Design for Recovery + Rehabilitation
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Haley Twillman | Senior Thesis | Fall 2018
An Addiction Treatment Center in New Orleans.
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Content 04
Overview
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Precedence
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Site
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Program
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Research
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Works Cited
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Overview
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Problem Statement Located in New Orleans, this three story 17,000 sq. ft. Addiction Treatment and Rehabilitation center that is owned and operated by a U.S. based healthcare company. According to the National Survey on Drug Use and Health (NSDUH), 21.5 million American adults battled a substance use disorder in the past year. With the country’s substance abuse problem, there is an increasing need for facilities that can give patients comprehensive care and the tools needed to live healthier, drug-free lives. What makes this facility unique is the incorporation of biomimetic strategies into the spaces in order to encourage healthy decision making.
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Thesis Statement The implementation of biomimetic strategies will impact human behavior and encourage healthier decision making. The deployment of sustainable materials and technologies will create a healing environment while reducing total operating costs.
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Goals + Objectives
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GOAL Design a non-stressful healthcare environment.
OBJECTIVES 1. Incorporate color to avoid creating a bland, “institutional� interior. 2. Reduce visual and audible noise.
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GOAL Create a space that is sustainable.
OBJECTIVES 1. Utilize locally and sustainably-sourced materials. 2. Implement the WELL Building Standard. 3. Select materials that have a long life-span and can endure heavy usage.
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GOAL Use wayfinding to establish a cohesive branding package.
OBJECTIVES 1. Apply a consistent color palette throughout the space. 2. Place sinage that is easy to understand. 3. Ensure color and sinage is aesthetically pleasing.
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GOAL Create a sense of community for both residents and visiting patients.
OBJECTIVES 1. Reduce size of private spaces in order to increase the size of common 1. spaces. 2. Provide common spaces that can be used by all. 3. Provide a diverse range of common spaces to ensure patient comfort.
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GOAL Encourage healthy decision-making within the space.
OBJECTIVES 1. Create inspiring common and excercize spaces. 2. Create a plethora of open spaces that can be viewed throughout the entirity of the 2. facility.
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Precedence
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Case Study #1 Project: Sister Margaret Smith Addictions Treatment Center Architects: Kuch Stephenson Gibson Malo + Montgomery Sisam Architects Location: Thunder Bay, ON, Canada Area: 52,000 sq ft Project Year: 2009 Project Type: Healthcare
The Sister Margaret Smith Addictions Treatment Center provides residential and non-residential services for the treatment of addictions including drug and alcohol, gambling and eating disorders. The Center has been designed to support the Core Values of the St. Joseph’s Care Group which are passionate and holistic care, dignity and respect, faith based care, inclusiveness, truthfulness and trust. Inspired by these values, the design creates a clear sequence of spaces which offer a variety of relationships to the exterior landscape. The healing quality of natural light has been a prime consideration throughout the design. The organizing spine of the building, called the Hall of Recovery, is where clients are introduced and oriented to this dignified, calm and welcoming setting. The building has been arranged around two landscaped courts: one for residential clients and the other for non-residential clients. Both courts provide a safe environment and are used for various therapeutic programs.
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Case Study #2 Project: Rehabilitation Centre Groot Klimmendaal Architects: Architectenbureau Koen van Velsen BV Location: The Netherlands Area: 14,000 sq m Project Year: 2011 Project Type: Healthcare//Rehab
The Rehabilitation Centre Groot Klimmendaal designed by Koen van Velsen gradually fans out towards the top and cantilevers out over the surrounding terrain. Despite its size, the brown-golden anodized aluminum facade allows the building to blend in with its natural surroundings. Full height glazing along the central space connecting the various different internal elements of the building creates continuity between interior and exterior. The surrounding nature has a strong visual and tangible presence everywhere in the building. The double-height ground floor at entrance level facilitates the special elements of the program such as a sports facility, fitness, swimming pool, restaurant and theatre. Not only patients but also family members and members of the local community (schools, theatre groups etc) use these facilities on a regular basis. As a result, both patient and building are placed at the center of the community. The care concept is based on the idea that a positive and stimulating environment increases the well-being of patients and has a beneficial effect on their revalidation process. The design ambition was not to create a center with the appearance of a health building but a building as a part of its surroundings and the community.
