Citation
Psychiatric health and treatment community resource center

Material Information

Title:
Psychiatric health and treatment community resource center
Creator:
Harley, Ned Richard
Publication Date:
Language:
English
Physical Description:
approximately 200 pages : illustrations, charts, map, plans ; 29 cm

Subjects

Subjects / Keywords:
Mental health facilities ( lcsh )
Mental health facilities -- Designs and plans -- Colorado -- Longmont ( lcsh )
Psychiatric hospitals -- Designs and plans -- Colorado -- Longmont ( lcsh )
Mental health facilities ( fast )
Psychiatric hospitals ( fast )
Colorado -- Longmont ( fast )
Genre:
Designs and plans. ( fast )
bibliography ( marcgt )
theses ( marcgt )
non-fiction ( marcgt )
Designs and plans ( fast )

Notes

Bibliography:
Includes bibliographical references.
General Note:
Submitted in partial fulfillment of the requirements for the degree, Master of Architecture, College of Design and Planning.
Statement of Responsibility:
by Ned Richard Harley.

Record Information

Source Institution:
University of Florida
Rights Management:
All applicable rights reserved by the source institution and holding location.
Resource Identifier:
12101805 ( OCLC )
ocm12101805
Classification:
LD1190.A72 1982 .H364 ( lcc )

Full Text
H An LE'i
environmental design auraria library
PSYCHIATRIC HEALTH AND TREATMENT COMMUNITY RESOURCE CENTER
by Ned Richard Harley, M.D.
A dissertation
sumbitted in partial fulfillment of the requirements for the degeee of Masters of Architecture in the Department of Architecture, College of Design and Planning,
University of Colorado at Denver December 13, 1982


INTRODUCTION
This project defines a new concept in psyhiatric care through placing health and treatment centers together on one site. The concept is a psychiatric health and treatment community resource center. Out-patient and partial hospitalization programs and facilities are placed together with canprehensive program and facility approaches to health.
To begin, the users are considered, including the general population and the psychiatric population. Then responses to the health and treatment needs of the conxnunity are considered in terms of actualalities and ideals.
Based on an examination of the actual and ideal responses to human psychiatric needs, Harley Plan 1 is presented as an idea, explanatory diagrams, a program, and a psychological/progromatic/functional analysis of each programmed area.
Harley Plan 1 is then adapted to a hypothetical site adjacent to Longmont United Hospital, as the Plan is considered as being placed near a general hospital with an in-patient psychiatric unit to which it closely relates. The Plan is considered to be an extension into the community of the comprehensive progranming of a modern day health science center hospital.
Finally, a problem statement is presented. This statement proposes a prototype and then specific site adapted design response to Harley Plan 1. The design response will make the Plan come alive into the concrete symbol of an actually developable facility.
When the design solution is complete, the result will be a comprehensive approach to the planning, programming and design of psychiatric health and treatment community resource centers (Harley Plan 1), a new, comprehensive, integrating approach to meeting the psychiatric needs of a ccnmunity.


CONTENTS
PSYCHIATRIC HEALTH AND TREATMENT CENTER BACKGROUND RESEARCH USERS
PSYCHIATIC SUBSTANCE ABUSE ADOLESCENTS HEALTH RESPONSES
BACKGROUND SUMMARY
PSYCHIATRIC FACILITY PRINCIPLES
THE HOSPITAL
PARTIAL HOSPITALIZATION
OUT-PATIENT
COMMUNITY MENTAL HEALTH CENTER HEALTH CENTER ARCHITECTURAL RESPONSES
RELATED DESIGN CONCEPTS OF LEADING ARCHITECTS PSYCHIATRIC ARCHITECTURAL DESIGN PLANNING RESPONSES PROCEDURES CERTIFICATE OF NEED ECONOMIC RESPONSES
FINANCIAL FEASABILITY THIRD PARTY
HARLEY PLAN' I FOR PSYCHLATRIC HEALTH AND TREATMENT COMMUNITY RESORCE CENTER AUTHOR
INITIAL PROPOSAL THE PLAN DIAGRAMS PROGRAM
GOALS AND RESPONSES
INFORMATION FOR ADAPTATION OF PSYCHIATRIC HEALTH AND TREATMENT RESOURCE CENTER TO HYPOTHETICAL SITE IN BOULDER COUNTY ADJACENT TO LONGMONT UNITED HOSPITAL DEMOGRAPHY REAL PROJECT
RELATION TO EXISTING FACILITIES
SITE
CLIMATE
ZONING
CODES
PROBLEM STATEMENT ACKNOWLEDGEMENTS DESIGN SOLUTION
APPENDIX: PARTICIPATORY DESIGN INSTRUMENTS AND RESPONSES


USERS
Users can be divided into health care providers and health care recipients, including patients. This section defines the different groups, reviews general reasearch on prevalence and needs, and then goes into more depth about prevalence and needs with regards to substance abuse and adolescents.
DEFINITIONS
Health Care Providers
Health care providers consists of physicians, nurses, psychologists, social workers, adjunctive therapists, administrative personnel, educators, and other professional people as well as ancillary staff.
By in large, these are relatvely healthy people who would be using the health center facilities to a much greater extent than the treatment facilities.
They would be interested in a coordinated facility for professional practicde, continuing professional education, general health education, as well as maximizing their health potential in the service of personal growth and disease prevention, (primary prevention)
Health Care Recipients
COMMUNITY USERS would be members of the community, not health providers, but with attitudes similar to the health providers, (primary prevention)
OUT-PATIENT USERS would be members of the community with or concerned about the possibility of having mental disorders. A coordinated program of treatment, frequently making use of adjunctive health center programs, would be indicated, (secondary prevention)
PARTIAL HOSPITALIZATION USERS would be patients with mental disorders severe enough that approximately two or three times a week out-patient psychotherapy with a moderate amount of adjuctive program involvement would not be enough to treat the mental disorder. Then a day, day/evening, or evening program of partial hospitalization together with a structured, coordianated therapeutic adjunctive program would be indicated. These partial hospitalization users would be divided into three basic categories: psychiatric, substance abuse, adolescent, (secondary prevention)
IN-PATIENT USERS would be patients from the general hospital setting who were at a stage of treatment where a transition towards partial hospitalization was indicated, either as a clear positive treatment plan development or in the context of evaluating the potential for finding a setting other than long term chroni hospitalization. (secondary and tertiary prevention)


PSYCHIATRIC
PREVALENCE
According to David Shern, Ph.D., Division of Mental Health, State of Colorado, the prevalence of DSMIII diagnoses in communities in general is 15%. This figure is taken from the Presidents commission and Bruce and Barbara Dohrenwend of Columbia College of Physicians and Surgeons. However, the Legislature of the State of Colorado, in infinite wisdom, has regularly used a 7% figure in determining funding for mental health centers through the Division of Mental Health.
Boulder County has a population of 185,000 according to the 1980 census. Therefore, the prevalence of DSM-III diagnoses in Boulder County is around 30,000, according to Shems prediction.
It should be noted that the number of open cases in the Boulder Mental Health Center is 1,000 cases.
It is still necessary to determine, for the purpose of this design need, the prevalence of mental disorders for which partial hospitalization is indicated. This is not a well researched subject. However, there has been a prototype study of needs which is useful to consider.
PROTOTYPE MENTAL HEALTH NEED STUDY
McGirk's study of Community Mental Health, A Survey of Boulder County 1978-1979, is considered as a general study related to mental health needs as well as a study related to the hypothetical site.
Indeed the study was published as a SOCIAL REPORT of the City of Boulder for 1979. In the preface to the article, the editors state: Dr. McGirks study of social functioning in Boulder County follows in the tradition of epidemiological studies o community mental health. So innovative and meticulous were the methods used in this assessment that it is considered one of the most comprehensive and thorough such studies since the textbook study of social functioning in Midtown Manhattan done in 1957.
How wwell we each get along in society results from th coplex interpaly of our own psychological and physical gifts and handicaps. Of course, external forces influence our behavior too, but psychologists have demonstrated that even in unusually stressful circumstances the personal style of the individual emerges to cause some to thrive, others to fail, and many to hang on in-between.
These days many community members find themselves upset about the economy and the value of goods. They worry about environmental pollution, dissolution of traditional family values, the difficult-to-understand and hard-to-manage technocracy, and disaffection from meaningful work. It makes especially good sense at this time to take inventory of individual ability to function well under the weight of these stresses. Psychologists have had a long-time interest in assessing the mental health of entire communities, but the task is far more difficult to accomplish than the epidemiologic study of physical


disease, a model on which the mental health assessments have been based, lb answer questions about the mental health of citizens, community psychologists have focused on individuals' social functioning, their observable relationships with friends and relatives.
Ihe ability to mske wise decisions about a mental health center's limited resources depends on an accurate assessment of the types and extent of mental health problems in the County. The Boulder County Mental Health Center therefore launched a large scale needs assessment survey to gather information about the locations of problem areas and about the characteristics of persons most likely to need mental health services.
In this study the Level of Functioning was assessed in relationship to problems with law/society, alcohol/drugs, physical health, thoughts, emotional health, behavior, getting along, school/job/hcme, and basic needs.
The results converted to a conservative estimate that almost 10% or over 15,000 of the 185,000 Boulder County population were very likely to be in need of mental health services.
The study did not address what proportion of those in need of mental health services were in need of out-patient, substance abuse free standing, partial hospitalization or in-patient services. Ihe study did indicate that a large percentage of those in need of mental health services were not receiving such services. The study also suggested that low socioeconomic status is positively correlated wtih impaired level of functioning.
This highlights the community problems of cost containment and who is going to pay for the services if an effective way of meeting the needs is successfully implemented and marketed. Financial feasability issues must be addressecd for an idea to be realistic.


SUBSTANCE ABUSE SECTION
Alcoholism and drug abuse have been the subject of much debate. Evidence indicates is is a serious problem. Indeed Former Health Secretary Califano has been reported by Associated Press as saying that alcohol and drug addiction could become America's No. 1 health problem. He believed that the cost to business and industry from substance abuse was greater than $100 billion per year. This was based on a 2 year study of substance abuse in New York.
Califano said early intervention is the key to curing alcoholism and drug abuse in the work force the identification of individuals with problems, pressing them to recognizze the problems and making it easy for them to find help. Califano believes that therapeutic programs can work. He found considerable denial on the part of management. Asked for an explanation, Califano said, "The stigma associated with alcoholism discourages some companies from setting up an early intervention progra. They just don't want to admit to the public that they have 'drunks working there."
Pollster George Gallup has reported findings (UPI) indicating a growing awareness of alcoholism and an increase in the number of those afflicted with the disease. His report states: Drinking problems have caused trouble in the families of one of every three Americans, and 81 percent of them say they think alcoholism is a major national problem. The majority of people believe that alcoholism is a disease (as it has been classified by the American Medical Association since 1955), insurance should provide coverage for treatment, and that the appropriate treatment was either a hospital treatment program or a self help group or "annonymous" meetings.


I
ADOLESCENT USERS
Adolescents are given important consideration in this study because it is such a developmental stage and the developmental progress and arrest aspects of psychiatry for both adolescents and adults can be seen in a proper study of adolescence.
SOURCE
ADOLESCENT HEALTH IN COLORADO: STATUS, IMPLICATIONS, DIRECTIONS is a publication of the Adolescent Health Task Force of the Colorado Department of Health.
This report highlights the fact that while most Colorado adolescents are perceived as being generally health, many have identifiable problems and many more are potentially high risk for problems.
PROBLEMS
The problems include unemployment, school dropout, crime, mortality, handicaps, alcohol and drug abuse, pregnancy, sexually transmitted diseases, lack of health education, and concerns of the youths themselves as the most catmon problems of adolescents are emotional rather than medical.
The report lists the health tasks of adolescence as: understanding growth and development, being fit, eating well, living with feelings, living in families, having friends, understanding sexuality, protecting oneself and others, coping with stress, coping with illness or injury, locating health resources, processing new health data, promoting family health, acting to create a health environment, choosing a healthy workplace, planning a healthy future.
TASKS
Each adolescent is occupied with several developmental taske as they engage in these health tasks. Although the developmental tasks are theoretical, health care providers often look at an adolescent's functioning in four areas in order to evaluate progress with these tasks:
1. Movement toward becoming independent from parents and family.
2. Plans for the future, either school or acquiring skills for future economic independence.
3. Development of a sexual identity and formation of responsible relationships with others.
4. Establishment of a realistic, stable, and positive self-identity and a sense of social responsibility.
The last task may be the most important in that without it success with the other three is improbable. It is basic to all aspects of adolescent health and functioning. Emphasis must be placed on the importance of the development of a positive self concept and self esteem to evey other phase of health.


EVOLUTION
Adolescents evolve through three broad stages: early, middle and late.
In early adolescence, the teenager must break away from parental domination and establish his or her own identity. This state is marked by increased indeptendence from the family and establishment of ties with a peer group. It is also an intensely ambivalint period. Abrupt expressions of independence alternate with continued dependence upon parents and others.
Young adolescents must also deal with their changing body image. With puberty come rapid changes in height, body mass, distribution of fat, muscles and growth of pubic and auxiliary hair. Adolescents must become readjusted to theri changing bodies both as individuals and in relationship to their peers.
Middle adolescence is a time of continued absorption with physical image and of comparison with cultural ideas. Middle teens contine establishing intense relationships with peer bgroups. This breaking away from parental influence is a further sign of individual identity formation. However, they also begin forming new and qualitatively different relationships with individuals of both the same sex and the opposite sex. They experiment with different styles an philophies. These changing relationships, social exploration, and general inquisitiveness often lead to sexual experimentation.
Late adolescence is a time of values clarification, moving toward economic and occupational independence, and formation of more intimate and intense sexual relationships with other individuals. The development of a workable value system often leads to the idealism characteristic of young people. There is a greater ability to verbalize abstractly and conceptually. Economic independence in our culture, however, is often delayed until the twenties because of educational demands.
Finally, passage through these stages and development tasks is filtered through the unique context of each individual adolescent. The socioeconomic group into which a person is born, whether they are male or female, the quality of their family relationships, their ethnic and cultural heritage, their rligious beliefs and commitment and the general role our society ascribes to adolescents are just some of the forces that can impede or enhance adolescent development and our ability to serve them.
PROBLEMS
Most young people experience this period without crippling stress or physical trauma. Yet, many problems of adolescence, be they medical, emotional or psychological, do arise because of the stresses related to the developmental stages and tasks of adolescence.
There is a "normal" degree of risk-taking and experimenting that occurs during adolescence, and some young people, for various reasons, become more frequent and more problematic risk-takers than others.
Motor vehicle accidents are the leading cause of daths among Colorado adolescents. Adolescents drivers are involved in a disporportionate number of fatal crashes. The percentages of these fatal crashes which are alcohol


related is very disturbing. Young people, particularly males, are also
frequently arrested for driving under the influence of alcohol.
Accidents not involving motor vehicles are the second leading cause of deaths among Colorado adolescents.
Suicide is the third leading cause of death among adolescents in Colorado. Almost thirty teenages each year take their own lives and many more make the attempt. Furthermore, many young deaths classified as accidents could actually be suicides. Reasons for youthful suicide come from a variety of sources, including the inherent stresses of adolescence. Other reasons stem from family problesm and pressures, recent loss of a family member from death or diviorce, loss of some other significant relationship, financial pressures, intense academic competition, recent relaocation, and drug and alcohol abuse. Parents of suicidal children have strong needs to strive for success. Their children are often seen as extensions of their own fantasied succcess. The children fell that only by being perfect can they win their parents' approval. In manyinstance, even minor deviations from perfections, such as getting a "C" rather than an "A" in class, are seen as terrible failures.
Many suicidal youth have difficulty duscussing problesm and frustrations with parents. They feel that these problems are unacceptable to the parents. In many instances, there is some breakdown in the family structure due to death, divorce, or parental rejection of the child.
It is important to note most teenage suicides are the result of the impulsive nature of adolescents. If suicidal youth are detected and counseled, most are happy to be living. Health professionals, teachers, counselors, schol nurses, parents, and others who work with students can be taught to look for and detect the signs of a potentially suicidal youth. These young people can very often be counseled by appropriate professionals to help them through their crises an to develop better coping skills.
Chronic health and handicapping conditions have the potential for severe disruption inthe development of a child and in the functioning of his or her family. They pose an especially difficult problem for adolescents. Adolescents' intense preoccupations with their physical image and changing bodies, their experimentation with social roles and their striving for independence all magnify the problems involved with any handicapping condition.
Other psychosocially-related health problems of adolescents are related to the four developmental areas mentioned previously.
An adolescent shoud be becoming independent of his family appropriate to his or stage- early, middle, or late and to his cultural and ethnic background. Some conflict or turmoil should be expected as childhood dependence upon parents is lessended. Children with chronic and handicapping conditions frequently have extral diffilculty with this task. Other children with unstable or unsupportive home environments may also have special difficulties. Teenagers who run away from home are very likely to be suffering conclicts about gaining independence from theri families, as well as experiencing possible abuse from their parents.
Teenagers should be formulating realistic plans for future scholing or a


