions and practices of psychiatry, such as its claim that it achieves universal, scientific objectivity. Its igniting influences were Michel Foucault, R.D. Laing,...

 movement, being a close friend of Peter Breggin

Peter Breggin

Peter Roger Breggin is an American psychiatrist and critic of biological psychiatry and psychiatric medication. In his books, he advocates replacing psychiatry's use of drugs and electroconvulsive therapy with humanistic approaches, such as psychotherapy, education, and broader human...

 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 biomedical model of psychiatry

Biological psychiatry

Biological psychiatry, or biopsychiatry is an approach to psychiatry that aims to understand mental disorder in terms of the biological function of the nervous system. It is interdisciplinary in its approach and draws on sciences such as neuroscience, psychopharmacology, biochemistry, genetics and...

 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 psychodynamic theories, particularly the theories of Carl G. Jung, humanism

Humanism

Humanism is an approach in study, philosophy, world view or practice that focuses on human values and concerns. In philosophy and social science, humanism is a perspective which affirms some notion of human nature, and is contrasted with anti-humanism....

, and existentialism

Existentialism

Existentialism is a term applied to a school of 19th- and 20th-century philosophers who, despite profound doctrinal differences, shared the belief that philosophical thinking begins with the human subject—not merely the thinking subject, but the acting, feeling, living human individual...

.

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:

• 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.
• 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.
• 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 .
• 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 .

Integrative milieu day treatment

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 psychodynamically-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.

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.

There are currently only three such programs in existence today:

• Associated Psychological Health Services
• Sequioa Psychotherapy Center and
• the Insight Center.