How to make residential units therapeutic

Svein Friis
Anne Berit Eie Torbjørnsen
Jon Vidar Strømstad
Anne Berit Eie Torbjørnsen, Jon Vidar Strømstad and Svein Friis.


It is generally well acknowledged that ward climate is of crucial importance for the treatment outcome.  However, to create a therapeutic milieu is easier said than done. The workshop will elaborate on following points:

  1. What are the characteristics of a therapeutic milieu? Here we will briefly present a theoretical basis for therapeutic milieus.
  2. How to get one off the ground? We will present how ward atmosphere can be measured, and present a systematic program to develop a therapeutic milieu. The practical process on how to implement WAS will be highlighted through examples from wards that already have used results WAS in their professional development of a therapeutic milieu.
  3. How to sustain a therapeutic milieu? Here we will elaborate on how outside and inside forces may threaten to undermine a therapeutic milieu, and what can be done to sustain such a milieu.
  4. Feedback of perceived ward atmosphere, possibilities and pitfalls. Finally we will elaborate on the possibilities and pitfalls in using feedback of perceived milieu as a changing agent.


Anne Berit Eie Torbjørnsen is a psychiatric nurse from Stavanger. She has been working with WAS since 2009 in the Psychiatric Division of Stavanger University Hospital.  As a head nurse she has been focused on the perspective of professional leadership and how it affects the therapeutic milieu in psychiatric wards.

Jon Vidar Strømstad is a psychiatric nurse and assistant ward leader from Stavanger. He has also been working with WAS since 2009 in the Psychiatric Division of Stavanger University Hospital. He is an experienced clinician and places himself in the tradition of Lars Thorgaards ‘relational treatment’.

Svein Friis is an emeritus professor of psychiatry at the University of Oslo. He is trained as a psychoanalyst, and has worked with clinical psychiatric research for more than 40 years, with special emphasis on evaluation of treatment programs. He has used the Ward Atmosphere Scale since 1972 and his research has demonstrated the need for differentiation of therapeutic milieus. He was for many years co-PI with Tom McGlashan of the TIPS-study that demonstrated the benefit of reduced Duration of Untreated Psychosis on long term outcome. He was associate editor of Acta Psychiatrica Scandinavica 2004-2015, and is since 2014 associate editor of Schizophrenia Bulletin.