Thesis report - Healingtecture

Healing-tecture Rehabilitation in Village School for Drug Addictor

Thomas Tong Wing Hong

Healing-tecture Rehabilitation in Village School for Drug Addictor

By

Thomas Tong Wing Hong (2012990544)

A thesis report submitted for the degree of

Master of Architecture

at

University of Hong Kong

June 2014

Under the supervision of

Mr. Martin Fung

Acknowledgement

Much thanks to Mr. Martin Fung, my thesis supervisor, for his generous guidance and encouragement on the thesis development.

Much thanks to Zheng Sheng College for the advice of rehabiltation

Much thanks to Maggie Caring Centre (HK) for the psychological advice

Much thanks to Nick Y. H. and social worker Ms. Dilys for psychological advice

Much thanks to Ms. Amy Kong and the group of Jehovah-jireh for being supportive and caring

To them I dedicate this thesis

Content

Thesis Statement

The Reserach

Case Study

Background of the client

The Site

Final Design

Comment from Critics

Design Development

Bibliography

Thesis statement

Base on the phenomenon of rapid urbanization in the coming decades, psychologist predicts that there are more and more people would be suffered by mental illness such as depression, and in particular schizophrenia. According to the survey conducted by Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, it mentions that there are around more than a half of population who live in the city area in 2011, but in 2050, an-other survey mentioned that it will be about 69% of total population in earth will move to city area from rural area. Psychologists claim that the loss of natural living environment is one of reason causing this social problem. Refer to a study conducted in Denmark in 2001 showed that people who grew up in capital have a higher risk suffered by schizophrenia.

Proportion of world’s population in city and rural in 2011


Source: Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, 68159 Mannheim, Germany

Source: Dye, C. Health and urban living. Science 319, 766–769 (2008). Source: C. B. PEDERSEN & P. B. MORTENSEN ARCH. GEN. PSYCHIATRY 58, 1039–1046 (2001)

“People from the city and the countryside respond differently to social stress, Stress is a major factor in precipitating psychotic disorders such as schizophrenia.”

City living & mental health

69%

This thesis ventures aims to explore how a man-made struc-ture situated in natural environment could enhance the mental

health, and even a psychological treatment.

The challenge of this architectural thesis for the enhancement of mental health and psychological treatment is that through an “active” or “passive” nature-encountering experience to assist a person entering a state of solitude or unity for healing purpose, and it involves various therapies and programmatic background. Therefore the methodol-ogy for my thesis will be approached in following manners:

1. Researches of the psychological influence in the natural living environment settings.

2. Precedent studies on architectural design emphasizing on the integration of natural landscape with the architecture for healing purpose.

3. Test ground of a local rehabilitation school, Zheng Sheng College focusing on the therapies had been applied and programmatic need

4. Design of a rehabilitation school for drug abuser

Outline of research / design methods

Experiment of viewing nature in hospital The following 2 experiments show that how the man-made environment influences the mental health in human and mouse. First one is conducted in hospital among the patient after heart surgery, it was discovered patient who views more natural environment that they could recover faster and take fewer painkillers than the patient who always view the abstract paint.

“Post-operative heart surgery patients were examined to assess the effect exposure to simulated nature views has on recovery. At Uppsala University Hospital in Sweden, 160 patients who had undergone heart surgery were allocated according to a modified random procedure to a visual condi-tion consisting either of a nature picture (trees, water/vege-tation), an abstract picture dominated by either rectilinear or curving forms, or a control condition with either a white pan-el or no picture. Findings suggested that individuals exposed to the view of water/vegetation experienced less post-oper-ative anxiety than the control groups and those exposed to the other types of pictures. Additionally, those patients with the water/vegetation views shifted more quickly than other groups from strong pain drugs to moderate strength pain drugs.” (Ulrich et al. 1993)

The experiment regarding to the brain stimuli and environment

Another experiment is conducted in mouse showing that what if there are more sensory stimulations in the artificial environment, the nerve in mouse’s brain could grow faster and more developed.

