Design Strategies to Foster Improved Experiences for Patients in Rehabilitation

Abstract

Purpose

This study examines the impact of facility design on patient experiences in substance abuse treatment centers.

Background

Therapeutic architecture enhances rehabilitation environments by incorporating sound, light, color, privacy, and views to promote healing. Thoughtful design can reduce stress, improve wellbeing, and support recovery and reintegration.

Method

A survey was conducted between October 2022 and May 2023, comprising 25 questions focused on privacy, safety, autonomy, social interaction, and technology. The survey included 67 participants, made up of healthcare designers and individuals with substance abuse histories, with data analyzed using Qualtrics XM and NVivo 12.

Results

Key themes of privacy, safety, autonomy, social interaction, and technology emerged. Participants emphasized the need for private spaces for communication, uncluttered environments, and staff monitoring for safety. Designs allowing patients control over lighting and temperature increased autonomy. Supportive environments, including art, enhanced social interaction. While opinions on virtual reality's usefulness varied, designers viewed it as a valuable distraction tool.

Discussion

The findings highlight the significant influence of environmental design on patient engagement and healing. Essential elements include privacy, safe layouts, home-like settings, and social support areas. Both patients and designers valued autonomy over environmental controls, such as lighting and temperature. Although virtual reality showed potential benefits, concerns were raised about its effects on safety and stigma.

Conclusion

Effective environmental design is crucial to improving patient experiences and engagement in substance abuse treatment. Key factors include privacy, safety, autonomy, home-like environments, and supportive social spaces, with virtual reality offering additional but debated benefits.

Keywords

experience design healthcare design substance abuse behavioral health patient engagement environmental design mock-up addiction

Get full access to this article

View all access options for this article.

References

Adams

Grieder

D. M.

(2004). Treatment planning for person-centered care: The road to mental health and addiction recovery. Elsevier.

Al-Bqour

Rababeh

Al-Rabady

(2022). The psychological supportive design features in hospitals: Case of a public Jordanian hospital in Amman. HERD: Health Environments Research & Design Journal, 15(1), 173–188. https://doi.org/10.1177/19375867211029560

Barbara. (2013). Invisible architecture: Experiencing places through the senses. Skira Editor Milano.

Basson

(2014). Adaptive healing: Exploring therapeutic architecture and the integration of addiction rehabilitation into the Cape Flats, Mitchells Plain.

Batbaatar

Dorjdagva

Luvsannyam

Savino

M. M.

Amenta

(2017). Determinants of patient satisfaction: A systematic review. Perspectives in Public Health, 137(2), 89–101. https://doi.org/10.1177/1757913916634136

Bayramzadeh

(2017). An assessment of levels of safety in psychiatric units. HERD: Health Environments Research & Design Journal, 10(2), 66–80. https://doi.org/10.1177/1937586716656002

Bjørlykhaug

K. I.

Karlsson

Hesook

S. K.

Kleppe

L. C.

(2022). Social support and recovery from mental health problems: A scoping review. Nordic Social Work Research, 12(5), 666–697. https://doi.org/10.1080/2156857X.2020.1868553

Carpman

J. R.

Grant

M. A.

(2016). Design that cares: Planning health facilities for patients and visitors. John Wiley & Sons.

Cieślik

Mazurek

Rutkowski

Kiper

Turolla

Szczepańska-Gieracha

(2020). Virtual reality in psychiatric disorders: A systematic review of reviews. Complementary Therapies in Medicine, 52, 102480. https://doi.org/10.1016/j.ctim.2020.102480

10.

Collins

(2020). The architecture and landscape of health: A historical perspective on therapeutic places 1790–1940. Routledge.

11.

Connellan

Gaardboe

Riggs

Due

Reinschmidt

Mustillo

(2013). Stressed spaces: Mental health and architecture. HERD: Health Environments Research & Design Journal, 6(4), 127–168. https://doi.org/10.1177/193758671300600408

12.

Dictionary.com. (2024, March). Dictionary.com. Retrieved from http://www.dictionary.com/browse/environment)

13.

El Shamy

(2021). The impact of architectural psychology on the interior design of psychiatric hospitals. Journal of Design Sciences and Applied Arts, 2(1), 41–59. https://doi.org/10.21608/jdsaa.2021.29937.1043

14.

Hosseini

Farshi

S. S.

Ahvazi

Shokohi

(2021). Optimization of Geometrical Properties Affecting Cooling Energy Demand of Central Courtyards in Hot-Humid Climates A Case Study: Bushehr.

15.

Huisman

E. R.

Morales

Van Hoof

Kort

H. S.

(2012). Healing environment: A review of the impact of physical environmental factors on users. Building and Environment, 58, 70–80. https://doi.org/10.1016/j.buildenv.2012.06.016

16.

Jonas

W. B.

Chez

R. A.

(2004). Toward optimal healing environments in health care. Journal of Alternative & Complementary Medicine, 10(Supplement 1), S-1. https://doi.org/10.1089/acm.2004.10.S-1

17.

Kellert

S. R.

(2005). Building for life. Island Press.

18.

MacAllister

Bellanti

Sakallaris

B. R.

(2016). Exploring inpatients’ experiences of healing and healing spaces: A mixed methods study. Journal of Patient Experience, 3(4), 119–130. https://doi.org/10.1177/2374373516676182

19.

