Anxiety Disorders are the most common mental illness in the United States. While nearly 18% of Americans will experience an anxiety disorder within any given year, only one-third of those will receive treatment. Current mental health treatment facilities must navigate opposing needs for both awareness and access as well as privacy and respite. This thesis explores the ability of architecture to influence emotion and mediate between opposites through the design of a community anxiety treatment center in the heart of Old Town Alexandria, VA. The building combines community services, outpatient treatment, and in-patient treatment under one roof. Rather than a treatment facility that is removed from the city, the center is placed within an urban community, creating increased awareness and access to treatment as well as an expanded care journey through community connectivity. The building itself mediates between urban and therapeutic space, sequentially removing patients from urban stimuli as they move through increasing levels of treatment. As patients recover and begin to return to the city itself, the building gradually reintroduces them to the urban environment. Post-treatment, the location in Alexandria, VA allows patients to continue recovery through community support groups and activities. / Master of Architecture

Can the built environment positively influence the treatment of an eating disorder? Does the built environment play a role in the quality of care, the rehabilitation process and the lasting affects of treatment in eating disorders and if so, what role does it play? What are the important parameters to consider in designing such a space? Currently there are few facilities designed specifically for the treatment of this disorder. Of those facilities, there is a lack of research regarding the effects of the built environment. Therefore, the process of answering these questions must begin by assessing parameters in architectural precedents that have a strong, therapeutic environment. After studying several therapeutic environments, certain parameters emerged as common elements in each project. Therefore, the following parameters were chosen and used to systematize research: spatial triad (group, therapeutic, and solitude spaces), connection between interior and exterior, natural light, and sensory qualities (acoustic intimacy, space and scent, shape and touch, skeleton and muscle). While several architectural precedents exist; La Tourette, a monastery near Lyon, France designed by architect Le Corbusier, became the most significant structure studied. Research of this monastery included a two night stay with complete access to the facility. Spending full days in the monastery provided an opportunity to absorb the therapeutic qualities of the space. After analyzing common parameters across several chosen architectural precedents, a design solution was developed as a means to check the analysis. The solution involved re-purposing a warehouse building in an urban setting. Spatial connections and current treatment research drove the conceptual process which included diagramming, model building, and sketching. Key criteria for spatial development involved privacy, security, and circulation. The final design incorporated each precedent, creating an interior type that addresses the specific needs of a residential eating disorder clinic.

Ce travail de recherche en Arts appliqués questionne la notion de soin(s) dans la pratique du design en milieu hospitalier. Nous faisons l’hypothèse qu’un environnement (objets, espaces, services) qualifié et adapté aux usages de soin via la conception en design, peut participer à la prise en charge globale de l’individu et avoir un impact positif sur sa santé, physique et psychique. Cette recherche, alliant réflexion théorique et pratique, nous a permis de redéfinir les contours d’une demande initialement formulée par le CHU de Toulouse, à savoir la conception d’un Oratoire polyculte au sein de l’URM (Hôpital Purpan). À l’issue d’études croisant divers champs disciplinaires nous avons pu redéfinir des besoins et proposer un nouveau type de lieu : L’Espace de ressourcement – dont la conception et la réalisation font l’objet de la partie pratique de ce doctorat. Dans le texte de la thèse, nous abordons dans un premier temps les implications de la notion de soin dans la société contemporaine et au sein de l’institution curative. Dans cette perspective, nous montrons comment l’intention de soin est intrinsèquement liée à l’approche même du design. Les second et troisième temps sont consacrés à la conception et la réalisation de L’Espace de ressourcement (dans ses dimensions plastique, symbolique, technique), puis à sa réception. Ce projet de recherche tend à démontrer que l’entrée de l’art et du design en milieu hospitalier peut réhabiliter les dimensions esthétiques et sensibles du rapport à ce lieu de vie. / This research work questions the notion of care in the practice of design of a hospital environment. We assume that a responsive environment (objects, spaces, services) recipient of health care through design conception can participate in the overall care of the individual and have a positive impact on their health, both physical and psychical. This research work, combining a theoretical and a practical approach, has allowed us to redefine the whole issue of a request originally issued by the Toulouse hospital, namely designing a multifaith space in the architectural building URM (Purpan Hospital). Following studies crossing various disciplines we were able to redefine needs and propose a new type of venue: L’Espace de ressourcement whose design and the execution became the practical part of this doctorate work. In the text of the thesis, we address initially the implications of the concept of care in contemporary society and in the heart ot the curative institution. In this perspective, we show how the intent of a care is intrinsically linked to the same design approach. The second and the third part is devoted to the design and implementation of the L’Espace de ressourcement (in its plastic, symbolic and technical dimensions) until its receipt. This research tries to prove that the bringing in the art and the hospital design can restore the aesthetic and sensitive dimensions compared to this type of place.