“Thirty six rats were sorted into three experimental conditions using 12 animals in each group:1) enriched 2)standard or 3) im-poverished environments. All animals had free access to food and water and similar lighting conditions. For the enriched environment, were provided objects to explore and climb upon. The objects were changed two to three times a week to provide newness and challenge; the frequent replacement of objects is an essential com-ponent of the enriched condition. For the standard environment, the animals were housed 3 to a small cage with no exploratory objects. After 30 days in their respective environments, all animals were anaesthetized before the brains were removed for comparison among the three groups. Results indicated clearly that the cortex from the enriched group had increased in thickness compared with that living in standard conditions, whereas, the brains from the im-poverished group decreased compared to the standard.”Source: Response of the Brain to Enrichment, Marian Cleaves Di-amond

Children’s Centre for Psychiatric Rehabilitation Sou Fujimoto / Hokkaido, Japan / 2006

It is the treatment centre for mentally disturbed children where they could live together to cure their mental health. The design basically emphasises on the intimacy and variety of a house, a surely irregular alcove-place is pro-duced between the boxes placed at random.

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It is a counselling centre for the cancer patient, and acts as a communal place for them and their family. It is formed as a cluster of seven small houses around two green outdoor spaces. Each house has its own specific function and together they form a coherent sequence of different spaces and functional rooms. A varying roof height and materials proactively distinguish itself from the surrounding hospital buildings. By the means of daylight quality, the room’s mood, colour, sound and the ability to be private and secure to serve the healing purpose physically and psychologically.

Livsrum – Cancer Counseling Center EFFEKT / Copenhagen, Denmark / 2013

It is a counselling centre similar to the previous one providing counselling services and related social services for the cancer patients and their family. In this centre, it deployed the high articulated roof to bring the variety of spatial character and penetration of natural light in each functional room.

Desiderata Alternative High SchoolJones Studio Inc / Phoenix, Arizona, USA / 2006

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Maggie’s Cancer Caring Centre Gehry Partner & Ronald Lu & partners / Tuen Mun, Hong Kong / 2013

It is a high school serving for the 125 students with emotional disorder and behavior problem so that they could be taught for the basic life skill. It is designed to integrate with exterior planted courtyards within the existing building’s walls in order to create outdoor classrooms and bring in natural light. The skylights take advantage of the industrial building’s high, wood roof structure to distribute natural light to multiple classroom clerestories, and the colored glazing and a variety of paint colors are deployed to distinguish its institutional image from a industrial building and to create the various learning environment as well.

To summaries those cases, apart from their different architectural language had been deployed by architects, one of the common points is that they have high distinguishability of solidity and communal experience in the spatial arrangement for different kind of treatment needs, and also the various levels of integration of natural landscape and penetration of daylight.

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Typical drug treatment and Rehabilitation centre in HK

Program

Nature

Target Group

Zheng Sheng College in HK Therapeutic boarding school in US

Isolation ApproachTraining & therapy within the centre

Isolation ApproachTraining & therapy within the centre

Mandatory Ordered by court

Mandatory Ordered by court

Teens abuse drugTeens abuse drug Teens with emotional, behaviour problem, substance abuse

Voluntary

Semi-isolated ApproachTraining & therapy outside and within the centre

Test ground - Zheng Sheng College

Zheng Sheng College is the test ground of this thesis. It is a rehabilitation school for troubled teen that physically get rid of drugs, but psychologically still rely on drugs. It was established in 1985 as a drug addiction treatment centre, and registered as a private school in 1998. Most of the teens in this school are sent by court with criminal back-ground to stay in this school for either the vocational training or traditional secondary school education.

TFor the proposed site which is in a high school had been abandoned for 10 years in Mui Wo in Lantau Island. In fact, the development of that site is proposed by the college in few years ago, because of the political concern; right now the development had been suspended. The merit of the site is that at one side, it faces to mountain and a beach which is talking about rehabilitation, and at the anther side, it faces to a small local community, which is talking about the reentry to the society.