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Case Study #3 Project: Therapeutic Community Sananim Architects: Sporadical Location: 398 11 Herman, Czech Republic Area: 990 sq m Project Year: 2016 Project Type: Healthcare//Therapy//Rehab
Sananim is one of the largest non-governmental organizations in the Czech Republic that provides services in the area of prevention, treatment and re-socialization of non-alcoholic drug addictions. Therapeutic community is a facility for long-term, in-house treatment and social rehabilitation of approximately 20 clients. The treatment consists of four phases that differ in the level of requirements, responsibility, and competences. The treatment includes group therapy, individual counselling, work therapy, endurance and sport programs, and leisure activities. Some of the rooms have special importance to the Community. The Community Room, used for group therapy, is the only space that protrudes out of the farmstead circumference. The meaning of it is that the therapy is a special occasion. All troubles and memories are blown away to the orchard via sliding glass walls. The symbol of a circle is formed of simple lights on the ceiling or arrangement of chairs. The glass corridor connects the courtyard to all spaces of the community. The Club is a spacious common room built inside the barn. It is the spot where clients and therapists meet informally. The clients alone prepare the food and cook. Daily meal is an important ritual. The dining room is set in the oldest corner of the farm, where the remains of old stone walls are visible. A small stone portal was restored to highlight the entrance to this room. 18
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Site
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New Orleans “New Orleans is offbeat, unusual, loud and proud.” Situated on a bend of the Mississippi River 100 miles from its mouth, New Orleans has been the chief city of Louisiana and the Gulf of Mexico’s busiest northern port since the early 1700s. Founded by the French, ruled for 40 years by the Spanish and bought by the United States in the 1803 Louisiana Purchase, New Orleans is known for its distinct Creole culture and vibrant history. A city in a class of its own, New Orleans offers endless opportunities for fun and entertainment, casting a global allure that brings more than 10 million visitors to the city a year.
Location Country: United States State: Louisiana County: Orleans City: New Orleans Zip Code: 70113 Longitude: -90.0715 Latitude: 29.9511 Altitude: - Elevation: 3 feet
Quick Facts Population: 393,292 Median Household Income: $37,488 Poverty Rate: 26.2% Total Land Area: 169.42 sq miles High School Graduates: 85.7% College Graduates: 36.2% 22
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Map 3525 Bienville St New Orleans, LA 70119
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Building Context
Column Grid
Anticipated Circulation
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Program
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Adjacencies Adjacency Considerations SQ FT Needs Public Access Daylight/View Privacy Plumbing Equipment For: Addiction Treatment Facility 1. Entry/Lobby 2. Kitchen 3. Dining Room 4. Gym 5. Pool 6. Group Fitness Room 7. Group Therapy Rooms 8. Private Treatment Room 9. Conference Room - Large 10. Conference Room - Medium 11. Locker Rooms 12. Living Room/Lounge 13. Private Stay Room 14. Restrooms 15. Janitor's Closet 16. Storage 17. Utility Rooms
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500 500 400 1000 1000 400 150 150 300 200 400 200 150 280 75 100 200
H M M H M H M L H M M M L H/M/L N N N
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Considerations Traffic Hub Commercial Kitchen Common Space Durable Materials Water Natural Light Privacy Common Space Natural Light Privacy Privacy Privacy Noise Control
ADJACENCY MATRIX
ADDICTION TREATMENT FACILITY | NEW ORLEANS, LA
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Plan Prototypes
Private Treatment// Consult Room
Private Residential Stay Room
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Private Office// Consult Room
Flexible Conference Room
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Plan Prototypes
Traditional Conference Room
Classroom
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Common Lounge// Breakout Space
Common Lounge Space
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Code The International Building Code (IBC) is a model building code developed by the International Code Council (ICC). It is widely adopted and utilized throughout the United States and even several outside countries. It is an essential tool to preserve public health and safety that provides safeguards from hazards associated with the built environment. It addresses design and installation of innovative materials that meet or exceed public health and safety goals.
Building Code in New Orleans Construction is regulated in accordance with the 2015 edition of the International Building Code, International Residential Code, International Mechanical Code, and International Fuel Gas Code. Electrical work is governed by the National Electrical Code.
Occupancy Classifications
Occupancy Factors
+ Assembly (A-2) (A-3) (A-5) + Business (B) + Educational (E) + Institutional (I-2) + Storage (S-1)
+ Storage 300 gross + Assembly - Concentrated ......................7 net - Unconcentrated .................15 net - Standing Space ...................5 net + Educational, Classroom ................20 net + Excercise Rooms .......................50 gross + Institutional - Inpatient Areas ............240 gross - Outpatient Areas ..........100 gross - Sleeping Areas .............120 gross + Kitchens .................................200 gross + Locker Rooms ...........................50 gross
Sprinklered Yes.
