Moral development as a crucial treatment goal for young people in institutional care: a critical comparison between milieu therapy and cognitive behavioral therapy

Abstract

PurposeThis article aims to analyze and discuss the role of moral development in treatment of behavior problems and, further, to describe differences and similarities between two different methods – milieu therapy (MT) and cognitive behavioral therapy (CBT) – in terms of addressing criminogenic needs and promoting moral development.Design/methodology/approachBy performing a literature review, the study shows that even though there are both pros and cons using MT and CBT in institutional care, relationships strong enough to restructure a young person's moral reasoning require time, and involves not only the young person's parents and social network members, but also a genuine therapeutic alliance with clinical staff at the institution.FindingsThese are central factors articulated in both CBT and MT, but are more explicitly expressed in MT. The results presented in this article highlight some important practical implications: in order to redevelop moral self and societal values, an overly narrow focus on criminogenic needs might exclude other components or processes of treatment and behavioral change. Together with a treatment program that views close staff‐resident interactions as of secondary importance, this could impair the possibility to obtain positive and long‐lasting treatment results.Originality/valueIn practice, moral development itself should be considered as an overall treatment goal, integrated into the daily life at the institution, 24 hours a day. Finally, the possibility to work with moral development in institutional settings is discussed.