career. Career counseling was revealed as a primary concern of Denver
teenagers.
The unfolding of a sexual identity is not the exclusive province of adolescence, even though adult sexual capabilities begin then. Sexuality reflects our human character, manifesting itself in every dimension of being a person. The development of gender identity, the sense of maleness or femaleness, is an inevitable process related at the most ffundamental levle to out overall sense of self-identity, personal security, and emotional well being. The further development of gender role throughout life, the process of learning about intimacy, establishing loving, caring relationships with people of all ages, and tolerating the wide range of possible expressions of sexuality either add to the firm foundation of security from which we relate to the world or heighten the uncertainty an suspicion with which we function.
Adolescence is the phase of life when many people begin to function as sexual adults. Adolescents from sexua behavior patters and make sexual decisions which affect their entire futures. Adolescence is also a time of rejecting traditional values, testing behavioral roles, and sexual experimentation even if this rejection and experimentation are only temporary, as is the case with many adolescents. Teenagers' impulsiveness and lack of
future orientation make seme of their sexual behavior risky.
These behaviors are risky in terms of possible pregnancy, inability to comprehend family planning and sexually transmitted disease.
POSITIVE SELF IDENTITY
As stated, developing a positive self-identity is crucial for every other developmental tak of adolescence. Without a positive self-conceept, good health, emotional stability, and future productivity are threatened.
"Mental health" during adolescence should be defined broadly. It should include psychological and emotional well-being. Mental health should encompass positive functioning and growth rather than focusing on negative aberrations from seme "normal" standard.
The definition of what is "mental health" varies with each program, agency, and individual. Consistent with a view that adolescent health must be viewed in wholistic terms, virtually every other health topic involves mental and emotional health. Since adolescence involves tremendous psychosocial and cognitive changes, the importance of emotional health should not be surprising.
The Colorado Division of Mental Health has estimated that 10 percent of all adolescents (314,948) aged 12 to 17 are severely to moderately psychologically impaired (Division of Mental Health State Plan, 1978). This estimation is based upon the recommendations from the Presidents Commission on Mental Health (1978). It could be expected then that an even greater proportion are experiencing less severe problems which are still significant, and may have long-term consequences.
Of all psychologically troubled youths, only a small percentage have a severe disorder such as schizophrenia, severe personality disorders, or organic brain dysfunction. These youths are the most likely to be seen and treated by the formal mental health system.
These and other adolescents may also be deprived and alienated by


pathological environments or alck of nurturing in their childhoods. Some of them move throug adolescence with little psychological growth or interpersonal involvement. Others may be extremely vulnerable to the stresses of adolescence and may need assistance in personal growth and in developing selfesteem to prevent their problems from carrying over into adulthood. This last group may not have found its way into the formal mental health system or the many other agencies and organizations which assist youth.
Even normal adolescents may have difficulty with the stresses of adolescent growth and development. Many teenagers have extremely trying periods during which they exhibit symptoms of mental or psychological stress. They need self guidance and couseling from some source, be it family, school, health care system, or other.
Some youth can be considered at high risk for mental or emotional problems. Medically ill adolescdents experience a high incidence of emotional and developmental problems. Physically handicapping conditions and chronic illnesses can result in significant problems in developmental growth. Even surgery, injuries, and less critical medical problems can trigger internal emotional stress.
Pregnancy among adolescent girls often reflects psychological problems and regressive behavior. The pregnancy and birth can perpetuate these problems into adulthood and affect the child. Teenagers who abuse drugs, are delinquent, or exhibit behavioral problems have underlying mental or emotional problems. The high rate of suicide among teenage boys reflects these problems.
Even many of those teenagers experiencing severe psychiatric disruption may fail to get treatment. Studies have shown substantially higher overall prevalence rates of mental illness among all ages than the rates known to be enrolled in mental health treatment. Recent national estimates by the National Institute of Mental Health indicate that of the 15 percent of the total American population experiencing a mental health disorder, only 21 percent annually receive mental health treatment (Grosser, 1981).
In Colorado, only 2 percent of the population receives services from the State-funded system, and an estimated additional 2 percent receives seervice from the private sector. This falls short of the 15 percent who have diagnosable disorders and the additional 15 to 20 percent who have stress-related mental health problems (Grosser, 1981).
Part of the reason these adolescents do not get treatment may be due to their relauctance to seek help and their self-conscious fear of being labeled different or crazy. They may also see seeking help as an admission of failure to achieve independence. Many of these disturbed youth end up in the juvenile courts, medical clinics, and emergency rooms. Health care workers must be especially alert for adolescents who seek medical care but whose primary problem is psychosocial in nature.
The information available indicates that if national estimates hold true for Colorado, about 10 percent, or 49,352 of our 493,516 adolescents aged 10 to 19 years have moderate to severe mental health problems. Many more have less severe psychological and emotiona troubles. Of all of these troubled youty, only 2 to 3 percent of those with the greatest problems are being admitted into the State-supported community mental health centers. An additional unknown number are using private mental health resources; other organizations such as schools, community groups, and churches; informal support systems such as family or friends; or receive no assistance. Indeed many of these problems of adolescents are more appropriately seen in settins other than the Colorado Mental Health Centers.
Many teenagers with psychological, emotional, or mental health problems


are not receiving effective help from the formal or information systems currently available to them. These collective mental health issues are among the greatest unmet needs among adolescents. Alternative and appropriate means of approaching these needs should be explored.
THE IMPORTANCE OF NUTRITION DURING ADOLESCENCE
Adolescents generally have the most unsatisfactyor nutritional status of all age groups. The teenage period represents a time of extremely rapid growht and development, accompanied by an increased need for energy and nutrients. If an adequate dietis not consumed during the adolescent years, the body will not have the required building materials with which to reach its full potential for growh and development. Growth deficiencies caused by an inadequate diet may prevent an adolescent from participating and succeeding in school, athletic and social activities to the fullest extent.
Adolescents are undergoing not only physical maturation, but ate undergoing tremendous social and psychological changes as well. This age group is extremely sensitive to peer acceptance. This desire to "fit in" or be accepted influences dietary habits. Adolescents may readily adopt altered eating patterns, such as weight-reducing diet or a "muscle-building" diet, if these diets, or their desired outcome, are favored by peers.
Adolescence brings increasing independence and freedom for teenagers to make their own decisions about what they will eat. Unfortunately, teenagers tend to be motivated in their food choices not by nutritional or health concerns but by factors o availability, sociability and status. Put simply, teenages eat what's available, what tastes good and what their friends like to eat. In addition, lack of nutrition information, failure to understand the effect of present dietary habits on future health status and busyy school and social schedules may leave teenagers with inadequate time and motivation to prepare or eat the most nutritious foods.
Mass media and advertising also exert a tremendous influence on the teenage diet. Advertising creates the image that certain foods are "fun," "glamorous" or "sexy," and unfortunately, these foods are generally not highly nutritious. Advertising and mass media also help to create certain standards for appearance (body shape, hairdo, skin condition, etc.) to which adolescents constantly compare themselves, usually with dissatisfaction. In attempting to conform to these standards of appearance, the adolescent may make inappropriate food choices and compromise optimal growth.
A further motivating factor for food choices is the teenage tendency to be preoccupied with their bodies. Teenagers are growing and changing rapidly and it is not uncommon for them to have a distorted and unrealistic image of their bodies. One study of teenagers showed that 70% of girls desired to lose weight while only 15% were actually obese. Conversely, 75% of boys wanted to gain weight while only 25% were underweight. (Adolescent nutrition, 1981)


BARRIERS TO MEETING ADOLESCENTS HEALTH NEEDS
There are several kinds of barriers in meeting adolescents' health needs. These include barriers related to service, education, the nature of adolescence, and our perception of adolescent needs.
Frequently, services are effectively inaccesible to adolescents for reasons such as: parental consent requirements, hours of operation that are not geared to school-attending youth, fragmentation of services (if adolescents have to make too many visits to different agencies, they may drop out of the health care system in frustration), and failure to guarantee confidentiality. Often, this is due to inadequate training.
Then too, education that can help adolescents learn more health habits is often lacking. Although the Colorado Department of Education found that more shool districts in 1980 thatn in 1975 were satisfied with teirh health education program, nearly half did not feel they provided a well-rounded and clearly focused health education program. Equally important, and alarming is that even as we identify further needs for education, these educational efforts are suffering reductions if funds that significantly weaken or even eleiminate good programs.
Some areas of health education are also controversial. Health education is sometimes slowly implemented because it must attempt to reflect different values on a variety of ccmnunity issues.
Adolescents in general are admonished to be responsible for their behaviors, including behaviors that affect their health, yet often do not have opportunities to actually be responsible in the process of learning about themselves. Youth become responsible, not from being told to be responsible, but, in part from activities that increase self-identity, self-esttem and belief that they are competent. Adolescents are often asked to be like adults, even while they are being treated like children.
Many adolescents, because they are basically healthy, do not think of using health services until they are in a crisis.
Many adolescents have difficulty connecting long-term health outcomes with their present behavior; thus, prevention and health promotion efforts must take this cognitive reality into account.
.Adolescents are not good advocates for themselves. Adolescents are not usually well-organized and carry little weight as a constituency. Indeed, their attempts to become visible and responsible advocates for themselves may be viewed by adults as disrepectful and irresponsible behavior.
Even trained professionals frequently lump young adolescents together with older adolescents, whose needs and resources are dramatically different.
Adolescents' needs are often very different from the needs aduluts presume than to have.
The primary "problem adolescents have is with emotional and psychological issues. General nervousness, anxieties about their changing bodies, worries about being accepted by friends, and for a minority of adolescents and preasolescents, emotional negleca and abuse, are examples. Because these problems are hard to detect and not as immediately serious as some other problems, such adolescents often fall through the cracks of the healh system.


D. Friedman, M.Arch.
HISTORICAL OVERVIEW OF TREATMENT OF MENTALLY ILL OVER TOE LAST CENTURY
The treatment of the mentally ill in the United States and Europe has gone through three phases and is now moving into a fourth phase.
Prior to the 1880's, the mentally ill were considered to be evil beings or weak people, inhabited by evil spirits. These people were hidden in their family hemes or in miserable prison-like mental institutions.
Between 1840 and 1880 faith in science and strong moral convictions combined to evolve the second era of treatment. Scientific and humanistic principles were discovered, codified, and practiced extensively. One pioneer of this era, Dr. Thomas Kirkbride, was highly involved in the design of an ideal prototype for the mental hospital facility. The 'Kirkbride Plan' called for large, institutional buildings; yet each building had socially functional subdivisions of patient numbers.
The third era of psychiatric treatment was the result of scientific and tecnological discoveries in the field of psychotropic medicine. This wwas the custodial era of the 1950's. Patients were drugged, given electroshock extensively, and occasionally persuaded to have briain surgery. Hospital staffs did not develop therapeutic activity programs for patients so much as develop a rationally efficient system.
In the 1960's and 1970's, with sympathetic public opinion and federal economic support, the emphasis was placed upon community mental health and treatment centers. This was the era of total deinstitutionalization. It was believed that no one could get better while living in an institution. Communities were given opportunities to help the patients cure their social problems. Patients living in communities would be safe, assuming that they went to therapy sessions and took their medications regularly; unfortunately they didn't always do these things due to a lack of supervision.
What we are now entering is perhaps best described as an era of responsible options treatments. This approach will require a coordinated functioning of institutional, semi-institutional, and de-institutionalized facilities. The type and intensity of the individual patient's illness will be emphasized as the primary determinant of what kind of facility he or she is sent to.


THE PRINCIPLES
STANDARDS FOR PSYCHLATRIC FACILITIES BY THE AMERICAN PSYCHIATRIC ASSOCIATION
The fundamntal principles expressed here are based upon a legacy of professional medical experience enjoyed by American psychiatry. Out of that experience, the American Psychiatric Association constantly seeks new knowledge and new and better ways to prevent mental disorders and to relieve the suffering of those who are afflicted with mental disorders. The APA stands inflexibly for effective treatment of the highest quality, reflecting excellence in staff performance, but recognizing the need for great flexibility in the manner in which resources and personnel are organized to deliver appropriate individual treatments.
Principle A: The primary functions of any psychiatric facility are to diagnose, to treat, and to restore mentally disordered persons to an optimal level of functioning and return to the community.
Principle B: The psychiatric facility acknowledges the dignity and protects the rights of patients.
Principle C: The psychiatric facility has an ethical, competent staff.
Principle D: The psychiatric facility integrates its services with other community resources and is responsive to community needs.
Principle E: The psychiatric facility cooperates with standard-setting and reimbursement requirements of various third-party payours in order to provide for its patients the economic protection of health insurance.
Principle F: The psychiatric facility keeps accurate, current, and complete clinical and administrative records.
Principle G: The psychiatric facility has written policies, procedures, and plans.
Principle H: The physical plant of the psychiatric facility provides a safe, wholesome environment that enhances the program.
Principle I: The pstchiatric facility is available, accessible and appropriate for the care of all potential patients.
Principle J: The psychiatric facility promotes a climate that makes possible the establishment of significant relationships between staff, patients, and their families.


THE IDEA OF A HOSPITAL
This section is based on the monograph, HOSPITAL, a health services research publication, an architecture project from Rensselaer Polytechnic Institute.
The emergence of new patterns of, new demands for, and new patterns of providing health services have placed the hospital-based health center in the role of the central facility for the provision of health services to the total community. In this role, the hospital continues to grow in size, in organization, and in the scope of services it offers.
These complex institutions organize people, programs, equipment and facilities for the diagnosis, treatment and prevention of illness together with research and education into the continuum of health and disease.
A hospital can constitute a nucleus for the provision of health services. It should provide the highest possible level of service, staffing, facilities and equipment. The intention must be excellence.
The position of a hospital to the way we live has not been clear. Most people do not know when to go to a hospital or a clinic or a doctors office. They usually go onlty when their illness is mature, and they are obviously sick. Disease is seldom detected at an early stage of development, at a time when it can be most effectively treated. Preventive medicine programs, integral with the total health system, are virtually non-existent. Consequently, the health system, especially at the hospital connection, is not integrated into our lives.
Our state of healthphysical, mental, and socialdirectly affects the quality of our lives and our work. Therefore, health awareness should be reinstated into the pattern of our lives. Health and health facilities have too long been separated frcm everyone and everything.
To solve these health integration problems, not met by traditionally conceived hospital programs and facilities, we must work from an understanding of needs. The goal is to integrate healt care resorces within the community along an understandable and cost-efficient continnum.
We must consider both the general, the total health system, and the particulars of individual man in his community. Each is reflected by and implicit in the other, and in all that happens in between.
What should be the relationship of tghe hospital and the city. Should we have a.set of large scale, single function institutions, each of which exists as an entity disengaged from its environment? Or should we have a lively and diverse urban continuum, a framework within and arond which many varied facilities of the neighborhood can find a place.?
Earlier practices were based on th notion that major civic institutions should be sorted into distinct functional categories and set apart from the general urban web. Congruent social theory emphasized the desirability of "zoning" the various aspects of community life and of rigidly formalizing therir distinguishing characteristics and interrelationships.


Work, play, and home life took on separate signifigances, an separate physical realms were created for their performance. This tendency applied escpecially to the realms which sequestered those activities and elements of society considered to be disruptive or unpleasant. Thus the institutions of the poor, the insane, the deviant, and the impoverished sick were dealed off from the community at large. The custodial function of these institutions prevailed over integrative arguments. The resulting programs and facilities were encasing rather than participatory, integrating and normalizing. The need to extract disease from the social organism was seen to be of far greater urgency than the need to restore this organism to a healthy state within the cortmunity.
Today, we may think we have moved a considerable way from these attitudes, but the forms persist. Segregation of the sick has given way to a new form of isolation. Se now build citadels within which the medical world operates in defensive retreat from the increasing social/psychological pathologies of the world outside. The doctor, who now sees his patients (decontaminated and depersonallized) within the walls, is increasingly out of touch with the social and environmental causes of disease.
The "citadel" is a "house of last resort," whode powers are invoked only in situations of extreme crisis. The modern hospital, as the stronghold/citadel of scientific and technical medicine, has become highly sophisticated in treating acute diseasethe crisis situation for which it is so well equipped. Its success in this specialized area has tended to crowd out its other potential functions in the total field of community health and to bring about a condtion of increasing detachment from the larger concdems of society.
The more the hospital can rid itself of the citadel image and form, the more effectively it will be able to extend its services in the community and coordinate its programs of preventive medicine with other caring institutions. The public is rapidly coming to expect and demand comprehensive care and more continuity of care. It seems logical that the hospital be a base for all community health programs. The goal should be to provide maximum accessability for all those who seek help in resolving any type of health problemincipient as well as established, social and psychic as well as biological.
Just as there is a need for the hospital to extend itself into the community, there is a need for the community to extend itself into the hospital. If there is a problem of motivating people to use health facitlities it is partly because these services are not environmentally integrated with everyday community activity. It mau be for the same reason that the recruitment and/or maintenance o staff is often so difficult.
The hospital is kind of a community in microcosm. It could set an expample by showing how the effective merging of community life and institutional life in a unified, well-planned environment could have a potent curative or therapeutic function. The more intimate union of institution and community might also stimulate many to join the ranks of volunteers for which the hospitls will have a great need in the cost-contained future.
In many ways, those in the hospital community are in an excellent position to gauge the nature, extent and intensity of general social


