Creating a Healing Environment

Perspectives in Psychiatric Care, Nov 2006 by Torre, Mary Ann La

For most of us, providing a healing environment consists of working with the process that occurs in the interaction between client and therapist. When considering the concept healing environment, what comes to mind is the therapeutic focus, the sense of connection and rapport that is created. But there is a larger picture that occurs around and beyond the relationship; the actual environment itself where psychotherapy is done. This external setting can have an important impact on healing by significantly reducing or increasing stress as well as empowering the client in their own process (Moore, 1998).

Research as early as 1980 has shown the effect of this environmental impact on both clients and staff in various healthcare settings (Rice, Talbott & Stern, 1980). Just adding a window to a room was shown to reduce recovery time and hospital stay (Ulrich, 1984), while using color, art, and plants created a space where people felt safer and calmer (Moore, 1998). The important discovery of the power of the environmental setting has created a whole discipline called supportive design and research continues which explores the restorative benefits of the external setting (Ulrich, Zimring, Joseph, & Choulhary, 2005). Applying these concepts to the therapeutic workplace can add a deeper dimension of healing and empowerment to the therapeutic interaction. This column will explore these concepts in general as well as discuss the specific practice of Feng Shui, a Chinese art of placement that focuses on harmonizing the environment by rearranging the room to balance energy (Jeffreys, 2000).

General Environmental Concepts

To begin a discussion of the environment as a healing tool it is helpful to look at some basic premises. A fundamental one being that since earliest evolutionary times human beings have had to be aware, responsive, and sensitive to their environment. It was essential for survival. From these evolutionary premises, environmental psychologists have done research in a number of areas to show how the quality of the environment can support well-being. Such research demonstrated that the more familiar, comfortable, and in control of the environment an individual felt, the greater the positive healing response (Bilchik, 2002). Thus, health care cannot be separated from the setting in which it is done (Malkin, 1992). Design elements have a significant impact on the individual and awareness of how specific components in the environment can be used to change a client's state of mind is an important part of the therapeutic process.

The practitioner who decides to work with the environmental setting to enhance the therapeutic process may find that there are structural restrictions in the building and rooms that make many healing concepts difficult to implement. There are, however, some important design concepts that can be used in any setting to promote health no matter what the structure and can be a good beginning towards creating a supportive atmosphere.

Color is an important component that can affect the entire setting and change the essence of a room. Color is one of the most powerful energizing forces and thoughtfully employing color in the therapeutic setting can make a significant difference in the stress or relaxation of a client. Research shows that color has an effect on our pituitary and thyroid gland, creating mood changes and physiological effects (Long, 2001). Colors as blue and green have been shown to promote relaxation and balance, while yellow and orange seem to activate and energize a room (McKahan, 1993). The intensity of color is also an important factor and often leads to the choice of lighter hues to make a room more spacious. Room color can also be altered through the use of lighting that can play off interesting features and draw the eye towards positive aspects such as art or views (Long).

Daylight and windows are another important component in any room since they significantly reduce fatigue and depression and help reconnect to nature (McKahan, 1993). Even if there are no windows, however, plants can create that sense of nature indoors and simply viewing nature can have a profound stressreducing effect (Long, 2001). Research has shown that negative emotions such as fear or anger diminish when looking at nature while levels of pleasant feeling increase (Ulrich et al., 2005). Even nature paintings can have a positive effect (Flower, 2005).

Thus, the environmental setting does make a difference in the healing process, and creating a space that is comfortable, light, and nature connected can enhance any treatment program. Practitioners who wish to expand their skills in healing design can explore the evidence-based research in the area as well as look to the Chinese since they have developed a whole discipline for harmonizing the environment called Feng Shui. Based on thousands of years of observation of how human beings react to their environment, Feng Shui (meaning wind and water) focuses on creating a supportive environment where the client's personal energies work well with the objects in the room (Jeffreys, 2000).