For the routine of site, normally all local and visitors will access to this island by the ferry, and most of visitors might take the transport from the bus station here to another spots in the island, some might go to a larger beach at the another side, some might have a meal in that local restaurant. So the local community there is a pretty quiet zone.

Open space/ park

Site

Public facilities

Residenetial area

10 mins walking distance

Existing country park pathway

For the planning consideration, in order to minimize the demolition, one of the existing blocks, the classroom block is kept, and also because the intention of creating certain controlled environment, 4 linear blocks forms the entire massing. Secondly for the consideration the intake of daylight and viewing propose, the blocking is slight shifted. Response to the site merit mentioned above, a better visual connection with the local community and the mountain behind is important, so there is a stepping approach of the blockings. Thirdly for the reinforcement of the internal community, 2 internal courtyards is formed, student community and the community with neighborhood. Fourthly in order to further breakdown of the massing into human scale for intimacy of space, a village scale of topology is deployed.

Final Design

Shop Community Hall

Classroom Dormitory Counselling Room

Outdoor Activities

Room

Rehabiltation programme

Programmatically all the iso-lated rehabilitation programs face to adjacent beach and mountain such as the out-door activities rooms and counselling rooms, while the reentry program faces to the local community, such as the different shops and restaurant which is operated by the stu-dent as a vocational training platform.

Healing Journey

Journey of Quietness Journey of Awareness Journey of Cognition

Journey of InteractionJourney of Preparation or Readjustment

Architecturally the gesture of building form is basically penetrated by different kind of tubes that extracted from the fabric of existing classroom block. Each tubes encourage the people to have particular focus while walking by the openness and light penetration in the tubular journey,, and most importantly which is cooperate with various therapies.

Healing in community through therapies

Healing in the interaction with local community

Healing in solitude in nature

In this thesis design, the tubular space act as “bridge” connecting the internal and external community, programme and therapy, people and nature, people being healed and healer, and multi-layers of individual spiritually for the purpose of rehabilitation ultimately. For the operation of this rehabilitation school which will be managed by Zheng Sheng College, it involves a range of therapies incorporating in the programme in daily, weekly and periodically routine. They are therapeutic community, mediation, time-out therapy, motivational interviewing, cognitive therapy and reentry programme.

In every morning, students will pass through a semi-opened tube leading them to the adjacent mountain and beach to have physical training in a group to learn about self-discipline and team-building. This is where the therapeutic community will be applied. It is a group-based approach for the long-term mental illness, personality disorders and drug addiction. The clients and therapists will live together, so that the clients could rebuild their certain habitat and discipline, and have been counselled in the certain environment.

Journey of Interaction

Journey of Interaction

After the physical training, students will have a quiet time for individual mediation in the internal court. Af-terward they will pass through another semi-opened tube solely for the schooling session.

Journey of Preparation

During the schooling session, students sometimes might have behaviour problem, for example, they will break the order of the class. At that moment, student will be brought to adjacent solid tube with skylight and bay-window facing to plant. They will be requested to stay there for self-reflec-tion, and a therapist will approach them one by one for their uncontrolled behaviour. This therapy is called Time-out. It is a form of punishment that involves temporarily separating a child from an isolated environment where inappropriate be-haviour has occurred, and is intended to decrease positive reinforcement of the behaviour.

Journey of Quietness


What if the said uncontrolled behaviour is constant-ly happened on the students, the therapist will bring the students to an outdoor area through a semi- en-closed tube below to have further counselling such as motivational interviewing. It is a method facilitating and engaging intrinsic motivation within the client in order to change their behaviour. In fact, this semi-en-closed tube with stepping pavement and washed granite stone acts as common self-reflection corridor at ground floor so that student will walk slowly in this space for reminder of daily learning.

Journey of Awareness

At the later stage of rehabilitation, the students will be arranged to train in different kind of social enterprise in front of this campus block for their re-entry to society. They will pass through tube with controlled circulation and skylight to said area for readjustment and safety purpose.