"dis-ease." Their first-habd contact with the products of a malfunctioning urban environmentthe grim harvest of chronically ill and emotionally exhausted peoplepermit them to offer informed judgments as t appropriate preventive measures. The hospital should be playing a key role in finding ways of improving the social and physical environment of cities. It can also provide a model or guidepost of healthy functioning.
Health is a field urgently in need of functional departures, participatory designs, economical facilities, integrated community and institutional planning. This must all be done witin the context of cost containment. The planninig of future health communitirs is a now necessity that must be central to the life of modem man.
Our conception of a hospital should reflect a changing organism in the constext of advancing history. One does not relect a changing organism with a traditional building. Traditional forms are unable to accomodate or participate with change.
Only change itself is predictable. What form it will take is not predictable. An organism based design can respond to change without destroying the order which gives it life. What should this design be and what will be the resulting organism?
After all who is healthy and who is sick? Health professionals themselves become sick and occasionally disabled.
We have learned that health providers, programs and facilities are certainly not "machines for healing." They are components of a community. Where it ends and where other communities begin cannot be distinguished. The hospital is a community of people containing processes of disease, getting well, and being wellall in a continuum, including everyone. For who is always "well?"
The hospital must be part of the community, linked by communication and access. The linkage must be not only in terms of roads an phones, but also in terms of human involvement through health directed physical, emotional and educational socialization. A hospital cannot only be concerned with curing disease. It must also concern itself with preventing disease. Prevention requires education on many levelsphysical, cognitive, emotional, and social.
A hospital is also concerned with promoting health. This requires education as well as treatmenton many levels. The hospital can be consdiered as a school not only for the patients, but also for the public, and certainly for those who treat and cure. Rapid change makes education for all participants especially necessary.
The community shold be an inspired interrelationship of activities of patient and staff, and also of others whose work, play, or living brings them close-by. For the patient, participation in this active community can be at times minimal. Yet the activities of others can make the patient's environment a changing and interesting one. As rehabilitation progresses, the patient's participation will increase, progressing through integration, discharge and reunionthe "well state."
For the others, commercial, educational, or recreational facilities of the hospital can provide the opportunity for certain kinds of community


activity. Both sick and well share control social needs.
The physical organization of the hospital is not static. Its nature is such that it generates constant change and improvement. Increasing flexibility of organization is indicated by looking at the recent rapid changes of history. Therefore, our conception of the hospital should be that of a changing organism. Due to change, traditional conceptions of the hospital may be literally obsolete before they can be built. Traditional forms are unable to accomodate change and unable to accomodate the new social role of the hospital.
Only change itself is predictable. What form it takes is not predictable. Only an organism can respond to this change without destroying the order which gives it life. A participatory, flexible, integrated, human, and usable design must reflect symmetry and order; also, it must be assymetrical and organic, and responsive.
In particular, the realization that the hospital can no longer be isolated from the environment which it serves, leads to the choice of a site which allows a maximum of integration with this environment with all aspects of the environment. Intertwined human activities and physical adjacencies influence the organization of the health and treatment center.
Partial hospitalization provides a means of integrating and differentiating some of the existing activity on the total hospital campus.
A problem approaching the complexity of a hospital can be solved only through a systematic process of first establishing a structuring framework, and then developing and modifying within it. This is the human way to a human solution, representing the most efficacious, time honored means of operation of the human mind in the service of meeting human needs.


PARTIAL HOSPITALIZATION
Reviews of partial hospitalization have appeared in the literature. Reviews by Moscowitz and Morrice (Great Britain) are summarized below. Over the past couple weeks this author has been made aware of other articles in the most recent edition of Hospital and Community Psychiatry as well as the publication this year of a HANDBOOK OF PARTIAL H0SPIALI2ATI0N. While time did not permit a written review of these pieces at this time, it appears that the plan and program response in HARLY PLAN I is consistent with the material published. Additionally while there is this new publication interest in partial hospitalization, design implications of this form of therapeutic endeavor have been minimally addressed in terms of a comprehensive plan, program, design and administrative philosophy.
Ira S. Moscowitz reports in an article entitled THE EFFECTIVENESS OF DAY HOSPITAL TREATMENT: A REVIEW which appeared in a 1980 Journal of Community Psychiatry:
The "day hospital" is a form of program organization which has been increasingly employed in the treatment of persons manifesting psychiatric disorders and/or problems in living. While it was originally developed to avoid seme of the limitations or deficiencies of psychiatric hospitalization, it has been argued in the literature that day hospital treatment offers many unique advantages in mental health treatment.
..., it has been estimated that 75% of all the patients currently treated by means of 24-hour psychiatric hospitalization could be treated effectively in a day hospital.
... These conclusions concerning the effectiveness of day hospital treatment appear clinically meaningful and significant.
J. K. W. Morrice M.D., F.R.C.Psych, from The Ross Clinic wrote a paper, A Day Hospital's Function in a Mental Health Service, which appeared in the British Journal of Psychiatry in 1973. In this articl he spoke about his experience with a day hospital in relationship to the claim that 50 75 % of patients in pschiatric hospitals could be cared for equally well in day units.
His experience was based on the Ross Clinic day hospital which was begun in 1968. The focus was on day treatment in the context of a therapeutic community with focus on group therapy, family work, vocational work, and teaching. There was attention to the problems of developing appropriate criteria for admission.
There was clear focus on the place of the day hospital in the eveolution of a comprehensive mental health service. Morrice saw the problem as: how to achieve a flexible and discriminating use of both institutional and community facilities with the patients' best interests in mind. He felt that mixed inpatient and day-patient care psosseses many advantages over more traditional methods. There is much to be said, according to Morrice, for the view that new psychiatic units should be primarily day centres with beds, rather than


in-patient units with day-patient facilities.
Individuals attending a day hospital, by the very fact of being day-patients, maintain active links with home and community that aid treatment and rehabilitation.
A year later Morrice's Life Crisis, Social Diagnosis, and Social Therapy was published in the same Journal. In the model described a social diagnosis led to a social prescription. The social prescription was fulfilled in a treatment regime placing reliance on group methods, a multidisciplinary team approach, and full participation of patients in matters of consequence to them. Nurses were heavily involved as therapists, taking part in group psychotherapy, work therapy, marital therapy, and encounter groups. Relatives were almost always involved, and formal marital or family therapy given not infrequently. The treatment program had limited but fairly well-defined goals which followed logically from identification of the patient's social crisis and disturbed social relationships. It was not suggested that the regime works well for everyone. Some people could not see the point, and some relatives refused to cooperate. But Morrice believed the attempt to deal with psychosocial disturbance by psychosocial therapy was relevant and beneficial for a wide range of patients. He concluded that his studies supported the suitability of a psychosocial approach in the context of a day hospital for a signifigant number of patients.
Morrices social diagnoses included:
1. interpersonal difficulty
2. antisocial behavior
3. financial problems
4. work problems
5. physical illness
6. accident
7. bereavement 3, pregnancy


SUMMARY OF RESPONSES FROM PARTICIPATORY DESIGN INSTRUMENTS
Responses from professionals in the field of partial hospitalization include:
A. Jack Bartleson, ACSW, MPA, Deputy Director Division of Mental Health Department of Institutions Colorado
1. The notion of cO-location of a number of treatment activities adjacent to the hospital in order to promote comprehensive care and efficient utilization of space and technical resources is sound.
2. The intent to integrate with the surrounding community is also an important feature. This should provide many reciprocal possibilities with other human resource programs.
3. Cne caution is to avoid the pitfall of an overly complex array of program and facilities which might lead to policies and procedures intended for organizational control and efficiency which could detract from any intent of an environment which would foster normalization and independence.
B. Ruth Fuller, M.D.
Assistant Professor, Psychiatry Director, Transitional Care
University of Colorado Health Sciences Center
The program elements that I would like to see in an ideal program whoul include the following:
1. Staff and consultant that include the major areas of medicine, i.e. neurology, psychiatry, internal medicine, obstetrics and gynecology, learning disabilities, psychology.
2. Staff that inludes nurses, occupational therapists, social workers, psychiatist, teachers (special education) AND flexible line item salaries to allow for dance, art etc. therapists. Also need technicians with flexible time.
3. A physical plant that includes adequate school space and time for not just the adolescents but potentially the adults also.
4. An area for minor child care that is used for observation.
5. Receptionist prominently located with natural, limited access for purposes of accountability.
6. Recreational facilities including a gym and a pool with staff.
7. Ihe class room recreational area work readiness areas should dovetail for efficiency.


C. Ira S. Moscowitz, PhD Psychologist Author:
The Effectiveness of Day Hospital Treatment: A Review James A Haley Veterans' Hospital Tampa, FI.
In my experience in Day Hospitals space requirements include:
1. a roan capable of seating all patients and staff for ccrrmunity meetings;
2. group therapy rooms to accomodate 1 or two staff and 8 or 12 patients (which can be used bo other treatment services when not used by the Day Hospital);
3. staff offices (one per professional and one for receptionist/secretary);
4. a recreational space (pool table, stereo, board games;
5. an occupational therapy clinic;
6. a kitchen where patients prepare lunch.
VA staff guidelines for Day Hospital usually recommend 1 staff per 4 or 5 patients.


OUT-PATIENT RESPONSE
The author brings almost a decade and a half of psychiatric out-patient education and experience to this project, including work in clinics, student health services, and private practice.
The author has extensive experience with individual, family and group therapy.
Out-patient psychotherapy is available throughout most communities. In terms of numbers of people being treated, out-patient psychotherapies represent the major modality of treatment.
Out-patient psychotherapy integrated with a partial hospitlization and hospitalization program is seen especially as providing a visible, available appropriate continuum of services for those patients working their way out of the hospital. Additionally, it offers therapists on the hospital and partial hospitalization staff a chance to maintain and develop their skills in outpatient psychotherapy. Furthermore, out-patient staff could back up the partial hospital and hospital staff.
A definitive comprehensive, medically based psychiatric program in a hospital setting, including out-patient and partial hospitalization, aids the entire medical community through providing professional input as to psychiatric standards and approaches for a wide range of mental and developmental problems.


COMMUNITY MENTAL HEALTH CENTER
There has been over a decade of community mental health center response to the psychiatric problems of our culture. Community mental health centers provide comprehensive, multi-disciplinary modes of treatment to a community. In general, their major mandate has been considered to be to the people too poor to afford private therapy.
A signifigant problem faced by community mental health centers has been the need to contract with private facilities for programs such as hospitalization. At times, because of the cost factor, community mental health centers have had to hospitalize their patients at a great distance from the community. While this frequently takes care of the immediate situation adequately, the reintegration potential of the distant facility is greatly reduced.
A partial hospitalization program would aid the reintegration of a patient back into the community whether the period of complete hospitalization occured within or outside of the ccrrmunity.


HEALTH CENTERS
Today the health center has become a major potion of our economy, even making the front page of Time. People attend health centers for comprehensive health reasons: physical, emotional and social. While jogging and biking are certainly also in they may have occasional climatic drawbacks, can be dangerous and certainly are more so at night.
Health centers are more climatically adapatable, do not have the joint pounding and tendon aching of jogging, and keep one safe from moving vehicular traffic. Additionally, they are social centers for people interested in health, individually and on a ccnmunity basis.
Adding a signifgant amount of health facilities to a hospital setting is not a new idea either, although it frequently does not occur because of cost and traditional thinking. The Grossmont Hospital in California recently began with tradional thinking and then even changed site in order to accomodate health facilities on the hospital campus.
The idea of making the health facilities on a partial hospitalization and out-patient site (and using a broad ranging definition of health services to include educational, emotional and health-based commercial) available to the members of the community who are interested in health is, as far as I can tell, a unique idea.


ARCHITECTURAL IDEAS RELATED TO HEALTH AND TREATMENT CENTER DESIGN
The works and writings of L. Kahn and Van Eyck are considered particularly appropriate for conceptualizing psychologically based architectural responses to psychiatric problems. I have expressed some of their ideas here as architectural design concept guideposts for my plan, program and design developments.
KAHN
To create a lasting public work, the ... architect must believe in and act for a social reality that transcends his own history: hence Louis Kahns continual acts of faith whch begin to create that reality.
It is only for such architects as Louis Kahn, for whom belief is the sine qua non of action, that men's ideals and their effect on the public domain really matter.
belief = Form = inspiration = institution
I really felt very religiously attached to this idea of belief because I realizeed that many thins are done only with the reality of the means employed, with no belief behind it. The whole reality isn't there without the reality of belief. When men do large re-development projects, there's no belief behind them. The means are available, even the design devices that make them look beautiful, but there's nothing that you feel is somehow a light which shines on the emergence of a new institution of man, which makes him feel a refreshed will to live. This comes from meaning being answerable to belief. Such a feeling must be in the back of it, not just to make something which is pleasant instead of something which is dull: that is no great achievement Everything the architect does is first of all answerable to an institution of man before it becomes a building. You don't know what the building is, unless you have a belief behind the building, a belief in its identity and in the way of life of man.
The institutions are the houses of the inspirations. Schools, libraries, laboratories, gymnasia. The architect considers the inspiration before he can acdept the dictates of a space desired. He asks himself what is the nature of one that distinguishes itself form another. When he senses the difference, he is in touch with its form. Form inspires design.
Reflect then on the meaning of school, institution. The institution is the authority from whom we get their requirements of areas. A school, or a specific design is what the institution expects of us. But School, the spirit school, the essence of the the existence will, is what the architect should convey in his design ... what School wants to be.
Thus we have the complementary aspect of all Kahn's work: both Form and Design, belief and a belief, inspiration and circumstance, existence, will and facts of a programme.


VAN EYCK
There were some architects who nevertheless tried very tenaciously to keep a resolution between the exterior and interior, task and symbol, and thus provide the multi-meaning in form which was the primary relaity of 'place' in pre-urban societies.
Prime among these architects, and hence a strong influence on the idealist tradition in the sixties, was Aldo Van Eyck. He stated the propostion to Team Ten very clearly in 1959:
Whatever space and time mean, place and occasion mean more. For space in the image of man is place, and time in the image of man is occasion ... Provide that place, articulate the inbetween ... make a welcome of each door and a coutenance of each window ... Get closer to the shifting centre of human reality and build its counterform for each mand and all men, since they no longer do it for themselves.
To substantiate the last point, Van Eyck said of Holland what could be said of most urban areas:
Instead of the inconvenience of filth and confusion, we have now got the bordeom of hygiene. Tghe material slum has gone in Holland for example it has but what has replaced it? Just mile upon mile of organized nowhere, and nobody feeling he is 'somebody living somewhere'.
But if all this were true, if the sociologists of Orgman were right then there was an unforseen problem for the inductivists of Team Ten. Because, as Van Eyck said, 'If society ahs no form how can the architect build the counnterform? This could be rephrased to "If society has no clear conception of itself, or even unconscious identity, then how can the architect induce the counterform?' Or put differently still, the problem was to generalize from particulars which turn out not to exist. A difficult, not to say impossible task. Stricktly speaking of couse, Van Eyck and the socilogists were wrong: society did have a form, a very complex one made up of many stratified layers each with its own identity, including the very recognizable identity of Orgman. But nevertheless the problem of induction versus deduction remained.
One
way this problem could be resolved was shown by Van Eyck himself in his paradigmatic Children's Home (1960). In the design of this he showed a continual oscillation from generral to particular and back until the factual requirements had modified the origian concepts and vice-versa. The building represented a near-perfect example of cybernetic design and the way out of the philosophic cunundrum. In fact, Van Eyck was quite conscious of this when he insisted, in presenting the building, that 'to establish the "inbetween" is to reconcile conflicting polarities. Provide the place where they can interchange and you re-establishe the origina dual 'twinphenomenon.' What he called the dual pjhenomenon or 'twinphenomenon of every object was its ability to function both as an autonomous whole and as a subordinate part of the next larger twinphenomenon. In short he argued that there is a continual relation between al the parts (or isolated functions ...) and that these relations are


just as important as the parts. By stressing these relations in his buildings and by continually relating the functions to form (and vice-versa in a lengthy cybernetic design process), Van Eyck achieved a multi-valence of meaning wghich could establish the sense and reality of the 'place'.
For instance, the entrance is made to serve many different but precise mmanings in an unobtrusive way. There is a slight change of pavement pattern and the slightest rise in step: two door-steps and two strange outdoor lamps articulate the place between the outside world and the home. This subtle transition is a crucial event because it is between a somewhat alien world (the children are orphans) and their adopted home, both of which should presumable interpenetrate so that the transition both ways is mediated. This is further reinforced by providing a semi-public area beyond the main entrance which both invites the outside world inside and controls it by a series of subtle articulations the administration bridge and bicycle ramp. A further sequence of transitional areas, or locks, continue until the completely private sleeping areas are reached furthest from the public and noise. In fact these areas are made even more private and personal by being raised off the ground and broken in their overall symmetry. That is, the general, repetitive geometry is made more particularized by being changed where a bedroom differs in size.
If one questions the use of elements, one finds the same dual phenomenon. There is a limitation to six main elements dome, cylinder, clerestory, window-wall, brick and doorstep which repeat trhoughout and impose an overall geometry. Yet this deductive order is broken from below and changed to suit the particualr context, either by being distorted the bedrooms cited above or by being varied in amount. The same duality exists also between the ortllagonal unit and the diagonal organization, or the centralized domes and their off-centre subdivision. While some of this variation is on the formal level, it also has its counterpart in content, since Van Eyck has provided for all sorts of possible activities, such as wading and admiring one's relection is surprise mirrors, located in unlikely places.
The reasons for analysing this building in some detail are that is it is intrinsically a multivalent work and also one which has had the greates effect on 'place making' in the sixties. In further projects, Van Eyck augmented his methods for crystallizing place. One, a project for a Protestant Church, showed again that place was dependent on 'multi-meaning', or what he also called 'labyrinthian clarity'. By this Van Eyck meant (among other things) the complex clarity that results whenever similar forms are overlaid (in this case circles) to produce a dual order: both centralized and decentralized, etc. Another project, actually built, the Amheirn Pavilion, developed further the idea that place deptended on the slow unfolding of an ordered experience. For instance, his description of the pariall veiled, partially revealed approach:
Central to my idea was that the structure should not reveal what happens inside until one gets quite close, approaching it from ends.
Bump! sorry. What's this? Oh hello!
This idea that place is dependent on occasion, on multiple meaning and on the significant image was taken up explicitly all over the world but nowhere


so strongly as in Van Eyck's native Holland.
In fact one could almost speak of a Dutch School springing from Van Eyck and related to the twenties Dutch movement of De Stijl. The coincidence of forms is more than just furtuitious, as is the constellation of similar ideas. For instance the buildings of Piet Blom and Herman Hertzberger share with Van Eyck and De Stijl the quality bo being made from many, small, autonoumous units added together in complex relationships. The intention is to make 'A Village of Children, A Village like a Home' (Blom) or 'A house is a tiny city, a city a large house' (Van Eyck) or 'Every corner and every space must be programmed for multiple roles' (Hertzberger). I have deliberately cross-quoted here to bring out the undeniably similar thought patterns which continually revolve around the idea of multivalence. This is also evident in the built-form the factory extension by Hertzberger which is built over the roof of an early twentieth-century factory. Hertzberger says that each unit of the whole 'must be open to the maximum number of interpretations', must be 'autonomous' and when added into a sequence always 'complete in itself'.
thus in effect these units are those 'twinphenomena' of Van Eyck which have a certain degree of autonomy and a great degree of multivalence. It is this last quality which is contray to ghe general trend towards univalence of form, and abstract, neutral space. But it was not the only attempt to re-establish the reality of place through the multiple-functioning object. There were at least two other directions which reversed the large-scale trend towards impersonalization: regionalism and historicism.


