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Inpatient hospital units (IUs), partial hospitalization (PH) or day treatment (DT) programs, and residential treatment centers (RTCs)—sometimes grouped as restrictive or intensive services—play a critical role for children and adolescents (youth) with severe and/or persistent mental illness requiring extensive or intensive health and psychiatric services. Federal reports sometimes combine residential and inpatient statistics, whereas PH or DT programs are pooled with outpatient treatments. A common set of values and expectations allows these programs to be considered together. A therapeutic milieu is central to each. In this chapter, I describe common features across these milieu treatments (MTs) and consider each modality by defining the intervention and describing its structure, its clinical role, and related issues.
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