Therapeutic architecture, sometimes referred to as “healthcare architecture,” or “patient-centered design”;
Or even “evidence-based architecture” are all concepts that are not entirely new,
but are slowly entering the consciousness of mainstream thought.
Therapeutic architecture emerged from studies of architectural facilities designated for psychological care.
It was originally an examination of people who lived and suffered in hospitals and institutions – and whether the limits of the environment itself exacerbated or decreased this suffering.
It was the beginning of a series of new ideas for architects:
That architecture itself can play an important role not only as a physical site,
but also as a mechanism of power and control.
Therapeutic architecture
Kate Johnston, is one of the few architects with a PhD in the field of “Healthcare Architecture” and is also the inventor of the term “Therapeutic Architecture”.
I was first drawn to this topic when I realized that there was almost no literature available on the subject.
I closely followed a case study in Greece,
where authorities blindly tried to transfer patients from a Leros asylum and reintegrate them into society.
Almost nothing is understood about the best course of action in this reintegration process.
Moving from healthcare engineering to therapeutic engineering
Healthcare engineering developed against the background of medical engineering.
This precedent focused almost entirely on regulating and restricting patients,
and had almost nothing to say about the environment itself.
It wasn’t until the medical community began to notice that space itself – physical space – held more value than first thought.
This recognition of the importance of space has encouraged environmentalists,
academics and clinicians to come together and re-evaluate the importance of architecture.
More importantly, how can the design of the surrounding environment itself support both medical professionals and the patients within.
It also encouraged medical practitioners and architects to collect patient and staff feedback,
And meeting with them to consult about what they think about the environment around them.
One of the early successes that brought therapeutic engineering into the mainstream was a project comparing public health care facilities with health care facilities designed to regulate mental health.
In the Camden and Islington NHS catchment area,
A photo exhibition was held containing hundreds of images of mental health facilities and comparing them to other non-mental health facilities.
The study found significant differences not only in how the two building types fit together, but also in location.
Mental health facilities were almost always far from transportation networks.
Benefits of therapeutic architecture
In the medical world, designing spaces to match the potential cognitive and physiological traits of residents places greater emphasis on the role that obstacles play in the environment.
For example, it is understood that any obstacle in our way requires additional energy to get around it – which is usually not a problem if the person is healthy.
But it can make a big difference if a person is sick or has to rely on resources that are hard to find or unavailable.
The role of therapeutic architects is to reimagine the environment so that it contains as few “obstacles” as possible.
This is, in theory, therapeutic for patients, because the environment suddenly becomes a restorative factor that supports their health and well-being.

Therapeutic architecture in malls
All of this research has helped catapult therapeutic engineering from being the domain of medical facilities only, into the broader context of the commercial and even residential world.
It helped convey the message that architecture is about space and place,
and how each shapes the physical context of our lives.
In both the commercial and residential sectors, the opposite of what is tested in the medical world is often preferable.
More “obstacles” can encourage better physical health,
Which in turn can improve mental health and avoid general health problems later in life.
Obstacles such as making public toilets far apart to encourage walking.
Stairs are large: If they are too narrow, hidden away, or too dark, they will likely be overlooked.
Improving the lighting or design of stairs in order to encourage more employees to use them is a big factor in improving the architecture of a building.
Then there’s lighting, as certain types of lighting can disrupt melatonin production in the body.
Therefore, remedial engineers prefer to take advantage of natural daylight whenever possible,
To further support healthy lifestyles.
In fact, it is now highly recommended that all offices have direct or indirect access to daylight.
Good views of nature are also very important,
along with clean air and adjustable air conditioning for thermal comfort.
The same applies to the communication space, as this can come in different forms:
From acoustics to privacy, to getting the right seating,
And get the perfect spaces for individual workstations, desks, and chairs.
All of these elements add together to improve employee satisfaction and reduce employee turnover rates.
The future of therapeutic architecture
As Kate Johnston said: “Designing spaces according to people’s cognition, physiology,
and best therapeutic practice, is the essence of therapeutic architecture.”
Quite simply, therapeutic engineering is about enabling safe movement and natural daylight to support mentally and physically healthy lifestyles.
As our society shifts more towards recognizing the importance of mental health in general,
and in our homes, organizations and companies, the future looks bright for therapeutic engineering.
In fact, it looks like it will dominate it and all its influences.
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