ARCHITECTS SPECIALIZING IN PSYCHIATRIC DESIGN
Lawrence R. Good, A.I.A. and William E. Hurtig wrote an interesting article, Evaluation: A Mental Health Center Facility, Its Users and Context, in the AIA JOURNAL, February, 1978. Mr. Good had been involved with the design of the Norwood Mental Health Center in Marshfield, Wis. In this project, important goals were to eliminate the hospital's image as an isolated, hostile-appearing place. Related goals were that the new center be compatible with the existing streetscape and yet display cues about its purpose. It had to be easily accesible and inviting to vehicles and pedestrians. So that patients and their treatment would be better accepted, community groups had to fell free to use the center, recreational facilities and meeting room.
Scale and profile of the building were designed to be compatible with the neighborhood. The site was planned to have distinct areas for different activities and to be utilized in an efficient manner.
i
The image of the design, symbolically, was to reflect active suburban society and current treatment methods. It was also considered preferable to be close to a general hospital and professional consultants.
Goals for the interior included encouraging dynamic relationships among peoplepatients, staff and the publicand among day patient and outpatient treatment programs. The staff considered it desirable to reduce the psychological and physical distances between different treatment areas and the individual.
The design also was to encompass a wide range of treatment activities and to encourage frequent use by staff and patients of lounges, treatment rooms, occupational therapy areas, the rehabilitation workshop, auditorium, and classrooms. Patients were to have as much privacy as they might need but also were to be kept in touch with the local ccnmunity.
These goals are achieved primarily by the arrangement of the interior spaces and by the circulation patterns. Separation between floors, treatment services and people is minimized by the use of split levels.
Design concepts include a "street" concept with activity areas at both ends, selective visual contact, "watching places", and materials/functional differentiation. Circulation concepts include an essentially barrier-free design; people tend to feel they are in a non-threatening atmosphere because they can see other people. There was some ambivalence to the design in that it made it virtually impossible for the staff to hide out. Staff have to have some privacy.
After a three and a half year evaluation, the authors felt it fair to suggest that basic changes in attitudes on the part of the staff and public about mental health have taken place in the community. There was also the opinion expressed that programs and attitudes about the degree of openness of a facility will change, and that a building must be able to make such changes without major alteration.
Also it was stated that, "The looks of a building add to helping people feel better."


certificate of need/1
CERTIFICATE OF NEED REQUIREMENT
In many states, including Colorado, a certificate of need from a state health planning agency is required prior to the development of any health care facility of the size and scope of this project. In Colorado this agency is the Health Facilities Review Council for the Region.
Justification of need has to cover:
1. clarifying the needs to be provided for;
2. demonstrating the appropriateness of the services provided;
3. demonstrating the uniqueness of the services provided;
4. demonstrating coordination of services with other health care providers;
5. demonstrating service availability and continuity;
6. demonstrating economy and cost containment.
/


financial feasability
FINANCIAL FEASABILITY
The argument for a partial hospitalization facility, if the hypothesis that 50 75% of in-patients in acute psychiatric facilities could be treated as effectively in partial hospitalization facilities could be proved, is financially feasable is clear cut.
Certainly in a community where the only signifigant hospitalization program is a private facility in which beds cost in the neighborhood of $400.00 per day before physician and pharmacy charges among others, the savings, in terms of not having people occupy and pay for beds unless it is indicated, is obvious.
Money saved on bed space and night staffing could be spent on treatment programs to reduce length of hospitalization as well as result in a signifigantly reduced cost per diem. These features would allow the patient to return to economically productive work sooner and leave him/her with more assets to utilize in the reintegration portion of recovery.
Thus, an accurate diagnosis of health and pathology in the context of an appropriate continuum of services could lead to signifigantly reduced expenditures for illneess.
Additionally, having the expensive adjunctive program available to and part of the community means that the facility could be paid for productively through a membership system by the entire community and not just be an extremely to prohibitively expensive portion of the psychiatric facility budget.
Eventually, the economy of building must be evaluated in terms of lives rehabilitated and made useful versus lives wasted, rather than just a bottom line dollars and cents evaluation.


HARLEY PLAN I
GOAL
The main objective goal of the Harley Plan I for a Psychiatric Health and Treatment Community Resource Center is to provide programs and facilities in the service of continuous development in the direction of health for humans.
Health is seen as a goal which must be continuously sought after by individuals and society. An accurate diagnosis of health and pathology at any point in time and place is seen as the primary necessity for positive development towards health to occur.
An appropritate continuum of diagnostic, preventive and treatment services is seen as the response to meet this need. Efficiency and cost containment in the service of conservation of energy and resources are critical parameters by which to gauge the response. However, they should not be used as an excuse to shy away from the critical accurate diagnosis of health and pathology, leading to medical progress.
Planning and design are seen as companion fields to biology, psychology and medicine when they participate together in the service of continuous development in the direction of health for humans.
PSYCHIATRIC HEALTH AND TREATMENT COMMUNITY RESOURCE CENTER IDEA
My response to the objective of developing a comprehensive complex of programs and facilities in the service of continuous development towards health in humans is the Harley Plan for a Psychiatric Health and Treatment Carmunity Resource Center.
This center is seen as consisting of a physical, emotional, educational health center plus out-patient and partial hospitalization components of a psychiatric treatment center. These components are under a single administration.
The site is considered to be adjacent to a general hospital with in-patient units, including a psychiatric unit. It is also considered to be closely related functionally to community housing for partial hsopitalization patients.
My idea is that a health and treatment center would be an effective extension of a traditional hospital into the community, development of a health and treatment center on a site adjacent to a general hospital would be a perfect companion to a general hospital in the context of a comprehensive hospital-based medical center.
The health and treatment center would contain a health center and a treatment center. These centers would be under the same administration. They would work together synergistically through appropriate definition and carmunication.


HEALTH CENTER IDEA
The health center would contain emotional, cognitive, physical, medical, child care, nutritional and commercial components. Its focus would be essentially educational and preventitive in the service of health. It would at the same time supply the adjunctive components of the treatment center programs.
Thus the health center would provide a healthy meeting ground for all groups within the community. It would be available on a membership basis to the entire community.
The advantages of this health center structure would be :
- 1. ECONOMIC in that support for the health center through
memberships frcm the entire community would help to distribute the cost of the health programs and facilities.
2. INTEGRATIVE in that there would be signifigantly less isolation of groups based on mental health descriminations and making an upward based continuum of identifications easier to achieve.
3. COORDINATING in that an adjunctive plan could follow a person no matter where they happened to be in the mental health continnuum of services.
4. ANONYMOUS in that anonymity would be healthily provided by the fact that the facility was available to the entire cctmunity and being in the center did not necessarily indicate a mental illness diagnosis.
5. PREVENTITIVE in that its health based education programs would provide healthy alternatives to pathologic community factors, aid early detection of disorder development, and be available in the service of dealing with potential provider "bum out".
TREATMENT CENTER IDEA
The treatment center would contain an out-patient unit and partial hospitalization units which would be coordinated with the in-patient units of the general hospital and potentially coordinated with related housing in the community.
The partial hospitalization units would consist of a psychiatric unit, a substance abuse unit, and an adolescent unit. Each of these units would be considered as containing two separate community pods, which would have areas of their own as well as areas shared by each of the community pods. In the interest of having the facility grow responsibly, initially there would be just two units, the psychiatric unit and the adolescent unit, with the substance abuse patients being treated on the "limit setting" pod in each of these units.
In the complete idea, the psychiatric unit would be divided into short term and long term pods; the substance abuse unit would be divided into alcohol abuse and drug abuse pods; the adolescent unit would be divided into limit setting and understanding pods.


DISCUSSION
Quality of program development and quality of facility participation with the essential purpose of the psychiatric programs are parameters critical to this plan.
The whole is seen as being more than the sum of the parts; yet each part must be examined separately in terms of itself and its context. In a coherent context their will be clarity of separations and bridging. The result will be a clearly defined continuum of service, program and facility availability congruent with the developmental therapeutic needs of the users. The focus is on tracts as much as centers. The pathway of focus is in the direction of integration, based on an accurate diagnosis of health and pathology.
The concept is that the services, programs and design can be the appropriate contraform to the endopsychic structure which needs to continuously develop in the direction of health for prevention +/or treatment.
The form, its meaningful content, and the functions that take place participate with the individual along the lines of organization (orientation and assessment), humanization (individuation and communication), and energy (healing and creative). Effective communication between the people, the forms, the meaningful content and the functions is part of the objective.
Another objective is normalization of the diagnostic, treatment and prevention processes in the service of providing the least restrictive, most humane context for psychiatric health and treatment. This allows people to be healthily in contact in a context that maximizes the possibility of identifying up the ladder of health.
The resulting product should advertise the resolution of the conflicts that endendered it. It should say that healthy man was here, will be here and is available.
The work presented here is an attempt to explore the design implications of these issues, and to apply the resulting set of principle to a paricular situation. Stress was placed on design as a process of organization. Methodological analysis of behavior, properties and complex interrealationships of the many subsystems that go to make up a modem health and treatment facility, along with critical linkages to the activity and movement systems of the urban area. It was recognized that this was a problem that must be examined and resolved at many physical scales; from regional to metropolitan to local to internal. It must be address through research, planning, programming, design, program development, administration and governance.
Health is a field urgently in need of functional departures, participatory designs, economical facilities, integrated planning, all within the context of cost containment. The planning of future communities is a now necessity that must be central to the life of modem man.


INTRODUCTION TO THE HARLEY PLAN 1 DIAGRAMS
These diagrams represent a diagramatic development of the ideas expressed in Harley Fran i.
The development begins with the overall idea, which is broken down diagramatically into component parts, demonstrating functional zones and adjacencies.


NOTE CN COMMUNITY RELATIONS DIAGRAM:
The health and treatment center is seen as an integral part of and contained within the community. However, to examine and develop the idea of a health and treatment center, it should be considered as separate from but closely alligned with the community. Furthermore, it is clarifying to examine the health center and the treatment center as separate entities, although with common administration, planning, research and quality control in the service of integration, cost containment, efficiency and effectiveness.


COMMUNITY RELATIONS DIAGRAM
which is to be considered as:
which in turn is to be cosidered as:
Further explanatory diagrams and notes follow:
ccnnrunity


NOTE ON HEALTH AND TREATMENT CENTER DIAGRAM:
The health and treatment center most clearly and closely relates to the community health care systems, human services systems, educational systems, and related housing.
In this model the health center is open to the entire community. Thereby adjunctive plans, developed in the health center, can be continued without the problem of differing evaluations leading to different plans from other human service centers confusing the patient. This provides a consistency to adjunctive services whereevera a person is in the health and treatment continuum of services. The focus is on relationship and tracts as well as on centers.
Furthermore, in this concept anonymity is achieved through integration, being where everybody else is, rather than by an isolation which has to be over cone at a later time, and frequently is thereby undone.
This leads to the health and treatment center being available to the health and treament providers of the camiunity (preventing isolation of them). This prevention of isolation and burnout leads to cost saving.
When a larger proportion of the community pays for the health center based adjunctive programs and facilities, rather than just the psychiatric in-
patients, a more comprehensive and effective adjunctive program is justifiably afforded.
When patients who are in partial hospitalization are given the opportunity to be with and identify with healthier populations rather than being signigantly tied to a sicker in-patient group, it is to their advantage.
\
I


HEALTH AND TREATMENT CENTER DIAGRAM


NOTE ON HEALTH CENTER DIAGRAM:
The health center contains the adjunctive programs and facilities for the community and for the oatients. This provides a meeting ground for integration and identifying up the ladder of health.
It should be a normalized space, inviting everyone to be as healthy as possible. The ideal of health, moving in a healthy direction, is available to all.


HEALTH CENTER DIAGRAM


NOTE ON TREATMENT CENTER DIAGRAM:
The partial hospitalization units are double units, described more fully in next diagram.
Ideally, there would be three double units. However, a phase of having two double units could be satisfactory for first phase development.
When there would be only two double units, they would be a general psychiatric unit and an adolescent unit.
When there would be three double units, the additional double unit would be a substance abuse unit. Until the third unit was built, substance abuse would be handled on the limit setting side of the general psychiatric and limit setting units.
The double units are more fully described in the next diagram and its
note.
Guesting beds or actual 24 hour in-patient hospitalization need to be considered as appropriate back up systems for the partial hospitalization program.
Staff on the partial hospitalization program benefit from being able to spend some time doing out-patient work to give them a sense of where there patients might be heading and what the issues of being an out-patient are.


SMHSJT C3EER DIAGRAM
in-pt. unit
to camtunity


COT-PATIENT UNIT DIAGRAM
NOTE ON COT-PATIENT AREA DIAGRAM:
Having an out-patient area near the partial hospitalization area would provide an appropriate continuum of services for certain patients as they reintegrate. Also, the continuum of services could apply to the partial hospitalization staff, for it is beneficial for partial hospitalization staff to spend seme portion of their time doing out-patient work.
The focus of this diagram is on the therapeutic areas and on the central area for the staff to have a sense of being a "staff."


DIAGRAM OF ADMINISTRATION
NOTE CN ADMINISTRATIVE AREA DIAGRAM:
This diagram indicates the major functions that would be required to take place in an administrative area to insure quality functioning of the health and treatment center.


TOTAL
I PROGRAM |
35,000 SQ.FT. (38,000)
ENTRY-------------------------------------------------1,000
HEALTH-----------------------------------------------22,000
TREATMENT---------------------------------------------9,500
ADMINISTRATION----------------------------------------2,000
(13,000)
PARKING
65,000


ENTKf-
1,000
entry lobby 1,000
HEALTH------------------------------------------------22,000
reception 250
physical movement swim lockers;2 at 500 shcwers;2 at 500 weignts office for 2 6,600 1500 2500 1000 1000 400 200
vocational crafts machine secretarial greenhouse kitchen office for 4 classroom 2,550 600 500 500 500 150 300 use cognitive area
cognitive classroom;2 at 640 study area 1,680 1280 400
emotional outreach confer, creative, indiv. creative, group gallery 2,250 350 600 1000 300
ccnmercial 500
diagnostic 900
childcare 1,500
cafeteria kitchen serving cafeteria 2,300 1000 200 1100
restrooms, storage 1,000
circulation
2,000


TREATMENT 9,500
reception 250
out-patient department 1,800
waiting 200
offices;5 at 110 550
group 200
family 150
vrork space 450
records(150)
meeting (150)
nutritional(150)
restrooms 100
circulation 150
partial hospitalization;2-3 at 3,600 7,200
community;2 at 400 800
work station 300
office;4 at 110 440
activity 250
nutritional prep. 160
group;2 at 200 400
family;2 at 150 300
quiet;2 at 100 100
computers 100
restrooms 200
circulation 350
(13,000)
(10,800)


AEMINISTRftTION-
1,750
reception 100 waiting 200 secretary 120 patient representative 120 administrator 200 accounting 120 records 120 quality control 120 research 120 conference 275 restrooms 100 circulation 150


INTFDDUCTiai TO THE GOAL/ RESPONSE MATRICES
The GOAL/RESPONSE MATRIX takes the major therapeutic objectives of organization, indiviudualization, plus energy (mood) motivation and modulation. It develops responses to these therapeutic objectives. First, a conceptual response is considered, followed by the human activities necessarily involved with the concept. Then interior and architectural responses which allow and participate with the concept cure considered. Finally, performance, adjacency and requirement responses are considered.
A matrix is developed for each of the areas in the program as a guide to what the design response will contain in terms of therapeutic, functional, physical health and safety objectives.


