A clinical ladder for milieu counselors. An opportunity to contribute to self-esteem.

1. Self-esteem affects motivation, achievement, and job satisfaction. 2. Access to a clinical ladder for milieu counselors rewards their achievements in a visible and tangible way, thereby increasing their self-esteem with positive effects on their job satisfaction and quality of patient care. 3. Since the implementation of the clinical ladder program for milieu counselors, there has been documented evidence of increased retention and higher levels of job performance on work evaluations.