Required Exits A min. of 2 exits per floor are required. There are less than 500 people per floor.
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Minimum Egress Corridor Width Institutional (I-2): 96” Business (B): 44”
Door Size Requirements 32” - 48”
Fire Requirements
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Accessibility
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Research
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Color The importance of color in a healthcare environment goes beyond aesthetics. Is it possible to enhance the patient’s experience and potentially impact clinical outcomes by understanding how to apply color in healthcare settings? Recent neuroscientific research and studies of circadian rhythms demonstrate that the color spectrum of light directly influences human biological systems and health outcome. It has been suggested that color has a therapeutic effect, although few empirical observations exist.
Design Implications 1. Consider the needs of each specific patient population in the selection of color. 2. Skin color is a vital clinical cue. 3. Understand the physiological effects of color and psychological perception of color. 4. Consider religious or symbolic associations with color, including cultural taboos, oobias, and nationality, that may be relevant to that particular community. 5. Consider functional factors. 6. Understand how color affects the perception of space. 7. Think about practical applications of color psychology. 8. Consider aesthetics. 9. Address a facility’s motivation: Many interior design projects are about improving oothe image of an institution. 10. Consider maintenance: Maintenance is extremely important in healthcare and ooocolor plays a role in the perception of cleanliness. 11. Take into account life-span: Healthcare environments are very public spaces oooand get used 24/7. Materials must withstand a higher level of wear than most oooenvironments. 40
Materials Creating a healing environment requires paying attention to all that patients take into their bodies. The health effects from building materials reach farther than the occupants of the building, stretching into the broader community. Design decisions play out across the whole life cycle of the materials brought into hospitals, starting with the extraction of the raw materials and their manufacture into building materials and medical products. Plastics have been used to produce high-performance finishes and medical equipment, but at a cost to human health and the environment. Bio-based materials are desired because, if sustainably produced, they will be available for generations, unlike materials based upon the use of fossil fuels, which are rapidly depleting.
Recommendations First steps + Adopt purchasing policies that clearly state a preference for green materials that are oprotective of health and maintain the highest standards of patient care. + Incorporate green building material preferences into design goals early in capital oprojects. + Use the plastics spectrum as a guide when specifying plastic-based products. + Prefer polypropylene and polyethylene plastics that do not contain hazardous oadditives and sustainably-sourced bio-based materials. + Give preference to low VOC products. Next steps + Require suppliers to disclose chemical and material content of products. + Avoid materials that contain highly hazardous chemicals. + Prefer materials and products with high recycled content and end-of-life recycling oprograms. Fully engage + Partner with suppliers who manufacture and develop products using green materials. + Require suppliers to provide comprehensive hazard data on the chemicals contained in omaterials and products. 41
14 Patterns of Biophilic Design Biophilic design can reduce stress, enhance creativity and clarity of thought, improve our well-being and expedite healing; as the world population continues to urbanize, these qualities are ever more important. Theorists, research scientists, and design practitioners have been working for decades to define aspects of nature that most impact our satisfaction with the built environment. “14 Patterns of Biophilic Design� articulates the relationships between nature, human biology and the design of the built environment so that we may experience the human benefits of biophilia in our design applications. Biophilia in Context looks at the evolution of biophilic design in architecture and planning and presents a framework for relating the human biological science and nature. Design Considerations explores a sampling of factors (e.g., scale, climate, user demographics) that may influence biophilic design decisions to bring greater clarity to why some interventions are replicable and why others may not be. The Patterns lays out a series of tools for understanding design opportunities, including the roots of the science behind each pattern, then metrics, strategies and considerations for how to use each pattern. This paper moves from research on biophilic responses to design application as a way to effectively enhance health and well-being for individuals and society.