Journey of Readjustment

Lastly, the students will be periodically brought to the counselling room at the rear side of the school through tube with baffle to conduct a further psychological treatment before they leave this rehabilitation school. For example, cognitive behavioural therapy (CBT) will be applied. “CBT aims to help people become aware of when they make negative interpretations, and of behavioural patterns which reinforce the distorted thinking. Cognitive Therapy helps people to develop alternative ways of thinking and behaving which reduce the psychological distress.” (Saul McLe-od, 2014). While they walk through this tube, light and shadow, and the mountain framed behind become the keys visual stimulation to the student before and after the counselling.

Journey of Cognition

Journey of Awareness


First Review

Critics: Jason Carlow, Martin Fung, Nasrine Seraji

1. Jason commented the entire narrative including the site and programme proposed was too intuitive.

2. Nasrine questioned about the justification of the site. She reminded me to think about the relationship between the urban context and the retreat centre.

Thesis statement

In the urban environment settings nowadays people unconsciously omit the importance of resting place, the usage of space have no tension to the concept of functional and saleable under capitalism. Moreover, compare with the people live in the country side, people who live in urban area apparently have no idea about encountering with nature and the concept of daily solitude. It might be a reason caused common emotional problems in city such as depression.

Memory is one of the key elements affecting our emotional behavior, and it could be contributed by architecture. Nobody will talk about their history or story without a place no matter it is man-made, nature or an imaginative one. Through the sensory stimulations including visual, audio, touch, smell and taste all the informations have been recorded, and pass through to our brain for processing and become part of memory and ourselves. Secondly by processing negative emotion in memory in the state of solitude suggested by psychologist is a method enhancing our inner searching and emotional health. However because of limited settings in urban area, the mentioned process had been hindered, rehabilitation in nature might be a way out. This thesis venture aims to explore the following question:

1. How can architecture in natural environment act like a door to help people to enter the space of memory, the drawers of happiness and sadness things?

2. Can the architectural experience be the part of treatment of emotional problem?

The challenge of this architectural thesis for the enhancement of psychological treatment is that through an “active” or “passive” sensory experience to assist the person enters a state of solitude or unity is highly personal, and it involves various therapies and programmatic background. Therefore the methodology for my thesis will be approached in following manners:

1. Exploration of the relationship between spatial/ sensory stimulation and psychological therapy applied in natural environment, which is adventure based counselling (ABC).

2. Case studies on architectural design emphasizing on the spatial/ sensory stimulation or programmatic approach to enhance the effect of treatment.

3. Design of a depression retreat center

Cognitive Psychology Source: http://www.edpsycinteractive.org/topics/cognition/infoproc.html

Long term memoryShort term memory

Receptor Environment

Response

Outline of research / design methods



Source: Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, 68159 Mannheim, Germany

Source: Dye, C. Health and urban living. Science 319, 766–769 (2008).

Source: C. B. PEDERSEN & P. B. MORTENSEN ARCH. GEN. PSYCHIATRY 58, 1039–1046 (2001)

A 2001 study in Denmark showed that people who grew up in large cities had a higher risk of schizophrenia

“People from the city and the countryside respond differently to social stress, Stress is a major factor in precipitating psychotic disorders such as schizophrenia.”

City living & mental health

69%

Children’s Center for Psychiatric Rehabilitation / Sou Fujimoto / Hokkaido, Japan / 2006

Case study - Healing architecture

This is the treatment centre for mentally disturbed children where they live together to get regaining their mental health, the design emphasis on the intimacy and variety of a house. A surely irregular alcove-place is produced between the boxes placed at random. It is the place of a small scale where children can hide in while they are connected to the living area. Although it is the space with no function in which it can make it avoidable in a simple form strangely, children play with the place like the primitive man who interprets landscape freely and lives very well in it. They hide in a place behind something, show up, relax at back, and run about here and there. By being separated and being connected are compatible, freedom and inconvenient live together in the meantime.