REQUIREMENT RESPONSE EXDR ENTRY LOBBY
SPACE:
1,000 S.F.
FURNISHINGS AND SERVICES:
Soft chairs and couches
Coffee tables and end tables
Textiles or plants for space dividers
Coffee service table
Views to outside
Pay telephones
MATERIALS AND FINISHES:
Natural
Durable
LIGHT:
Natural
Fluorescent general Incandescent areas
ACOUSTICAL:
Moderate acoustical insulation
ELECTRICAL:
110 V.
HVAC:
Good ventilation important
1


AREA: ENTRY LOBBY
PARTICIPANTS: ENTIRE COMMUNITY
GOALS VT7 PROGRAM RESPONSE
Therapeutic Objectives | Cbnceptual I Response 1 1 Activity j Response 1 1 Interior Response 1 1 Architectural Response 1
ORGANIZING I ORGANIZATION iMULTIPLE j PIjr-iGILc/ iv I HIGH LEVEL
orienting | SHOULD REFLECT | ALTERNATIVE I AND ORIENT lOF DYNAMIC
assessing 1 IDEA ORIENTA- I PATHWAYS OF I ONESELF AND 1 DESIGN
ITION OF ENTIRE!APPROACH WITH |ASSESS ONESELF 1 RESPONSE
1 FACILITY AND I ALLOWANCES FOR IWITH ATTENTION I INVITING
I ITS OPENNESS 1 DIRECT, ITO FITTING INTO! INTEREST +
Ito apprdpri- I INDIRECT, AND Ithe organiza- 1PARTICIPA-
Iate ASSESS- 1 WANDERING THRU Ition. Ition. the
IMENT IN CON- 1 BEFORE AND j DIFFERNTIAL + I PROVERBIAL
1 text OF I AFTER AS WELL | DIFFERENTIATING I BEST FOOT
I PRESERVATION Ias DURING 1+ DISCRIMINAT- I APPROACH +
lOF RIGHTS. I MEMBERSHIP. jING PLACES. j FOLLOW THRU.
INDIVIDUALIZING I INDIVIDUAL 1 INDIVIDUAL I PLACES OF |A coherent
empathizing I CHOICES AND 1APPROACH ICHOICE FOR I DESIGN
ccmunicating 1WAYS OF 1 ACTIVITIES, !CHOOSING. I INDICATING A
1 APPROACH 1 INVITING 1 1 MULTITUDE OF
IMUST BE I ALTERNATIVES 1 1 INDIVIDUAL
1 CONSIDERED IWITH A FINAL 1 1 CHOICES
1 FOR A | PATHWAY TO 1 I WITHIN A
1 SUCCESSFUL, 1 HEALTH AND, 1 1 COHERENT,
1 INVITING, 1 IF INDICATED, 1 |DEFINED
1 PARTICIPATING 1 TREATMENT. 1 1 ENTITY TO BE
1 INTRODUCTION. 1 1 1 INDIVIDUALLY
1 1 1 1 UTILIZED.
ENERGIZING 1 MOVING THRU AN|MOVING THRU AN I ENERGETIC 1 ENERGETIC +
healing I IMPORTANT I IMPORTANT I COMPOSITION OF I ENERGIZING
creating 1 PLACE AND 1 PLACE AND 1 PLACES THAT 1 COMPOSITION
Ilifeplace IS Ilifeplace in 1 ALLOW VARIOUS jOF ELEMENTS
|A HEALING, 1 VARIOUS WAYS, I PRIORITIES OF IlNTO A
1 CREATIVE, 1 CONSCIOUS AND I CONSCIOUS + I CREATIVE
1 ENERGIZING 1PRECONSCIOUS OF|PRECONSCIOUS 1 WHOLE IN THE
I PROCEDURE. 1 ALTERNATIVES IENERZATION + I SERVICE OF
1 ITHAT ALLOW ONE 1 MODULATION. 1 HEALING AND
1 Ito DEFINE ONE- 1 1 HEALTH: A
1 1 SELF AND BE. 1 | STATEMENT.
PERFORMANCE RESPONSE
ADJACENCY/FORM TENDENCY RESPONSE
Direct, Indirect and Non PATHWAYS are all encouraged1


REQUIREMENT RESPONSE FOR COMMERCIAL AREA
SPACE: 500 S.F.
FURNISHINGS AND MATERIALS:
Display counters Display book cases Cash register Mirrors Security doors
MATERIALS AND FINISHES:
Curable
Glass
LIGHTING:
Natural
View
ACOUSTICAL:
Allow moderate noise
ELECTRICAL:
110 V,
HVAC:
Entry lobby level of ventilation and breeze.
'I


AREA: COMMERCIAL AREA
GOAL/RESPONSE MATRIX
PARTICIPANTS: SALES PERSONS + COMMUNITY
GOALS \T7 PROGRAM RESPONSE
Therapeutic Objectives | Conceptual I Response ! I Activity 1 Response 1 I Interior I Response 1 1 Architectural I Response j
ORGANIZING i Organization IMoving in and 1 Catmercial | Ccmvercially
orienting |is critical lout among 1 interior that 1signifigant
assessing lfor people Iorganized |speaks bo land
I to be able 1 alternative 1healthy 1 identifying
jto find what 1 health pro- 1 orientation + 1design.
[they want Iducts, such as 1 organization. 1
I efficiently, Ibooks, foods, 1 1
land then 1 garments. 1 1
1 assess the 1 1 1
Iproduct to seel 1 1
|how it fits in| 1 1
I orientation. 1 1 1
INDIVIDUALIZING | COMMERCIAL 1 SELLING AND IINDIVIDUAL IA UNIQUE
empathizing IMUST I BUYING BASED I PLACES FOR I COMMERCIAL
ccnntunicating [ADDRESS ION INDIVIDUAL | .VIEWING I DESIGN WITH
1INDIVIDUAL IHEALTH NEEDS, | .LEARNING |FOCUS ON
|NEEDS TO I EMPATHIZING |.CONVERSING I HEALTH.
|BE IWITH AND I.CONSIDERING 1
I SUCCESSFUL. I COMMUNICATING 1 1
ITHIS COULD BE |TO COGNITIVE, 1 1
I GREAT LEARN- I EMOTIONAL AND 1 1
IING EXPERIENCE|PHYSICAL 1 1
1 1 I COMPONENTS. 1 1 1 1 1
ENERGIZING IA COMMERCIAL I OSCILLATIONS I APPROPRIATE IAN
healing I PLACE FOR I OF CONSIDERA- I PLACES WITH I ENERGIZING
creating 1 HEALTH MUST ITIQN: I APPROPRIATE | COMMERCIAL
I LEAD TO I .VIEWING ICIRCUIATIQN. | DESIGN WITH
ITHE I.THINKING 1 I FOCUS ON
I DEVELOPMENT 1 .LEARNING 1 I HEALTH.
|OF ENERGIES I.CONVERSING 1 1
I FOR HEALTH + I IN CONTEXT OF 1 1
I CREATIVITY IHEALING AND 1 1
1 WITH APPRO- I CREATIVITY 1 1
IPRIATE MODULA 1 GOALS. 1 1
PERFORMANCE RESPONSE
ADJACENCY/POFM TENDENCY RESPONSE
lobby
Access
cannunity
location as a time passer and an active purchasing place.


REQUIREMENT RESPONSE FOR CAFETERIA SERVING AREA
SPACE: 200 SF
FURNISHINGS AND SERVICES:
Waiting line area Food warmers and serviers Food servier shields Food service counter Dining tray rack Self serve salad bar Cash register
MATERIALS AND FINISHES Natural, non-institutional
LIGHT:
Seme view inport ant so can decide where to eat
Natural through skylight
Incandescent
ACOUSTICAL:
Provide a break between this area and kitchen Provide a break between this area and cafeteria Use this area as break between kitchen and cafeteria
ELECTRICAL:
110V
Ventilation important for smells and dealing with heat gain
)


AREA: CAFETERIA SERVING
GOAL/RESPONSE MATRIX
PARTICIPANTS: COMMUNITY

GOALS \YJ PROGRAM RESPONSE
Therapeutic 1 Conceptual Activity 1 Interior 1 Architectural
Objectives 1 Response f 1 Response i Response i Response i i
ORGANIZING |The serving I Going through 1 Semi-linear. 1 Semi-linear.
orienting I area MUST be I serving line + 1 1
assessing 1 clearly and 1picking out 1 1
1 efficiently 1organized. 1 1 1 1 1 1 1 Imeal. 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
INDIVIDUALIZING |HAVING I CHOOSING A I VISUAL I AIDING THE
empathizing I INDIVIDUAL I HEALTHY MEAL, I COMPREHENSION 1 VISUAL
carmunicating I CHOICES BASED lEVEN WHILE 1 OF WHAT IS 1 COMPREHENSION
j ON KNOWING j OFTEN BUSILY 1 AVAILABLE IAND THE
I ALL OF WHAT I ENGAGED IN j FOR CHOICE; 1 HEALTHY
IIS AVAILABLE 1 CONVERSATION. 1 AIDING IAPPETITE
IIS VERY 1 I APPETITE 1 DEVELOPMENT
j IMPORTANT 1 1 DEVELOPMENT, Iand CONTROL
1 SENSE IN 1 I MAINTENANCE + 1
1 HEALTHY EATINGl I CONTROL. 1
IALSO MUCH 1 COMMUNICATING 1 1 1 1 1 1
ENERGIZING I CHOOSING A 1 CHOOSING ON A I SOOTHING 1 SOOTHING
heeding 1 HEALTHY DIET I HEALTH BASIS SO|ENVIRONMENT I ENVIRONMENT
creating jIS CRITICAL IAS TO MAXIMIZE 1 1
jTO HEALTH + 1+ MODULATE 1 1
1 CREATING. 1 1 1 1 1 1 jENERGIES FOR j THE DAY, AND 1 LOOKING INTO jlHE FUTURE. 1 PATHOLOGIC 1 EATING HABITS 1TREATED. 1 1 1 1 1 1 1 1 1 1 1 1 1 1
PERFORMANCE RESPONSE ADJACENCY/FORM TENDENCY RESPONSE 1
entry 1 1 /""S Register
plates, trays, utensils ! kitch./ E \
appetizers 1 R
salads 1 v v J cafe
sandwiches 1
main courses 1
deserts i entry +
drinks ! exit
register to cafeteria 1 i
1 Seni-linear flew allowing viewing, I Between kitchen and cafeteria.
choosing, serving, paying, passing,
conversing. 1 1 1
1


REQUIREMENT RESPONSE FOR CAFETERIA
SPACE: 1,100 SF
FURNISHINGS AND SERVICES:
Movable seating for 72 people 18 tables, 4 places each Tray return carts Display area
MATTERIALS AND FINISHES: Natural, non-institutional
LIGHT:
Views to outside Natural lighting
ACOUSTICAL:
Make use of background noise of groups
ELECTRICAL:
110V
HVAC:
Ventilation important
This is heat gain area with people
Also near heat gain of kitchen and serving
Passive solar features


AREA: CAFETERIA
yjjvt\u/ rvca^rv^L'ioxj vjrx^ixj^x
PARTICIPANTS:
GOALS PROGRAM RESPONSE
Therapeutic Objectives 1 Conceptual I Response ! I Activity Response 1 ! Interior i Response 1 1Architectural Response 1
ORGANIZATION 1Organization 1 Eating and 1Organized and 1Conerent.
orienting |is required 1 socialization 1 coherent. 1
assessing land is 1 require 1 1
1 observable. I organization 1
1 I which is 1 1
1 1 1 1 1 1 1 1 assessable. 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
INDIVIDUALIZING | CHOOSING, 1 CHOOSING A I DIFFERENT TYPES | INDIVIDUAL
empathizing I PARTICIPATING ,| PLACE, EATING, !OF PLACES FOR I DESIGN GIVES
ccnmunicating I PARTICIPANT- lAND TALKING. I DIFFERENTIAL 1A SENSE OF
1 OBSERVING 1 I RESPONSES 1 PLACE AND
\JS NORMALIZED 1 1 BASED CN 1 IDENTITY.
j SETTING ALLOW 1 I COGNITIVE, 1
IINDIVIDUALIZA- -1 I COMMUNICATIVE, 1
|TION. 1 1 1 1 1 1 1 1 1 I MOOD CHOICES. 1 1 1 1 1 1 1 1 1
ENERGIZING 1 POSITIVE HABIT!EATING; I CLEAN AND 1 DYNAMICALLY
healing I ENCOURAGED + 1 CONVERSING; I HEALTHY. 1 DEVELOPED
creating I DEVELOP 1 LOUNGING; 1 IWITH FUNCTION
I INERTIA; 1 EVALUATING. 1 1st MIND.
INEGATIVE 1 1 1
1 HABITS 1 1 1
1 DISCOURAGED. 1 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1
PERFORMANCE RESPONSE
r

n

ADJACENCY/FORM TENDENCY RESPONSE


SPACE
1,000 S.F.
FURNISHINGS AND SERVICES:
Walk in freezer and refrigerator Catmercial oven and stove burners Ccmercial dishwashing sink Catmercial automatic dishwasher Base and wall cabinets Stainless steel surfaces Roan temperature food storage pantry
LIGHT:
Natural and electric ACOUSTICAL:
Needs acoustical attention in terms of location and insulation
ELECTRICAL:
220 Volt
HAVAC:
Ventilation important.
Extensive heat gain in this area. Air-conditioning must be carefully considered.
ST
V-
O'


AREA: KITCHEN
PARTICIPANTS
GOALS PROGRAM RESPONSE
Therapeutic Objectives I Oonceptual 1 Response 1 1 Activity Response 1 I Interior Response 1 1 Architectural Response 1
ORGANIZING iFollowina I Washing; 1 Definite 1 Organized;
orienting 1 directions I unpacking; 1 linear 1 responsive
assessing land assessing 1 organizing; I organization; |to linear
1 results |inventorying; 1clarifyingly I development
1 individually 1 assessing 1visualizable. land the
land collec- 1 situation. 1 1 circulation
1tively, organ- -1 1 1 necessary.
Iizes. 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
INDIVIDUALIZING | Cbntinuous |Choosing what + 1 Places to IVery
empathizing I requirement Ihow; sharing 1participate 1 functional
carmunicating 1 for choices 1 these choices +1 indivdually, land
Ithat require 1 sharing in 1 observe, + 1 signifying
1 empathy and 1 choices. 1 participant- lof function
1 communication 1 1 observe. land place in
1 for overall 1 lEigononic 1 continuum of
1 success. 1 1 i i 1 1 1 1 1 1 attention. 1 1 1 1 1 functions. 1 1 1 1
ENERGIZING IWORK THAT I PRODUCTIVE I ERGONOMIC 1 APPROPRIATE
healing [YIELDS RESULTS I KITCHEN WORK. I SENSITIVITY I CONTINUUM OF
creating 1 ENERGIZES, 1 ITO HUMAN 1 SPACES.
1 INCREASES 1 Ienergy AND 1
| SELF-ESTEEM, 1 1 ECONOMY 1
lAND PROVIDES 1 [SITUATIONS. 1
Ifuel FOR 1 1 1
I HEALING. 1 1 1
Ialso THE 1 1 1
Ifood HEALS. 1 1 1 1 1 1 1
PERFORMANCE RESPONSE
1
SENI-LINEAR FLCW
AEJACENCY/PORM TENDENCY RESPONSE
SEMI-LINEAR FLOW


REQUIREMENT RESPONSE FOR HEALTH AND TREATMENT RECEPTION AREAS

SPACE:
250 S.F. each
FURNISHINGS AND SERVICES: Counter
Telephone-interccm
Stools
Desk
Soft chairs Pay telephone
MATERIALS AND FINISHES:
Natural
Durable
LIGHTING:
Natural
Views _
ACOUSTICAL:
Must allow some privacy of communication between users and providers, especially in relation to treatment area.
ELECTRICAL: 110 V.
HVAC:
Comfortable to sit
Could be good passive solar area


AREA: HEALTH RECEPTION
GOAL/RESPONSE MATRIX
PARTICIPANTS:
GOALS | PROGRAM RESPONSE
Therapeutic Objectives 1 Conceptual 1 Response 1 1 Activity I Response 1 I Interior Response 1 1 Architectural Response 1
ORGANIZING I PROPER I CONVERSATION Ian organized |A PLACE
orienting I ASSESSMENT 1 VIEWING 1 PLACE WITH ICQNTAININING
assessing 1 CRITICAL I DIRECTING 1 CLEAR SENSE lAPPROPIATE
ITO ORIENTA- 1 I OF ASSESSMENT 1 ORGANIZED +
Ition AND 1 I ORGANIZATION 1 ORGANIZING
1 SENSE OF 1 I AND VIEWS OF 1 PLACE WITH
1 ORGANIZATION. 1 1 APPROPRIATE 1 CLEAR PATHS,
I OBSERVATION + 1 1 ORIENTATIONS 1 VISUAL AND
1 PARTICIPANT 1 1 |MOVEMENT, TO
I OBSERVATION. 1 1 1 ALTERNATIVE,
1 i 1 1 DEFINED
1 1 1 1 CHOICES
INDIVIDUALIZING I COMMUNICATION 1 GREETING, |A PLACE TO 1 HIGHLIGHTING
empathizing 1 OF INDIVIDUAL-1 DIRECTING I RELATE ONE ON lOF A SEPARATE
carmunicating 1IZATION IS I BASED ON I ONE WITH A 1 SPECIAL
1 CRITICAL 1 INDIVIDUALIZED 1 SENSE OF 1 BEGINNING
1 BECAUSE IT IS I ASSESSMENT + 1 INDIDUAL I PLACE,
1 INTRODUCTION 1 EMPATHY. I PRIVACY AND 1SUBTLELY, SO
ITO THE WHOLE 1 1 IMPORTANCE. 1 IT IS STILL
1 SENSE OF USER 1 1 I INTEGRATED +
I OWNING THE 1 1 1 INTEGRATING
1 PLACE FOR 1 1 1 FOR THE
1 HEALTH. 1 1 1 INDIVIDUAL.
1PARTIC/OBSERV. 1 1 1
ENERGIZING I CRITICAL TO |A beginning I WARM WITH |A coherent
healing IGIVE THE ISPOT FOR THE ISOME BRIGHTNESS I SENSE OF
creating 1 SENSE THAT 1 PROCESS. A lAND VARIATRIONSI CHOICES AND
1 THIS IS THE Itake OFF INTO ITHAT SPEAK TO 1 alternatives
1 BEGINNING OF 1 HEALTH AND 1 CHOICES AND lAND APPROPRI-
I HEALTHY I CREATIVITY BY 1 SOLUTIONS. Iateness,
1ENERZATION I PASSING BY AND 1 1 LEADING TO
1 WHETHER IT IS I THROUGH THIS 1 1POSITVE,
1 ACTIVITY OR (area. 1 Iauowing
1 SLOWING DCWN 1 1 I SOLUTIONS.
INDICATED.