Extensive questions have been asked regarding the factors that influence psychotherapeutic effectiveness. Past research has addressed the methods, techniques, as well as the client and therapist variables which potentially influence psychotherapeutic effectiveness. The majority of the research indicates that the therapeutic relationship and other contextual variables exert the greatest influence on psychotherapy successes. This implicates the broader social context in psychotherapy processes. Language appears to be one of the primary contextual factors influencing psychotherapeutic processes and is also embedded in social discourse. Society dominant discourses appear to be based on deficit beliefs toward psychotherapy and emotional functioning. The more relevant issue concerning psychotherapeutic effectiveness therefore appears to be society's dominant discourses affecting the profession. Collaborative social discourses embracing psychology are seldom integrated into mainstream public discourse. A post-modern, ecosystemic perspective is applied to these concerns, proposing a collaborative approach to social discourse, psychotherapy and research. This utilizes reflective, multi-dimensional, respectful and nonjudgmental values, reflecting the shift in social paradigms from the Industrial Age to the Knowledge Age. This shift recognizes that cultural, social and language variables appear to have a greater impact on psychotherapeutic effectiveness than most therapeutic techniques or interventions. These discourses are explored and recommendations are made in an attempt to align psychotherapy with a shifting social paradigm. This alignment could enhance psychotherapeutic effectiveness and the general understanding of psychotherapy. / Psychology / D.Litt. et Phil. (Psychology)

Extensive questions have been asked regarding the factors that influence psychotherapeutic effectiveness. Past research has addressed the methods, techniques, as well as the client and therapist variables which potentially influence psychotherapeutic effectiveness. The majority of the research indicates that the therapeutic relationship and other contextual variables exert the greatest influence on psychotherapy successes. This implicates the broader social context in psychotherapy processes. Language appears to be one of the primary contextual factors influencing psychotherapeutic processes and is also embedded in social discourse. Society dominant discourses appear to be based on deficit beliefs toward psychotherapy and emotional functioning. The more relevant issue concerning psychotherapeutic effectiveness therefore appears to be society's dominant discourses affecting the profession. Collaborative social discourses embracing psychology are seldom integrated into mainstream public discourse. A post-modern, ecosystemic perspective is applied to these concerns, proposing a collaborative approach to social discourse, psychotherapy and research. This utilizes reflective, multi-dimensional, respectful and nonjudgmental values, reflecting the shift in social paradigms from the Industrial Age to the Knowledge Age. This shift recognizes that cultural, social and language variables appear to have a greater impact on psychotherapeutic effectiveness than most therapeutic techniques or interventions. These discourses are explored and recommendations are made in an attempt to align psychotherapy with a shifting social paradigm. This alignment could enhance psychotherapeutic effectiveness and the general understanding of psychotherapy. / Psychology / D.Litt. et Phil. (Psychology)

Le mal de ventre chez les enfants est un lieu de métissage et de créolisation traversé par des dimensions sociales et culturelles. Il est construit collectivement au sein des familles nucléaires avec leurs parcours migratoires et leurs souffrances. Par le biais d’entretiens menés auprès de familles haïtiennes vivant à Montréal, nous documentons les trajectoires de ces douleurs, dans lesquelles les perceptions, les explications et les moyens mis en œuvre pour les soulager interagissent d’une manière dynamique. En général, les enfants perçoivent leurs maux de ventre comme une expérience insaisissable, diffuse et ayant un impact sur leur vie sociale, tout en étant tolérés par les enfants et par les mères. Ces familles n’ont pas reçu de diagnostic médical et elles attribuent à ces maux des explications provisoires en constante recomposition. En général, elles ont recours à différentes méthodes de prise en charge des maux de ventre. L’espace familial, les activités réalisées au sein des églises et la médecine officielle sont des espaces thérapeutiques privilégiés. / Belly-stomachaches in children are a space of hybridity and creolization, affected by social and cultural dimensions. These aches are collectively constructed within nuclear families, with their migratory histories and their sufferings. Having interviewed Haitian families living in Montreal, we documented the illness trajectories, the perceptions, explanations and means of relieving the aches, which all interact in a dynamic mode. Generally speaking, the children perceive their belly-stomachaches as an irregular experience that has an impact on their social life, although tolerated by the children and theirs mothers. Families have not received a medical diagnosis and give temporary, changing explanations to the aches, in a constant reformulation. In general, families will use different methods to deal with belly and stomach aches. The family space, church activities, and official medicine are privileged therapeutic spaces.

Le mal de ventre chez les enfants est un lieu de métissage et de créolisation traversé par des dimensions sociales et culturelles. Il est construit collectivement au sein des familles nucléaires avec leurs parcours migratoires et leurs souffrances. Par le biais d’entretiens menés auprès de familles haïtiennes vivant à Montréal, nous documentons les trajectoires de ces douleurs, dans lesquelles les perceptions, les explications et les moyens mis en œuvre pour les soulager interagissent d’une manière dynamique. En général, les enfants perçoivent leurs maux de ventre comme une expérience insaisissable, diffuse et ayant un impact sur leur vie sociale, tout en étant tolérés par les enfants et par les mères. Ces familles n’ont pas reçu de diagnostic médical et elles attribuent à ces maux des explications provisoires en constante recomposition. En général, elles ont recours à différentes méthodes de prise en charge des maux de ventre. L’espace familial, les activités réalisées au sein des églises et la médecine officielle sont des espaces thérapeutiques privilégiés. / Belly-stomachaches in children are a space of hybridity and creolization, affected by social and cultural dimensions. These aches are collectively constructed within nuclear families, with their migratory histories and their sufferings. Having interviewed Haitian families living in Montreal, we documented the illness trajectories, the perceptions, explanations and means of relieving the aches, which all interact in a dynamic mode. Generally speaking, the children perceive their belly-stomachaches as an irregular experience that has an impact on their social life, although tolerated by the children and theirs mothers. Families have not received a medical diagnosis and give temporary, changing explanations to the aches, in a constant reformulation. In general, families will use different methods to deal with belly and stomach aches. The family space, church activities, and official medicine are privileged therapeutic spaces.