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The center is designed as a cluster of seven small houses around two green outdoor spaces. Each house has its own specific function and together they form a coherent sequence of different spaces and functions such as a library, kitchen, conversation rooms, lounge, shops, gym, and wellness facilities.The house offers a wide range of different rooms for informal advice, therapy and interaction with a focus on the users’ comfort and wellbeing. A varying roof height and materials used means that the building will have its own unique architectural character that clearly distinguishes it from the surrounding hospital buildings. The basic idea is not that architecture alone can heal, but that the architectural design in terms of daylight quality, the room’s mood, color, sound and the ability to be private and secure to support the healing that takes place both physically and psychologically.

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Livsrum – Cancer Counseling Center / EFFEKT / Copenhagen, Denmark / 2013

Case study - Healing architecture Maggie’s Cancer Caring Centre / Page and Park / Scottland / 2006

The design for the Maggie’s Centre acts as a harmonious and interconnected meeting of landscape and built form – seeking to blur the perceived boundaries between internal and external spaces, enclosure and openness. To take care the emotional need of the cancer’s patient, this centre provides occasional enclosed space so the patient/client can hide themselves from the world, but also the space encourage the client to go out. These are both internal and external, with varying degrees of enclosure and exposure to and with the surrounding ‘public’ spaces, thus responding to the emotional variances of people associated with cancer. The second vesica shape begins within the heart of the building enclosure, and emerges to create an enclosing wall to the first of the surrounding ‘garden’ spaces.This space with its complete enclosing wall provides opportunity for people to step outside in the context and safety of the Centre within a controlled and private environment – important ‘breathing’ space away from the activity of the internal spaces and rooms. This ‘intimate garden’ spatially sweeps around and into the heart of the Centre, but does not stop there. The space flows through the building and out into the landscaping, through the mound forms and beyond.


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Maggie’s Cancer Caring Centre / Gehry Partner & Ronald Lu & partners / Tuen Mun, Hong Kong / 2013

Maggie’s centre Hong Kong deployed the high articulated roof to bring the variety of spatial character and penetration of natural light in each functional rooms. Timber was deployed for both in the interiors and in the wood and metal roof on concrete for the single storey structure. Shaped skylights and clerestories that shape the landscapes seen through them. Internally the kitchen acts as the main room, all the other areas radiate outwards from this open space to branch off like spokes into closed and semi-private areas. These include the library, a multipurpose function room for yoga or recitals, an administrative office to house six fulltime staff members and three consultation rooms. The homely arrangement of the kitchen helps to foster a sense of community. Moreover winding timber path similar to walkways in Chinese gardens leads to a consultation room set like a contemporary pavilion within a reflecting pond. It is brightly lit with a large rectangular picture window that looks out to the gardens beyond.


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Summary of case study - Healing archiecture

Floor height varation Free flow of circulation

Integration of landscape

Natural lighting Varity of natural material

Sense of community Levels of privacy

Proposed programme - Adventure based counselling (ABC)

ABC is a therapeutic tool and a mixture of experiential learning, outdoor education, group counseling and intrapersonal exploration.

Awareness of psychological needs and rise of therapeutic camping In 1901, an overcrowding problem at Manhattan State Hospital resulted in having patient live in tents on hospital grounds for “tent treatment” including tubercular and psychiatric. After war world II, Kurt Hahn and Lawrence Holt further address the psychological needs of youth in the organization Outward Bound (OB), particularly for the change of attitude and decline of abilities.

Target client:

Youth at risk Families Professional Female Group College students People with emotional problems conduct disorder, survivors of breast cancer

Personally I am a kind of “seaman”, I familiar with swimming, kayaking and sailing. Every time after I get back from the ocean I will be totally retreated physically, psychologically and spiritually. Natural environment does play an important role to human being. Particularly when people experience nature in a specific programme and in a unique space, nature does heal you in a subtle way. One of the therapy example is the adventure based counseling (ABC) that I experienced before in an organization called Life frontline which is similar to the well-known Outward Bound.