REQUIREMENT RESPONSE FOR CHILDCARE AREA
SPACE: 1,500 S.F.
FURNISHINGS AND SERVICES:
Counter, adult Childrens tables Childrens counter Sink, adult Sink, child
MATERIALS AND FINISHES:
Natural
Durable
LIGHT:
Natural
Views
ACOUSTICAL:
Childrens noise utilized as background noise
ELECTRICAL:
110 V.
HVAC:
Must be comfortable for children.


AREA: CHILDCARE
GOAL/ RESPONSE MATRIX
PARTICIPANTS: CHILDREN + TEACHERS
D
goals program response
Therapeutic Objectives I Conceptual I Response i t I Activity | Response I | Interior 1 Response I 1Architectural | Response 1
ORGANIZING 1Organization +|Organized but I Organized but I Organized
orienting 1 orientation Iplayful acti- Isubtlely so [especially in
assessing |important to Ivities in which|as not to 1 relationship
1 children vho I organization is I detract fran or I to entrances,
Iwill be 1 not necessarily | inhibit the Iwaiting,
I without their 1 apparent but is I developmental I deciding to
1 parents and 1 available to be|activities of 1 join, and
|are expected 1 adhered to and I the children. I actual
I to utilize 1addressed. 1 1participatory
|the time 1 1 Iplaces.
Ibeneficially 1 1 1
Iwithout anxityl 1 1
INDIVIDUALIZING 1 Group 1 Different 1 Different I Identifies- o
empathizing ! communicating [activities [appropriate Ition as a
ccnrnunicating I activities I appropriate to 1places for 1 childrens
| in which how 1 child devel- 1different 1place is
lit is done + lopment as I activities I critical.
I then hew 1 individuals in |+/or different 1
1different |a group: blocks Iways of view- 1
I children do itIwater colors, ling the 1
1 different ways I follow the 1 different 1
Iwith consis- Ileader, listen- -1activities 1
I tent adult ling, etc. I appropriately 1
1 empathy. 1 |in same place. 1
ENERGIZING |CHILDREN 1 PLAYING + I PLACES TO IA MOOD
healing I PLAYING AND 1 RELAXING I PLAY AND I MODULATING
creating I DEVELOPING I UNDER I PLACES TO I PLACE THAT
|TOGETHER IN [DEVELOPMENTAL I MAX AND ICAN SET
I ALTERNATE I SUPERVISION I PLACES FOR IAPPROPRIATE
IMODES OF ISO THAT A I UNOBTRUSIVE IMOOD MODUIA-
I RELAXING AND IA CREATIVE |OR CLARIFYING ITING TONE +
I GOING FOR IT IOSCIALLATING I OBSERVATION + |BE BASIC
IWITH ATTENTION| FHYIHM IS I LIMIT SETTING. I EXAMPLE TO
|T0 MODULATION I DEVELOPED AND 1 1 ENTIRE
1 [ACKNOWLEDGED. 1 1 FACILITY.
PERFOFMANCE RESPONSE
ADJACENCY/POIM TENDENCY RESPONSE
This should be near entrance and in areas such as physical and creative where children can visually identify with adulthood positively.


REQUIREMENT RESPONSE FOR POOL AREA
SPAfe:
*££?sf
FURNISHINGS AND SERVICES:
25' x 50' pool (1,250 sf)
Weights for swindling Rest area
Supervision area and tower Child pool area 15' x 15' (225 sf)
MATERIALS AND FINISHES:
Swirnming pool typical Warm and woody as possible
LIGHT:
Natural
Exterior views to Plaza
Consider having facility out of doors
ACOUSTICAL:
Noisy
ELECTRICAL:
Related to heating especially HVAC:
Consider having out of doors


AREA: SWIM
GOAL/RESPONSE MATRIX
PARTICIPANTS: CCM4UNITY
GOALS
TT7
PROGRAM RESPONSE
Therapeutic I Conceptual 1 Activity I Interior 1
Objectives I Response 1 1 1 Response Response 1 1 1
ORGANIZING
orienting
assessing
I Health,
I safety and I general Iwelfare I organization.
rules and regulations.
jChild pool 115' x 15'
I
I Relaxation area
I
IWatching area
I
I Lifeguard lobserving I area.
! Dynamic organization
Architectural
Response
INDIVIDUALIZING I Individualized I Individual
empathizing
caimunicating
Iswimming I levels and I approaches I considered I in order to I ccmnunicate I general I accepting I atmosphere I for indivs. land groups.
Iswimming activities and group swiitming activities under general supervision.
IIndividualized Iswimming,
Iwaiting and Iwatching Iplaces.
IImportant Iview place for I supervision.
I
Swimming
pool
identity
with
natural light Accepting feeling in general and individuated expressions of component areas.
ENERGIZING
healing
creating
Iswimming is
I CRITICAL
Ihealing
I ACTIVITY FOR jNUMEROUS I AILMENTS,
I PLUS EXCELLENT j PREVENTIVE +
IAEROBIC I EXERCISE1
EXERCISES.
I POOL MUST BE I BASICALLY I PRO-EXERCISE I AND HAVE I APPROPRIATE j ADJACENT I EXERCISE AND jRELACAXATION I AREAS.
I
SPEAKS TO THE HEALING QUALITY OF SWIM
EXERCISE, WITHOUT XS JOINT STRAIN.
Speaks clearly to exercise.
25' x 50' basically linear pool.
In the health section, closely related to movement and showers.


SPACE:
REQUIREMENT RESPONSE FOR MOVEMENT AREA
*\
' l5~o 0 S'F.
FURNISHINGS AND SERVICES: wood surface floor
nirrors
LIGHT:
natural
ACOUSTICAL:
near other human noise areas


AREA: MOVEMENT
GOAL/RESPONSE MATRIX
PARTICIPANTS:
GOALS PROGRAM RESPONSE t
Therapeutic I Conceptual Activity I Interior I Architectural
Objectives ! Response 1 Response 1 Response 1 Response 1
ORGANIZING I following 1 instructing Iview of Iview of
orienting I instructions 1 I instructor I instructor in
assessing 1orients and 1 1 1 coherent
1 allows I assessment 1 1 1 1 I 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I space 1 1 1 1 1 1 1 1
INDIVIDUALIZING I Moving I Moving I Places for 1 Creative
empathizing lin relation 1 individually + 1 moving by |objects +
ccarriunicating I to self and Iwith + in Iself, with + I spaces
lathers allows 1 relation to |in relation to 1 individually
1individualiz- 1 groups. 1 others. 1 expressive +
ling empathy + 1 ccrrmunication. 1 Social 1 interaction 1 1 1 1 1 1 1 1 |in harmony. 1 1 1
1 encouraged. 1 1 1
1 Pro-expressiveI 1 1
I dancing. 1 1 1
ENERGIZING IMOVEMENT 1MOVING AT I CREATIVE I SPACE FOR
healing 1 DEVELOPS AN I DIFFERENT |PLACES jFREEDOM OF
creating 1 ENERGIZING I PACES I ALLOWING [PERSONALITY
1 INERTIA WITH 1 PURPOSEFULLY |CREATIVE 1 DEVELOPING +
I HEALING AND I FOR HEALTH + IMOVEMENT |EXPRESSED IN
|CREATIVE 1 CREATIVITY. I SOLUTIONS. IlHE DESIGN
1 MODULATIONS. Ievokative OF I KINETIC, I HAPPY |RESPONSES 1 1 1 1 1 1 1 1 1 1 I ITSELF. 1 1 1 1
PERFORMANCE RESPONSE
t
\

' l
\ / 1 ) .
/
/
/ / /
' '< 1

N
- V-
>space to move freely
\
ADJACENCY/FORM TENDENCY RESPONSE
>near other human noise areas >near main health circulation


FEQUIREMENT RESPONSE FOR SHOWERING AREA
h
SPACE:
2 of locker at 500 each = 1,000 S.F. 2 of shower at 500 each 1,000 S.F.
2,000 S.F.
FURNISHINGS AND SERVICES:
lockers
Benches
Sinks
Counters
Mirrors
Toilets
Showers
Drying area
MATERIALS AND FINISHES:
Tile
Carpet
LIGHT:
Natural
ACOUSTICAL:
NOise relatively o.k.
ELECTRICAL:
110 V.
HVAC:
Requires ventilation
Requires temperature for comfort while undressed


AREA: SHOWERS
PARTICIPANTS: MEMBERS
GCALS \T7 PROGRAM RESPONSE
Therapeutic I Conceptual Activity 1 Interior I Architectural
Objectives I Response 1 Response I Response 1 | Response 1
ORGANIZING 1 shower and .changing Ian organized I showing
orienting I lockers are clothes 1 space for I structure and
assessing 1parts of the showering Ipeople to Iventilation
1 physical conversing I change clothes 1
1health system 1 1 1 1 1 1 1 land shower 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
INDIVIDUALIZING 1 Giving enouggh changing 1A warm, natural 1A warm,
empathizing 1 space for clothes 1 setting I natural
canmanicating leach conversing 1 1 setting
1 individual showering 1 1
land making it 1 1
1 comfortable 1 1
Ifor people to 1 1
Ibe near each 1 1
1 other while 1 1
1 undressed. 1 1 1 1 1 1 1 1
ENERGIZING |An integral Showering 1 Showers 1 Positive,
healing Ipart of 1 I health
creating 1healing 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 design 1 1 1 1 1 1 1 1
PERFORMANCE RESPONSE
ADJACENCY/POFM TENDENCY RESPONSE
swim move ment
health
recep
tion


REQUIREMENT RESPONSE FOR CRAFTSHOP AREA
SPACE:
3S&-SF
FURNISHINGS AND SERVICES:
Woodblock top talbles with lockers below
Clay kiln
Potter's wheels
Sink with sludge trap
Base cabinets ard counter
Wall cabinets
Weaving loan
Storage cabinets for materials and tools Storage for projects in progress
LIGHT:
Natural
ACOUSTICAL:
Average noise generation
ELECTRICAL:
Kiln requires 220 v.
HVAC:
Natural ventilation encouraged


AREA: CRAFTS
GOAL/RESPONSE MATRIX
PARTICIPANTS: COMMUNITY + TEACHERS
GOALS PROGRAM RESPONSE
Therapeutic Objectives 1 Conceptual I Response 1 ! Activity Response 1 I Interior Response 1 I Architectural Response 1
ORGANIZING 1 Following i Pottery i Work tables lUse of
orienting 1 orienting and I Weaving 1 Pottery wheels 1 elements in
assessing !assessing 1 1 Kilns 1 organized
1 organizational I 1 Loans 1 craftlike
1 directions is 1 1 1modes;
Ian essense of 1 I Organized 1 detailing
Icraftwcrk. 1 Ipattern 1 organization
1 1 1 |of elements
1 1 1 |in coherent
1 1 1 1 harmony;
1 1 1 1whole and
1 1 1 1 parts.
INDIVIDUALIZING 1 Crafts are 1 Choices in I Individual 1 Allows
empathizing 1 utilitarian 1deciding Iplaces to 1 viewing of
ccmunicating land creative, 1where and with Iwork, clearly Iplaces and
1cairounicating Iwhat to begin (identified + 1 identifies
Iwhat is 1 cannunicate laccessable; I them as
1 needed 1 needs and 1 also access- 1 creative
1 functionally I response to lable visually, Iplaces,
Iwith an 1 needs along j verbally and 1 creating a
1 individual 1 individual 1 actually for Iwhole out of
1carmunication. 1 lines. Iteaching and 1basic ele-
1 1 1 demonstrating. Iments in
1 1 1 1 creativity.
ENERGIZING I CRAFTING TO 1 CRAFTING AND I INSPIRING 1 INSPIRING
healing Imeet ACTUAL Iteaching of I PLACEMENT OF jSYNERGY OF
creating 1AND PSYCHO- 1 CRAFTING IN 1 TOOLS WITH [ELEMENTS
1 LOGICAL NEEDS 1 DISCIPLINED, I FOCUS ON I PLACED
1 ENERGIZES + 1 EFFICIENT 1 TRADITIONAL 1APPROPRIATE
1 INCREASES 1 MANNER, I PREPARATIONS Ito FUNCTION
| SELF-ESTEEM I EMPHASIZING 1 AS ALLOWING Iand
IlN HEALTHY I TRADITION + jCREATIVE 1 SYNTHESIZING
1 CREATIVITY. 1 PREPARATION I DIMENSION TO I INTO A
Iteaching I PRIOR TO Iwork. I CREATIVE
1 ENERGIZES,TOO. 1 RESULT. 1 IWHQLE.
PERFORMANCE RESPONSE Preparatory space ADJACENCY/FORM TENDENCY RESPONSE 1 1 1 1 1 1 1 1 |Near main entrance as can participate
WORK PLACE Evaluating space Iwith the exterior or be viewed fran Ithe circulation, inviting others to 1 join. 1 1 1 1


REQUIREMENT RESPONSE FOR PLANT CRAFT AREA
SPACE:
500 SF
FURNISHINGS AND SERVICES:
Racks and tables for plants Table and chairs for people
MATERIALS AND FINISHES:
Rocks
Wood
Earth
LIGHT:
Natural Solar exposure Shade control Views to outside
ACOUSTICAL:
Allcw moderate noise, natural. ELECTIRCAL:
110V
HVAC:
Passive solar greenhouse effect using rocks and water as capacitors Mechanical heating option Ventilation and humidity control


GOAL/RESPONSE MATRIX.
AREA: PLANT CRAFTS (GREENHOUSE) PARTICIPANTS: PLANTERS AND TEACHERS
GOALS VT7 PROGRAM RESPONSE
Therapeutic Objectives 1 Conceptual I Response ! I Activity Response | I Interior Response 1 I Architectural Response 1
ORGANIZING orienting assessing I Oriented I Procedures of 1 understanding Iplanting and lof plants and 1plant 1 assessing |maintenance. I their poten- I Itials and 1 environmental I I constraints is I 1 avenue of 1 reality test- I ling which can | |be assessed. I 1 Earth to plant |in, places to 1plant from, [places to 1 observe frcm, 1 learning the Iwhat and hew lof planting IAdditional 1 environmental I relating 1 features. I Focus on I relation to I environment lets an 1 organizing, (orienting + I assessment I basis. 1 1 1 1
INDIVIDUALIZING 1Human choices IIndividual 1 Allowance for I Design
empathizing 1about planting|choosing in I individual 1 emphasis on
cannunicating 1 reflect !context of 1 choices within I plant and
I individual 1proper 1overall 1 environment
1 knowledge and 1preparation + 1 traditional 1 identity
1 catmunication 1 tradition. 1 context and I in coopera-
1 skills; I Advocate 1 means of Ition with
1observations I research; I evaluating 1humans and
lallcw for 1 cooperative 1 results; I research
1 developmental 1 double blind Ireseach aids. 1 capabilities.
1 growth of 1 research. 1 1
1 individual. 1 1 1
ENERGIZING I HEALTH 1 CHOOSING AND I MULTILEVEL, Ienerzation
heeiling 1 MAINTENANCE OF|EVALUATING I MULTIDISTANCE lOF MAN
creating I PLANTS AND 1 RESULTS IN I INVOLVEMENT I WORKING
1 CREATION OF I OBJECTIVE AND I PLACES FOR I HARMONIOUSLY
Inew plants I EMOTIONALLY ITOUCHING, j IN AND WITH
1 ENERGIZES 1 INVOLVED 1 SMELLING, I ENVIRONMENT
1 AIDING 1 OSCILLATION, 1 SEEING, 1 MUST BE
1 SELF-ESTEEM I ENERGIZES. I THINKING, I HIGHLIGHTED
IAND ESTEEM 1 RESEARCH |FEELING, jWITH FOCUS ON
j FOR THE I PRODUCTIONS ADD|BEING IN + I FUNCTIONAL
1 ENVIRONMENT. Ienerzation. IWITH NATURE. j EDUCATION.
PERFORMANCE RESPONSE PREPARE
V
PLANT
HARVEST
PARTICIPANTS
TEACHERS
ADJACENCY/FORM TENDENCY RESPONSE
OBSERVERS
VIEWABLE AND ENVIRONMENTABLE
TO MAINTAIN AND CREATE IN HARMONY WITH THE ENVIRONMENT.


REQUIREMENT RESPONSE FOR MACHINE SHOP AREA
SPACE:
500 SF
FURNISHINGS AND SERVICES:
Fewer saw
Fewer drill
Fewer lathe
Tool storage pegboard
Industrial size vacuum
Fire extinguishers
Exhaust fan to outside
LIGHT:
Must be adequate ACOUSTICAL:
Noisy and requiring isolation fran areas needing quiet.
ELECTRICAL:
220 V.
HVAC;
Important to ventilate adequately.


