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The Therapist's Chair and How Interior Design Can Improve Patient Outcomes

Updated: May 12, 2020

After many decades of research, we are now designing healthcare facilities with a human-centric approach. Evidence has proven that interior design is a transformational force in our ability to heal, engage and respond in positive ways. Improved patient outcomes is a fact.

Evidence-based design is moving into other domains - slowly. For me, interior design has always had a deeper meaning - something meaningful, something more important than just fabulous throw pillows. That intuition combined with intimate experiences with mental illness has shifted my professional focus towards creating spaces that support the human spirit.

For mental health care service providers, it's critical to provide a safe, supportive, and restorative space for service users. If your patient can't achieve their "window of tolerance", how can they engage in the process of recovery? To aid in achieving this level of engagement, the design of a therapeutic space must be intentional. The design (or lack thereof) of the office and also the much forgotten waiting area is another valuable tool that is underutilized.

Sited in the Mental Health Facilities Design Guide which is published by the Department of Veterans Affairs Office of Construction & Facilities Management (U.S.), the introduction of this document summarizes the underlying reason for therapeutic design quite well:

“Facility design impacts the beliefs, expectations, and perceptions patients have about themselves, the staff who care for them, the services they receive, and the larger health care system in which those services are provided.

Details matter in therapeutic spaces. Art - needs to be a positive distraction, which means it can't be about personal likes. Art must be intentional in terms of the visual, no abstract art, placement is key - I can go on...

Your lighting, furniture, materials, and placement are all relevant to creating a space that aids in engagement and disclosure. And don't forget your waiting room - an area that is usually much forgotten but so important to that person waiting with anxiety, prepping themselves to spill their guts.

"Room layout affects service user perceptions of psychological safety, intimacy, willingness to self-disclose, to build therapeutic rapport, and to feel a sense of agency in the space. Poor layouts in the therapeutic area can exacerbate feelings of otherness, mitigate development of agency, reduce communication, and have poor service user outcomes and experience", said Dr. Stephanie Liddicoat-Ocampo Ph.D., Architectural research at the University of Melbourne. Given this evidence, applying these fundamental design principals to therapeutic spaces is a way to empower both the service provider and the user.

Full disclosure...Long before I found my way into the field of evidence-based design, I spent time in "the therapist's chair". While I credit much of my recovery to the outstanding care I was blessed to receive, the spaces did not always support the process. I will admit that I have a tendency to "silently critique" pretty much every room I enter. Looking back, I didn't know I was engaged in a sub-conscious research study.

Dear Therapist, call me - I can help you.

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