Peer-Oriented Milieu

The Teton Peaks program incorporates a Therapeutic Community approach for milieu management. TC principles are based upon a collaborative, democratic, and deinstitutionalized approach to staff-patient interaction. TC places a strong emphasis on the residential treatment peer group as a means of support and influence. TC groups hold significant power in molding, shaping, and influencing the behavior of their peers. TC helps mobilize the power of the group to shape pro-social behavior. The program's residents are taught care and concern with proper guidance from experienced professionals. The aim of TC is for residents to develop self-worth, significance, dignity, and responsibility as they become committed to the positive values of helping and caring for others and themselves. Residents learn much through the routine interactions of daily life and the experience of being therapeutic for each other.

The therapeutic community provides a structured milieu in which treatment activities occur. A typical weekday involves a blend of:

  • Structured activities (Group Builders, Skills Builders, Thinking for a Change, etc.)
  • Therapy (Individual, Family, Recreational, and Group)
  • Academic activities
  • Leisure or free time
Treatment is sequenced into phases, which are represented by a three-tiered level system. These levels are the fundamental tier, the privilege tier, and the independence tier. Passage from one tier to the next requires the resident to met specified criteria reflective of progress along behavioral, emotional, and cognitive dimensions. Movement to a more advanced phase brings with it increasing responsibilities as well as privileges.

Fundamental

When a resident first arrives, she is placed in this tier. The resident is given the opportunity to learn all of the objectives and expectations of the program. She is given time to attain and practice more adaptive skills. She is asked to identify, with the help of family and treatment professionals, problem areas that require attention. She is then asked to formulate a plan and make a commitment to address these issues. Completion of these tasks and participation in all planned groups and activities allows a resident to proceed to the next phase in her treatment.

Within the fundamental tier, residents are given access to all forms of therapy and group activities. They are required to move around the unit in groups of three and are not allowed privileges that can be granted on other tiers. Privileges granted vary based on individual needs, and are designed to reward residents and provide additional motivation to improve personal functioning.

Privilege

Once a resident shows an increased amount of self-control and self-awareness, he begins to enjoy the benefits of higher functioning, which include more privileges and trust within the program. Moving to the privilege tier incorporates the same access to therapy and recreational activities, and includes more opportunities for freedom and personal growth. Residents will have access to activities and privileges that include moving alone on the unit, moving in groups of three outside the unit, free time, movie time, outings to the park or swimming pools, and participating in the program's hiking-trail beautification program.

If a resident chooses not to maintain the commitment he has made to improve and resolve issues, he may be returned to the fundamental tier. Residents spend the majority of their treatment working in the privilege tier. When residents begin to show an internalization of changes made, they are eligible to progress to the final tier, independence.

Independence

The independence tier provides residents with an opportunity to transition from Teton Peaks to home. This tier is design to allow a maximum amount of freedom while still providing structure and direction. The general goal of this tier is to provide residents the opportunity to learn and practice independent living skills while still participating in therapy and skill-building classes. Much more freedom and responsibility are given to residents on the independence tier.