“Gravity is measure by the bottom of the foot; we trace the density and texture of the ground through our soles. Standing barefoot on a smooth glacial rock by the sea at sunset, and sensing the warmth of the sun-heated stone through one’s sole, is an extraordinarily healing experience, making one part of the eternal cycle of nature.” Juhani Pallasmaa

Perceived risk Real risk

Concept of application of real life

Release of emotion

Metaphor

Metaphor

Programmatically, the ABC treatment aims to bring risk to the clients, both perceived risk and real risk, is a necessary construct. Ewert (1989) defined real risk as that which actually exposes the client to a danger or possible harm, where perceived risk is only the illusion of danger. The nature of risk provides the potential for intense levels of cognitive and emotional arousal (Robinson, 1992). Gall (1987) explained risk taking as getting clients to do and translating this attitude metaphorically to how they approach life and career or school.

Psychological therapy in the adventure based counselling (ABC)

Through debrifing by the coach or metaphor



Perceived risk

Real risk

Conc

ept o

f app

licati

on

of rea

l life

Rele

ase

of e

mot

ion

Adventure setting in the wilderness environm

ent

Group brie

fing

Solit

ude

Mindset processing

Spatial Experience

Randomnessof the mindset

processing for each individual

Spatial / sensory implication in the adventure based counselling (ABC)

Case study - Existing campsite of outward bound

Office & CanteenDebriefing Multi-function room

Rope course Pier for sailing yacht and boatOut door briefing space Equipment room Dormitary for client

Dormitary for client

Programme : Canoing, sailing, Rope course

Type of client: College students, youth in risk with social worker, families, adult from the same company (Max. 160 users + 30 staffs)

Dormitary for staffs (30)

Proposed site - Off-shore islands in Hong Kong / proposed client

Islands for utilies or proposed utilies

Developed Islands for residential and tourist

Area protected by marina park ordinances

Potential site

Proposed programme & user

With varities of geographic condition, type of activities could be maximized

Dormitory

CanoeingSailing HikingCamping

Solitude space Pavilion for briefing Solitude walk Counselling Room Flexible modular Counselling Room Dinning area

Target user: People who diagnose the depression problem

Second Review

Critics: Chu Tao,Ulrich, Martin Fung

1. Tao quoted the project of La Tourette to ask him to think about the spatial quality in a kind of retreat programme which is similar to the rehabilitation programme. And he suggested to consider more about the sectional relationship with site context.

2. Ulrich referred to the case study I mentioned, children psychiatric center by Fujimoto that I should try to think about the heterogeneity in each functional rooms

Third Reivew

Critics: David Edelman, Eric, Martin Fung

1. Eric questioned for the difference between my rehabilitation school and general university design, and point out the four separated block did not express its own character, the entire design is too homogenous. And for the relationship of viewing and healing, it have not been reflected in the design at all, for example, how to response to the view of ocean besides.

2. David questioned for the system of communal and transition space in between the classroom, and also the System of façade which like the container.

Final Review

Critics: Toshiko Mori, Weijen, David Edelman, Eric, Martin Fung

1. Toshiko commented that I should reference to more rehabilitation precedents, to balance supervision and place for individual, and questioned that what is the difference between my rehabilitation school and normal dormitory.

2. David doubted that the weak relationship between building blocks

Bibliography

The architecture of Hope, Charles Jencks

Place of Advantage, applied psychology for interior architecture

Behaviorology, Atelier Bow-Wow

Mind your behavior, how architecture shapes behavior, 3XN

正是這樣正生會的全人互動治療社區, 陳兆焯

Elcorquis 138, RCR arquitectes

Questions of perception phenomenology of architecture, Juhani Pallasmaa

The Eyes of the Skin: Architecture and the Senses, Great Britain, Academy Group Ltd (1996), Juhani Pallasmaa,

Parallax, Steven Holl

Thinking architecture, Peter Zumthor

Atmosphere, Peter Zumthor

A natural history of the senses, Diane Ackerman

Theorizing a new agenda for architecture, ch.10, Toward a New Horizons in architecture (1991), Tadao Ando