AREA: MACHINE
KjmtXLJ/ 1\JLa3XTWUXJ rjniiuj\
PARTICIPANTS: MACHINE OPERS.+TEACHERS
GOALS PROGRAM RESPONSE
Therapeutic Objectives I Conceptual 1 Response Activity Response 1 Interior Response |Architectural Response 1
ORGANIZING i GRI2NTAI IGN, i ASSESSABLE umLY i vERY vkOAl-i 1 aiEL [ GRGc-u.'ixxlljx'
orienting I ORGANIZATION, |SKILLED OR I ALONG SAFETY IMACHINE +
assessing jASSESSMENT + IUNDER SUPER- I PARAMETERS WITH I SAFETY
IALL REALITY I VISION FOR [ATTENTION TO I NECESSITY
jTESTING jPURPOSES OF I SUPERVISION + IIDENTITY TO
I FUNCTIONS ARE IHEADVY DUTY Iteaching. IBE HIGH-
I CRITICAL IN I BUILDING (high ccncen- | LIGHTED.
I POTENTIALLY IWITH TOOLS AND 1TRATION OF I MINIMUM #
I DANGEROUS AREA | MACHINE TOOLS I FOCUSED lOF DISTRAC-
1 1 1 ATTENTION ITION ELEMENTS
1 1 1 1 I DESIGNED FOR. 1 1 1
INDIVIDUALIZING I Individuality 1 Traditional I Individual 1 Machine
empathizing |is clearly to 1 machine 1 places per 1 tradition
canrrunicating |be subserv- I activities by 1 tradition, I emphasized
lient to 1 established 1 canrtunicating land
1 tradition and Iprocedures 1 safety and I ccntnunicated
1doing it right I 1 successful 1
1 1 1 outcomes. 1
1 1 IFocus on 1
1 1 1proper response]
1 |to proper 1
1 1 1 1 1 procedure. 1 1 1
ENERGIZING 1Machines 1Machines used 1 Realistic, 1 Energetic
healing lean energize |to aid 1 efficient 1humanly
creating |a system of 1production of 1placement of 1 modulated +
1production; 1fabricatred 1 machine 1 controlling
1 this needs to 1 results with 1places to 1 design.
|be modulated I attention to 1 allow 1 Individual
|in the service 1 safety and [production 1 concentration
|of safety. 1 reality so Imaximums in 1 promoted with
1 Ithat inertia ofI safety. Focus 1minimal
1 lenerzation is t|of attention 1 design
1 1 remains positivlis work. I distraction.
PERFORMANCE RESPONSE ADJACENCY/FORM TENDENCY RESPONSE 1 1
preparatory space 1 1 1
4- \ 1 1
work space MACHINE ITSELF T / 1 1
J / product space 1 1 1 1
1 1 1 Noise requires protection of other 1places from noise. Sound acoustics + 1 adjacent to places that would mind 1 less.


REQUIREMENT RESPONSE FOR SECRETARIAL SKILLS AREA
SPACE:
500 S.F.
FURNISHINGS AND SERVICES:
Desks, chairs and return tables
Typewriters
Adding machines
Calculators
Computer
Security door
MATERIALS AND FINISHES:
Modem office durability and look
LIGHTING:
Natural View windows
ACOUSTICAL:
Moderate degree of noise.
Make use of background effects.
ELECTRICAL:
no v.
HVAC:
Must be comfortable to sit in and work


AREA: SECRETARIAL SKILLS
GOAL/RESPONSE MATRIX
PARTICIPANTS: SECRETARY STUDENTS & TEACHERS GOALS U7 PROGRAM RESPONSE
Therapeutic Objectives 1 Conceptual I Response 1 1 Activity Response I Interior Response 1 Architectural Response
ORGANIZING IOGANIZATION iSECRETARIAL I WORK PLACES I OFFICE
orienting IWITH AN Iwork I ORGANIZED ALONG|BUILDING
assessing 1 ABILITY TO I.TYPING 1 LINES OF Ilook
1 ORIENT AND 1 .WORD i EMPLOYMENT ITO AID
IASSESS AS I PROCESSING I PLACES, I TRANSITION
1 OTHERS WOULD 1.STENOGRAPHY I WITH VIEWS OF -f |T0
IWANT YOU TO 1 I PLACES TO BE j EMPLOYMENT.
IIS CRITICAL 1 jVIEWED BY 1
ITO EMPLOYA-IBLE SECRETARIAL [FUNCTIONING. 1 1 1 1 |TEACHERS. 1 1 1 1 1 1 1
INDIVIDUALIZING IIndividualiza- 1 Secretarial 1 Individual 1 Office
empathizing 1tion should be Itaskes per- 1places. 1 building
cxxrntunicating [able to be 1 maintained in 1 the secretar-lial work 1 context, to Iprevent 1 physical, 1 emotional land mental lbum out. 1 formed with lthe degree of 1indivdiduali-Ization that 1 exists in 1 office work. 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1individuali-1zation 1 formats. 1 1 1 1 1 1 1
ENERGIZING iAbility to 1 Attention to 1 Places should |A positve
healing 1 maintain [modulation of I contain 1 statement
creating 1 individual 1 energy output [capacities for 1 about
1 energy, [with attention [modulation of 1modulation
1 individually |to cognition, 1 energy |of energy
1modulated, Imood, energy 1 involvement land altema-
lis important land output; lin relation to Itives for
1 adaptive task 1 Developing Iself, others, (health in
lin office lability to make 1 mind, emotions, 1 context of
Iwork settings. 1 healthy Ibody. 1workaday
1decisions. 1 Ivor Id.


\
REQUIREMENT RESPONSE FOR CLASSROOM
SPACE:
640 S.F.
FURSNISHINGS AND SERVICES:
Chairs for 32 people Chalkboard Projection screen Audio visual storage Demonstration table
MATERIALS AND FINISHES:
Natural
Durable
LIGHT:
Natural
General
Task
ACOUSTICAL:
Needs quiet area
ELECTRICAL:
110 V
HVAC:
Quiet and unobtrusive
1
r.


AREA: CLASSROOM
PAKi'lClFAINTS): SiTJUCJNTD -r irirti
l
GOALS \T7 PROGRAM RESPONSE
| Therapeutic 1 Conceptual I Activity I Interior I Architectural
k Objectives War* 1 Response 1 Response 1 Response 1 Response 1
ORGANIZING 1 ORGAN! 7ATTON Caching and (APPROPRIATE FOR (NORMALIZED
orienting I OF COGNITION I LEARNING 1 LECTURING AND (ORGANIZED
1 assessing IWITH ATTENTION | ACTIVITIES I AUDIO-VISUALS, I CLASSROOM
ITO ORIENTATION | WITH FOCUS ON IWITH VARYING Iwith clear
1 Iand ASSESSMEOTlLECTURES AND Inumbers of I ORIENTATIONS
1 IIS CRITICAL TO|AUDIO-VISUAL (TEACHERS AND 1
I CLASSROOM 1 PHENOMENA. (VARYING STYLES 1
* |WORK AND 1 lOF LECTURING. 1
I I PROGRESS. 1 IVIEWS IMPORTANT |
w 1 1 I AUDITORY IMPOR- 1
i 1 1 (TANT. VARYING 1
i 1 1 (DISTANCES ALSO. 1
INDIVIDUALIZING 1Individuali- (Techniques for 1 Modes for the 1 Focus on
I empathizing 1zation in 1 individualizing | instructor to (circulation
ccmnunicating 1 midst of |the learning Imoce back and |in order to
1 classroom 1 process. 1 forth between 1 allow for and
| Imust always be I 1 students and 1 encourage
1 addressed, 1 1 styles should 1 alternatives
1 especially 1 |be related to Ithat can
tm Iv^ien users 1 Iwith attention Iwork.
f 1 require 1 |to this 1
1 alternative 1 I circulation. 1
I education 1 1 1
| 1 techniques. 1 1 1
ENERGIZING |A classroom I Modulation of 1 Modulated 1 Modulated
jrt healing Imust be able (alternatives in 11 alternatives 1 energetic
f creating 1 to maintain 1 search of 1 available 1 design
|a signifigant, I finding the Iwith adequate I allowing
1 modulated 1 alternatives 1 circulation, Ithe interior
1 energy in Ithat work in 1 carmunicating 1 alternatives
1 1 order to be 1 terms of I concerned Ito be
I effective. I developing + 1 response to 1 coherent
| t 1 1 maintaining I energy land effective
I 1 1 appropriate (modulation 1
1 1 learning energy I requirements. 1
PERFORMANCE RESPONSE I ADJACENCY/FORM TENDENCY RESPONSE


REQUIREMENT RESPONSE FOR OUTREACH CONFERENCE AREA
SPACE:
350 S.F.
FURNISHINGS AND SERVICES:
Chairs for 16 people
Chalkboard
Table
Display walls
MATERIALS AND FINISHES:
Natural
Durable
LIGHTING:
Natural
General
Mnimal view windows
ACOUSTICAL:
Qiiet to be available Acoustical insulation Acoustical placement for quiet
ELECTRICAL:
no v.
HVAC:
Comfortable place to sit and work


AREA: OUTREACH CONFERENCE
GOAL/RESPONSE MATRIX
PARTICIPANTS: COMMUNITY
GOALS U7 PROGRAM RESPONSE
Therapeutic Objectives I Conceptual 1 Response l | Activity 1 Response i 1 Interior I Response i 1 Architectural I Response i
ORGANIZING 1outtreach 1 group meetinqs Irocm for I flexible
orienting 1meetings 1 I informal, 1 organization
assessing 1 extend the 1 1 semi-formal + 1
1health 1 1 formal 1
1 organization 1 1organizations 1
lout into the 1 1 1
1 caimunity 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
INDIVIDUALIZING I Outreach I Individual 1 Individual |A unique
empathizing 1 meetings 1 communication 1 places. 1outreaching,
ccnmunicating 1provide a 1 within a grp. 1 1 individual-
1 forum for 1 1 listic
1 canmunication I 1 I design.
land empathy 1 1 1
iwhich breaks 1 1 1
Ithrough denial| l 1
land allews 1 1 1
1 individuals to I 1 1
|be in touch 1 1 1
Iwith themselfs| 1 1
ENERGIZING I Outreach group|Confronting + 1 Allows free- 1Design allows
healing I activities lempathic I dem of 1 expression
creating 1 lead to I conversation. 1 expression in 1
I energy 1 Igroup 1
1 against 1 1meeting 1
|denial; 1 I context. 1
1 allow 1 1 1
1productive 1 1 1
Ihealing 1 1 1
1 energies. 1 1 1 1 1 1 1
PERFORMANCE RESPONSE
Requires flexible space for different types of meeting groups, all of which encourage intermingling, expression, confrontation. A leader space should be architecturally evident, but not dcminatinq.
ADJACENCY/ FORM TENDENCY RESPONSE
health
recept.
entry
Near health reception, so it is easy for new people to be directed there.


REQUIREMENTS FOR DISPLAY GALLERY AREA
SPACE:
300 S.F.
FURNISHINGS AND SERVICES:
Storage for display equipment Picture hanging tracks Sculpture display places
LIGHTING:
Controlled lighting for pictures or three diminsional objects. Natural skylight
ACOUSTICAL:
Generally quiet and requiring quiet.
ELECTRICAL: 110 V
HVAC:


AREA: DISPLAY GALLERY
PARTICIPANTS: ARTISTS + VIEWERS
GOALS
\T7~
PROGRAM RESPONSE
Therapeutic Objectives I Conceptual I Response 1 ; Activity Response 1 1 Interior Response 1 1Architectural Response 1
ORGANIZING IAESTHETIC i vTjjniN'a I -* -titt m | wnLj^u jl V xj I CREATIVE
orienting | ORIENTATION, j.MOVING jINTERIOR I ORGANIZATION
assessing I ASSESSMENT + j .APPRECIATING 1 RESPONSE, jwiTH
jORGANIZING |PRINCIPLES j HIGHLIGHTED. 1 1 1 1 1 1 j .CONVERSING 1 1 1 1 1 1 1 1 j LEAVING ROOM IFOR CREATIVITY j0F INDIVIDUAL jARTISTS AND I VIEWERS. 1 1 1 1 I ATTENTION TO j ARTISTIC AND j VIEWER NEEDS j AND jINTEREST j DYNAMICS. 1 1 1
INDIVIDUALIZING 1HIGTLIGHTING I CHOICES ABOUT I PLACES OF I UNIQUE,
empathizing lOF PRINCIPLES IHOW TO ICHOICE: I INDIVIDUAL
ccrrmunicating 1 OF INDIVIDUAL IDISPIAY, HOW I.TRADITIONAL jDESIGN
1 CREATIVITY IN I TO BE j.CREATIVE ICGMMUNICAT-
Ithe CONTEXT j DISPLAYED, j .AVAILABLE jlNG VALUE
lOF EMPATHY + i AND BOW TO j ATTENDING TO I OF INDIVI-
I COMMUNICATION. 1 VIEW AND j INDIVIDUAL IDUAL WORKS
|STATEMENTS j APPRECIATE jCHOICE AND j DISPLAYED.
ITHAT "MAN" lARE j COMMUNICATION. j GIVING VALUE
IWAS + IS HERE, 1 individualizing! j+ RECEIVING
j INDIVIDUAL + |+ ALSO 1 1 VALUE,
I RESPONSIVE. j INTEGRATING. 1 jSYNERGISTIC.
ENERGIZING 1 CREATIVITY I INDIVIDUALS + | ATTENTION TO Ian ENERGETIC
healing lOUT THERE IN I GROUPS RELATE I CIRCULATION j DESIGN
creating Ithe viewable jTO VIEWABLE jPATHS FROM j COMMUNICATING
j WORLD FOR jCREATIVE jPLACE TO jSOMETHING OF
j APPRECIATION + j PRODUCTS IN j PLACE. IVALUE AND
1 CONSTRUCTIVE I CREATIVE WAYS 1 Iflexibilty
j CRITICISM, j WHICH 1 jTO BE
jENERGIZES AND jENERGIZE 1 jINTEGRATED
I PROVIDES NIDUS 1 HEALING AND 1 1 WITH OTHER
j FOR GROUP jCREATIVE 1 I ARTS AND
j ACTIVITIES. jPROCESSES. 1 I EDUCATION.
ADJACENCY/FORM TENDENCY RESPONSE
PERFORMANCE RESPONSE
p TvKtE~
Located in a place where it would be open to the oamiunity that is outside, inviting them in, as well as to the inside membership cannunity. Flexible to be used by music, poetry, minitheatre, and educational health displays
Creatively opening up to the cannunity, inviting paticipation and integration.


REQUIREMENT RESPONSE FOR INDIVIDUAL CREATIVITY AREA
SPACE:
600 S.F.
FURNISHINGS AND SERVICES:
Counters
Tables
Easels
Sinks
Storage
Display area
MATERIALS AND FINISHES:
Basic white and brown finish
Durable
Cleanable
Exposed structure
LIGHTING:
Views
Natural lighting
Interesting lighting variations
ACOUSTICAL:
Moderate noise level People are generally quiet
Noise does not bother as much as other work/educational areas
ELECTRICAL: 110 V.
HVAC:
Good ventilation required


AREA: VISUAL CREATIVITY
GOAL/FESPONSE MATRIX
PARTICIPANTS:
GOALS PROGRAM RESPONSE
Therapeutic Objectives I Conceptual I Response 1 1 I Activity I Response ! I Interior 1 Response I 1 Architectural 1 Response !
ORGANIZING 1 sufficient 1getting the 1 creative |an organized
orienting 1organization I materials out +1 production Iplace with
assessing lean be |in the right 1 places, such as I proper
I assessed 1 1 1 1 1 1 1 1 1place 1 1 1 1 1 1 1 1 Ieasesl, 1 drawing boards, Iparallel bars. 1 1 1 1 1 1 1 orientation Ifor visual I examinations ; 1 a place to 1 critique. 1 1 1 1
INDIVIDUALIZING I Choices as to 1 Continuous IIndividual I The design
empathizing 1 what, why, + 1 series of Iplaces with 1 should
ccrtmunicating |hcw of 1 individual 1 individual I speak
1 creative I choices in 1materials + I clearly to
1 expression 1visually 1 sense of I individuality
lean be I creative I individuality. land visual
1 examined for 1 ccxitent, I expressiveness 1 ccniTTunication. 1 1 1 enterprise. 1 1 1 1 1 1 1 1 1 1 1 1 creativity. 1 1 1 1
ENERGIZING |CREATION OF I CREATIVE I DYNAMIC IAN ENERGETIC
healing I CREATIVE 1 ACTIVITIES. [FUNCTIONAL IAS WELL AS
creating I PRODUCTS OUT 1 IINTERPLAY I SIGNIFYING
I THERE TO BE (APPRECIATED, I FOUND IMEANINGFUL + |CHERISHED IS |AN ENERGIZING 1 1 1 1 1 1 I BElWEEN THE I PLACES OF | CREATION 1 1 1 I AND I SIGNIFICANT I ARCHITECTURAL I DESIGN. 1 1
I FEATURE. 1 1 1 1 1 1
PERFORMANCE RESPONSE 1 1 ADJACENCY/POIM TENDENCY RESPONSE
easels views 1 1 1
I 1 VISUAL
1 1 CFEAT. gallery
dark desks 1 1
roan ! 1
1 1 group
1 1 1 creat.
A rather free, freely aranagable space 1 1 1 Need views of outside with people,
i c *i rv^i firM* arfi cf in -FYcu2w^/^im I lan^cnano ^oeirme 4-r^ clrafrV>


REQUIREMENT RESPONSE EXDR GROUP CREATIVITY AREA
SPACE:
1,000 S.F.
FURNISHINGS AND SERVICES:
Stage area Audience area Seating
MATERIALS AND FINISHES:
Comfortable
Durable
LIGHTING:
Flourescent background Special lighting
ACOUSTICAL:
Audience acoustics
People an stage must be able to project. Audience noises must be softened.
ELECTRICAL:
Sufficient for special lighing.
HVAC:
Must be comfortable heated, cooled and ventilated for audience comfort and ability to attend to the productions.