Mansourihanis

Maghsoodi Tilaki

M. J.

Sheikhfarshi

Mohseni

Seyedebrahimi

(2024). Addressing urban management challenges for sustainable development: Analyzing the impact of neighborhood deprivation on crime distribution in Chicago. Societies, 14(8), 139. https://doi.org/10.3390/soc14080139

20.

McIntosh

S. E.

Freer

Grissom

C. K.

Auerbach

P. S.

Rodway

G. W.

Cochran

Hackett

P. H.

(2019). Wilderness medical society clinical practice guidelines for the prevention and treatment of frostbite: 2019 update. Wilderness & Environmental Medicine, 30(4_suppl), S19–S32. https://doi.org/10.1016/j.wem.2019.05.002

21.

McLellan

A. T.

Lewis

D. C.

O'brien

C. P.

Kleber

H. D.

(2000). Drug dependence, a chronic medical illness: Implications for treatment, insurance, and outcomes evaluation. JAMA, 284(13), 1689–1695. https://doi.org/10.1001/jama.284.13.1689

22.

Metzger

I. W.

Anderson

R. E.

Are

Ritchwood

(2021). Healing interpersonal and racial trauma: Integrating racial socialization into trauma-focused cognitive behavioral therapy for African American youth. Child Maltreatment, 26(1), 17–27. https://doi.org/10.1177/1077559520921457

23.

Mira

(2014). Key components. Retrieved from Alta Mira Recovery Programmes: http://www.altamirarecovery.com

24.

Morgan

Pullon

McKinlay

Garrett

Kennedy

Watson

(2021). Collaborative care in primary care: The influence of practice interior architecture on informal face-to-face communication—an observational study. HERD: Health Environments Research & Design Journal, 14(1), 190–209. https://doi.org/10.1177/1937586720939665

25.

Novin

R. S.

Taylor

Hermans

Merryweather

(2021). Development of a novel computational model for evaluating fall risk in patient room design. HERD: Health Environments Research & Design Journal, 14(2), 350–367. https://doi.org/10.1177/1937586720959766

26.

Oi-Zhen

Weng-Wai

Yu-Tian

(2015). Quality of healing environment in healthcare facilities. Jurnal Teknologi, 74(2), 101–108. https://doi.org/10.11113/jt.v74.4529

27.

Patterson

M. S.

Francis

A. N.

Pew

S. H.

Liu

Kang

Heinrich

K. M.

Prochnow

(2025). Exploring support provision for recovery from substance use disorder among members of a sober active community. Scientific Reports, 15(1), 8740. https://doi.org/10.1038/s41598-025-92029-1

28.

Payam

Hossaini

Zaschka

Friedmann

Mall

(2023). Designing well-being: A qualitative investigation of young patients’ perspectives on the material hospital environment. HERD: Health Environments Research & Design Journal, 16(3), 168–181. https://doi.org/10.1177/19375867231165763

29.

Reiling

Hughes

R. G.

Murphy

M. R.

(2008). The impact of facility design on patient safety. Patient safety and quality: An evidence-based handbook for nurses.

30.

Seaward

B. L.

(2011). Health and wellness journal. Jones & Bartlett Publishers.

31.

Segawa

Baudry

Bourla

Blanc

J. V.

Peretti

C. S.

Mouchabac

Ferreri

(2020). Virtual reality (VR) in assessment and treatment of addictive disorders: A systematic review. Frontiers in Neuroscience, 13, 1409. https://doi.org/10.3389/fnins.2019.01409

32.

Singha

(2020). Future healthcare design. RIBA Publishing.

33.

Substance Abuse and Mental Health Services Administration (SAMHSA). (2016). Facing addiction in America: The surgeon general's report on alcohol, drugs, and health. U.S. Department of Health and Human Services.

34.

Sui

T. Y.

McDermott

Harris

Hsin

(2023). The impact of physical environments on outpatient mental health recovery: A design-oriented qualitative study of patient perspectives. PLoS ONE, 18(4), e0283962. https://doi.org/10.1371/journal.pone.0283962

35.

Ulrich

R. S.

Zimring

Zhu

DuBose

Seo

H. B.

Choi

Y. S.

Joseph

(2008). A review of the research literature on evidence-based healthcare design. Health Environments Research & Design Journal, 1(3), 61–125. https://doi.org/10.1177/193758670800100306

36.

Wright

Eden

Hancox

Windget

Elliott

Glossop

Bell

S. L.

(2024). A qualitative exploration of the contribution of blue space to well-being in the lives of people with severe mental illness. People and Nature, 6(2), 849–864. https://doi.org/10.1002/pan3.10620

37.

Xuan

Chen

(2020). Impacts of nursing unit design on visibility and proximity and its influences on communication, privacy, and efficiency. HERD: Health Environments Research & Design Journal, 13(2), 200–217. https://doi.org/10.1177/1937586719881443

38.

Yan

Azmi

Mansor

Wang

(2024). Healing spaces as a design approach to optimize emotional regulation for patients with mood disorders. Buildings, 14(2), 472. https://doi.org/10.3390/buildings14020472