AREA: GROUP CREATIVITY
GOAL/ RESPONSE MATRIX
PARTICIPANTS: MEMBERS, PTS., LEADERS
GOALS
PROGRAM RESPONSE
Therapeutic Objectives I Conceptual I Response 1 1 Activity Response 1 I Interior Response 1 I Architectural Response 1
ORGANIZING orienting assessing Iorganized I enough but Inot rigid; I clarity and Iorientation |of participants and 1 observers Imust be clear 1 1 1 I directors, 1 directing; Iparticipants, I participating; Iobservers, lobserving. 1 1 1 1 1 1 jorganization ofI tripartite j separations 1 functional Ibetween 1differentia-I directors, Ition Iparticipants + I responded to Iobservers Isignifigantly Ipaid attention.I and | dynamically. 1 I 1 1 1 1 1 1
INDIVIDUALIZING I IMPORTANT TO I THEATRICS AND | INDIVIDUAL I VERY
empathizing lACT OUT SELF I OTHER GROUP I SIGNIFICANT I DYNAMICALLY
canmjnicating 1AND OTHERS IN I CREATIVE I PLACES AND [INDIVIDUAL
1ORDER TO jPROCESSES Irocm TO j SPACE WITH
|BECOME 1 WHICH ARE I CREATIVELY | COHERENT,
IEMPATHIC WITH j BEING DIRECTED I DEFINE OWN | DIFFERENT
Ithe WAY MAN 1 BY A CREATIVE |SPACE AS IIATED +
IIS AND YOU I PERSON WHO IS I INDIVIDUAL + IHARMONIOUS
ICAN BE AND I PROFESSIONALLY 1 AS GROUP; | INTEGRATION.
1 COMMUNICATE 1AWARE OF I ALL VIEWABLE, 1
j SELF TO I HEALTH GOALS + I COHERENT +
lOTHERS. I POSSIBILITIES. j SIGNIGIGANT. 1
ENERGIZING 1CREATIVE GROUP]GROUP Iroom to split Ian
healing I ACTIVITIES I ACTIVITIES lOFF AND COME | ENERGETIC
creating j CAN BE I EMPHASIZING Itogether IN Idesicn that
I EXTREMELY I INDIVIDUAL + I UNIQUE MANNERS lADDS TOO
j ENERGIZING; 1 GROUP POSSI- I DEVELOPING THE |AND
ICARE MUST BE 1BILITIES IN j ENERZATION OF jCOMMUNICATES
Ipaid to attend1 context OF I DIFFERENT IWITH,
Ito individual I HEALTH j POSSIBILITIES j WITHOUT
Ifall out and lENERZATION + lOF BEING. IBECOMING
Inked for 1 attention TO I j PRIME +
I MODULATION. IMODULATION. I IDETRACTING.
PERFORMANCE RESPONSE ; ADJACENCY/FORM TENDENCY RESPONSE 1
preparing directing participating 1 1 I CREATIVE TRIPATITE FORM WITH I CREATIVE ENTRANCING AND EXITING. 1 1 1
observing 1 1
FOCUS ON ROCM AND VIEWS AND ACCESS IN CONTEXT OF CREATIVE TRIPARTITE FORM. 1 | IN THE CREATIVE END, NEAR THE 1 MAIN ENTRANCE, DYNAMICALLY PARTICIPATING WITH THE ENTRANCE AND POTEN-ITIAL AUDIENCE. ALSO SEPARATE FROM 1 POTENTIAL AUDIENCES AND SECUREABLE. 1


REQUIREMENT RESPONSE FOR HEALTH AND TREATMENT RECEPTION AREAS
SPACE:
250 S.F. each
FURNISHINGS AND SERVICES: Counter
Telephone-intercan
Stools
Desk
Soft chairs Pay telephone
MATERIALS AND FINISHES:
Natural
Durable
LIGHTING:
Natural
Views
ACOUSTICAL:
Must allow some privacy of communication between users and providers, especially in relation to treatment area.
ELECTRICAL:
no v.
HVAC:
Ccmfortable to sit
Could be good passive solar area


vjut\u/ i
AREA: RECEPTION FOR TREATMENT CENTER PARTICIPANTS: RECEPTIONISTS + OTHERS
GOALS
W
PROGRAM RESPONSE
Therapeutic
Objectives
ORGANIZING
orienting
assessing
Conceptual
Response
PROPER ASSESSMENT INDICATED FOR PROPERLY ORIENTING PEOPLE IN AN ORGANIZING DIRECTION.
Activity
Response
.CONVERSATION.
.VIEWING.
.DIRECTING.
Interior
Response
AN ORGANIZED PLACE TO ASSESS THE SITUATION AND THE PERSON,
FOLLOWED BY
CLEAR VIEWS OF
APPROPRIATE
ALTERNATIVE
TREATMENT
PLACES.
Architectural
Response
A PLrtCE CENTRAL TO A NUMBER OF ALTERNATIVE TREATMENT PLACES WITH CLEAR VIEWS OF ALTERNATIVES, HAVING SIGNIFIGANTLY DIFFERENT FORMS FOR ID
INDIVIDUALIZING
empathizing
ccrrmunicating
COMMUNICATION I OF INDIVIDUAL RESPONSE TO INDIVIDUAL NEEDS IS CRITICAL BECAUSE THIS IS INTRODUCTION TO WHOLE SENSE OF USER TREATMENT FOR THE USER.
I .GREETING.
I .INDIVIDUAL ASSESSING AND DIRECTING, BASED ON EMPATHIC RESPONSE TO INDIVIDUAL'S IMMEDIATE AND DEVELOPMENTAL NEEDS.
A PLACE TO RELATE CN A PRIVATE ONE TO ONE BASIS WITH A FEELING OF THE IMPORTANCE OF THE SELF AS AN INDIVIDUAL.
HIGHLIGHTING OF A PLACE THAT IS A BEGINNING TO A HEALTH-PROMOTING TREATMENT PROCESS IN CONTEXT OF POSITIVE CONSIDERATION
ENERGIZING
healing
creating
CRITICAL TO GIVE SENSE THIS IS BEGINNING OF HEALTHY PROCESS OF ENERZATIQN + MODULATION OF NEW CREATIVE ENERGIES.
BEGINNING SPOT FOR PROCESS;
A DIRECTED PLAN INTO HEALTH + CREATIVITY THRU APPROPRIATE DIAGNOSTIC ASSESSMENT OF HEALTH AND PATHOLOGY.
WARM AND BRIGHT COMMUNICATING SOLUTIONS THAT ENERGIZE AND HEAL, PROVIDING BASIS FOR CREATIVE CHANGE.
A COHERENT
SENSE OF
APPROPRIATE
CHOICES AND
ALTENATTVES,
LEADING TO
POSITIVE,
ENERGIZING
SOLUTIONS
MODULATED BY
CHOICE.
PERFORMANCE RESPONSE
treatment services

public, observable by recept.
\
lobby
(carmunication sys) RECEPTION FOR TREATMENT
V
^ ^privacy for one to one I 1 conversation
/
"ADJACENCY/ FORM TENDENCY RESPONSE
health
recep-
tion
The treatment reception must be identifiable frcm the lobby with its own unobtrusive but signifigant design form.


rvc/^uxrujriciMi nijoru.'iOE, run. ujddi atu£v\
SPACE:
200 S.F.
FURNISHINGS AND SERVICES:
Soft chairs Coffee table Couch End tables
MATERIALS AND FINISHES:
Natural
Durable
LIGHTING:
Vies
Natural
ACOUSTICAL:
Relatively quiet, making use of background noise of group
ELECTRICAL:
110 V.
HVAC:
Comfortable for sitting
(


AREA: LOBBY
PARTICIPANTS: OUT-PATIENTS
GOALS PROGRAM RESPONSE
Therapeutic I Conceptual 1 Activity I Interior I Architectural
Objectives Response 1 Response Response Response 1
ORGANIZING ]GETTING READY ! SITTING ISFATING IN 1 OOHRENT,
orienting IFOR THE 1 THINKING. 1 LOOSE, 1 ORGANIZED,
assessing I SESSION LEADS 1 ICOHERENT, 1 MEANINGFUL
Ito construc- 1 I NON-RIGID |SPACE.
ITIVE SELF + i I ORGANIZATION. 1
lOTHER 1 1 1
IASSESSMENT. 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
INDIVIDUALIZING 1 choices of 1 thinking and 1 choices of 1 individual
empathizing 1places and 1occasional 1 spaces 1 places within
ccmunicating Ihow to 1 casual 1 conducive to 1 context of
1 prepare for 1 conversation 1 different la whole
Ithe session 1 1 mental 1
land best 1 I preparation 1
1 camrunicate 1 1 styles; 1
1 inner self. 1 1 1 1 1 1 1 1 1 1 reading 1 1 1 1 1 1 1 1 1
ENERGIZING llhe mental 1 Thinking and 1 Spaces to be 1 Creative
healing I preparation 1 relaxing. 1 oneself and 1 self-
creating 1 in the contextI 1 prepare. 1 assessment
lof restful, 1 1 1 encouraged +
1 healing 1 1 1 allowed;
I setting allow 1 1 I unique
I for creative 1 1 1 solutions
1 energizing 1 1 1 emphasized
1self-reali- 1 1 las
1zations. 1 1 1 1 1 1 energizing. 1
PERFORMANCE RESPONSE ADJACENCY/FORM TENDENCY RESPONSE 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1


REQUIREMENT RESPONSE FOR INDIVIDUAL OFFICES
SPACE: 110 S.F.
FURNISHINGS AND SERVICES:
Desk and chair File cabinets 2 soft chairs Book shelves
MATRIALS AND FINISHES:
Natural Dorable x
LIGHT:
Natural
View
ACOUSTICAL:
Must be acoustically tight by insulation and isolation
ELECTRICAL:
no v.
HVAC:
Must be camfortalbe to work in while sitting


AREA: INDIVIDUAL THERAPY OFFICE
PARTICIPANTS: THERAPIST AND PATIENT
GOALS PROGRAM RESPONSE
Therapeutic Objectives 1 Conceptual 1 Response 1 I Activity Response I Interior 1 Response 1 1 Architectural Response 1
ORGANIZING i REALITY iEST- i THINKING, | ORiiMiM i 7.r.i duI i ORunNizEu BUI
orienting IlNG THROUGH jFEELING, INOT RIGID. Inot rigid.
assessing I ORIENTATION + 1 CONVERSING. 1 1
|ASSESSMENT IS 1 1
1 CRITICAL 1 1
I FEATURE OF 1 1
Itherapy. 1 1
1 OSCILLATIONS 1 1
IHETWEEN 1 1
1 COGNITIVE + 1 1
1 empathic. 1 1 1 1 1
INDIVIDUALIZING I ALLOWANCE FOR [CONVERSATION 1 INDIVIDUAL 1 INTIMATE AND
empathizing Iand apprecia- IlN EMPATHIC 1PLACES FOR 1 EMOTIONAL
canuunicating ITION OF Iand 1 INDIVIDUAL 1 BUT NOT
1 INDIVIDUALITY. I CX2LFR0NTATI0NAL I THERAPEUTIC 1 INTIMATELY
1 OSCILLATIONS 1 MODES. 1 RESPONSES. |NOR
Ibeiween 1 1 EMOTIONALLY
1 COGNITIVE + 1 1 INTIMIDATING.
1 1 EMPATHIC. 1 jIDENTIFIED AS
ICOMRADERY, 1 1 COGNITIVE +
1 NEUTRALITY, 1 1 EMPATHIC.
Iand confrgn- 1 1
ITATION. 1 1
ENERGIZING | MOVEMENT 1 PROFESSIONAL 1 COMFORTABLE 1 COMFORTABLE
healing 1 TOWARDS TWO I OSCILLATIONS Iand speaking Iand speaking
creating 1 SEPARATE, 1 BETWEEN ITO THE ITO THE
1 DISTINCT 1 COGNITIVE 1 HEALING AND 1 HEALING AND
I COMMUNICATING Iand empathic 1 CREATIVE 1 CREATIVE
1 INDIVIDUALS 1 MOVEMENTS + 1 DEVELOPMENT OF |DEVELOPMENT
1 ENERGIZES, IVERBAL 1 POTENTIAL 1 OF POTENTIAL
I ALLOWING 1 RESPONSES IN 1 ENERGIES. 1 ENERGIES.
1 MENTAL + 1 CONTEXT OF 1 1
1 INDIVIDUAL 1 SITTING. 1 . 1
1 DEVELOPMENT. 1 1
PERFORMANCE RESPONSE
ADJACENCY/PORM TENDENCY RESPONSE


I
REQUIREMENT RESPONSE EXDR FAMILY THERAPY AREAS
SPACE:
150 SF
FURNISHINGS AND SERVICES:
Soft chairs End tables Play table
MATERIALS AND FINISHES:
Natural
LIGHT:
View important Natural light Incandescent task lighting
ACOUSTICAL:
Needs to be quiet through acoustical insulation Double door
Location should be acoustically hidden
ELECTRICAL:
110V
HVAC:
Relates to main system
/
r

(


REQUIREMENT RESPONSE FOR GROUP THERAPY AREA
SPACE:
200 S.F.
FURNISHINGS AND SERVICES:
Soft chairs Couche End tables
MATERIALS AND FINISHES: Natural
LIGHT:
View important Natural light Incandescent task lighting
ACOUSTICAL:
Needs to be quiet through acoustical insulation Double door
Location should be acoustically "hidden"
ELECTRICAL:
110 V.
HVAC:
Need to be comfortable while sitting
(


AREA: FAMILY THERAPY
PARTICIPANTS: PT.,FAMILIES,THERAPISTS
GOALS
PROGRAM RESPONSE
Therapeutic Objectives I Conceptual I Response i 1 Activity Response 1 1 Interior Response 1 I Architectural Response 1
ORGANIZING (Family organ!- -IFamily allowed | A family area |A family
orienting Ization should |to choose Iwith 1 place,
assessing |be apparent 1 places that 1 differentiated 1 normalized +
I to reduce Iwill reflect I possibilities I humanized
1 anxiety and 1 itself, its lof organization!oriented to
I provide I orientation + |+ orientation, I health and
1material for 1 organization Iwith a clear 1 psychological
1 analysis, |in the service Ibut unobtru- [assessment,
1 diagnosis, lof cohesiveness Isive place for 1 always in
land basis for Icanfort and 1 therapist 1 context of
1 change 1 non-threatening|identification 1"we are
1 interpretationI assessment. 1+ control. j family"
INDIVIDUALIZING I THE FAMILY Ithe FAMILY 1 INDIVIDUAL IREADS AS A
empathizing IORGANIZATION I INDIVIDUALLY Ifamily PLACES 1 NORMAL
camiunicating I CAN BE j AND AS A GROUP Ifor COMFORT, I FAMILY
1 CONSIDERED AS 1 RESPONDS TO jCLARITY + I STRUGGLING AS
IA BASIS FOR Ithe issues at 1 COCMUNICATION 1 FAMILIES DO
lEMPATHIC I HAND AND MAKES j IN CONTEXT OF 1 TO ALLOW
1 UNDERSTANDING 1 ITSELF AVAILA- 1 EMPATHY AND IINDIVIDUALI-
lOF EACH |BI£ TO PROFES- lEMPATHIC 1ZATION OF
I INDIVIDUAL'S ISIONAL, INDIVI- IINDIVIDUALIZA- jITS MEMBERS.
1 POSITION + |DUALIZED INTER- ITION; AIDED BY 1
1 DEVELOPMENT Iventions. I THERAPIST 1
I POTENTIAL. 1 I LEADERSHIP. 1
ENERGIZING 1 PATHOLOGIC lOPEN lOPENESS TO I OPTIONS FOR
healing I ENERGY SYSTEMS IDISCUSSSION OF I CCtMUNICATION I ENERGETIC
creating |NEED TO BE 1 WAY IT IS I ABOUT THE 1 CHANGES IN
1EVALUATED IN I AND THE WAY I FAMILY AND 1 PATTERNS OF
1TERMS OF COST, Ieach WANTS IT j INDIVIDUAL 1 RELATING CAN
I INERTIA, ITO BE SO THAT Ienergy AND 1 BE CGM4UNI-
1 REASONS IN |AN ENERGIZING 1 ESTEEM ISSUES ICATED IN THE
I ORDER TO ALLOW| PLAN FOR HEALTHlWITH ROOM PORE 1 DESIGN; AN
I HEALTHY MODES |AND CREATIVITY 1 HEALTH BASED |ESTEEMED AND
I AND MODULA- 1 CAN EVOLVE. jCHANGES TO BE | ESTEEMING
Itions TO BE. 1 1 tried OUT. 1 DESIGN.
PERFORMANCE RESPONSE
ADJACENCY/FORM TENDENCY RESPONSE