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1. Visual Connection with Nature. A view to elements of nature, living systems and natural processes. 2. Non-Visual Connection with Nature. Auditory, haptic, olfactory, or gustatory stimuli that engender a deliberate and positive reference to nature, living systems or natural processes. 3. Non-Rhythmic Sensory Stimuli. Stochastic and ephemeral connections with nature that may be analyzed statistically but may not be predicted precisely. 4. Thermal & Airflow Variability. Subtle changes in air temperature, relative humidity, airflow across the skin, and surface temperatures that mimic natural environments. 5. Presence of Water. A condition that enhances the experience of a place through seeing, hearing or touching water. 6. Dynamic & Diffuse Light. Leverages varying intensities of light and shadow that change over time to create conditions that occur in nature. 7. Connection with Natural Systems. Awareness of natural processes, especially seasonal and temporal changes characteristic of a healthy ecosystem. 8. Biomorphic Forms & Patterns. Symbolic references to contoured, patterned, textured or numerical arrangements that persist in nature. 9. Material Connection with Nature. Materials and elements from nature that, through minimal processing, reflect the local ecology or geology and create a distinct sense of place. 10. Complexity & Order. Rich sensory information that adheres to a spatial hierarchy similar to those encountered in nature. 11. Prospect. An unimpeded view over a distance, for surveillance and planning. 12. Refuge. A place for withdrawal from environmental conditions or the main flow of activity, in which the individual is protected from behind and overhead. 13. Mystery. The promise of more information, achieved through partially obscured views or other sensory devices that entice the individual to travel deeper into the environment. 14. Risk/Peril. An identifiable threat coupled with a reliable safeguard. 43
WELL Building Standard + Provides a model for design and construction to integrate human health features in the build environment + Is a performance-based system to measure impact of built environment on human health + WELL fosters a holistic formula for better health and wellness outcomes, leading to improvements in things like employee productivity, engagement and retention.
AIR
FITNESS
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WATER
NOURISHMENT
COMFORT
MIND
LIGHT
DESIGN CONSIDERATIONS + Air: optimize and achieve indoor air quality + include removal of airborne contaminants, prevention and purification resources + Water: optimize water quality while promoting accessibility + one of the most used resources within a building, include removal of ooooooocontaminants through filtration and treatment + Nourishment: encourage healthy eating habits + provide occupants with healthier options with behavioral cues and knowledge oooooooabout nutrient quality + Light: minimize disruption to the body’s circadian rhythm + requirements for window performance and design, light output and lighting ooooooocontrol, and task-appropriate illumination levels are included to improve energy, ooooooomood and productivity.
CURRENT TRENDS + Health and Wellness: + one of the largest growing industries, and consumers are impacting the growing ooooooodemand by increasingly wanting to live healthier lives. + Circadian Lighting: + enforcement of company sleep policies, company travel time restrictions for ooooooocrossing zones, no email communication during night hours. + Group Lunch Spaces: + shared lunch spaces promote community spirit within the office and slow down ooooooofood intake that leads to less overeating. + HVAC Comfort Zones: + workspaces where people can work where its colder, warmer, etc. and have ooooooomore control over their personal environment.
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Research Study: Healthy Habits + Design In collaboration with Jessica Peterson
The Experiment Who: Virginia Tech Interior Design Students What: Social Experiment Where: ITDS Studio, Burruss Hall When: Nov. 2 - Nov. 10 Why: To get a better understanding of human behavior as it relates to social ooooointeraction in an interior environment.
Phase I: Self-Motivation + Personal Gain When: Nov 2 - Nov 6 Posters were placed on walls throughout the ITDS studio. Posters stated facts regarding the benefits of keeping a clean desk area.
A study conducted at Harvard University found that untidy workspaces can undermine people’s persistence in completing tasks, therefore
affecting productivity.
KEEP YOUR DESK NEAT, MARK TASKS COMPLETE
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Students working in a clean
environment tend to be happier than those working in an untidy environment.
A CLEAN LIFESTYLE WILL MAKE YOU SMILE
A cluttered desk can result in you trying to focus on too many things at once, which lowers your
stress threshold.
LESS MESS MEANS LESS STRESS
Phase II: Positive Reinforcement When: Nov 6 - Nov 7 Thank you cards and lollipops were placed on clean desktops between Tuesday night and Wednesday morning. Clean Desk: + No Trash + No Open Food + No Crumbs + No Stray Papers/ Supplies
Phase III: Social Belonging When: Nov 7 - Nov 8 Thank you cards and lollipops were placed on clean desktops between Tuesday night and Wednesday morning. Human Need A sense of belonging is a human need. The need to belong is an intrinsic motivation to affiliate with others and be socially accepted. A sense of belonging to a greater community improves your motivation, health, and happiness. Social Behavior Individuals tend to behave in a manner similar to those who are in a group that they want to be in or are already a part of. @lexxtraterrestrial
Phase IV: Fear of Authority When: Nov 8 - Nov 10 The one and only Lisa Tucker (authority figure) went to each studio and ordered students to clean their desks before the upcoming Interior Design Open House. 47
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Works Cited
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Overview Addiction Treatment Center. (2014). Healthcare Design, 14(7), 101. Retrieved from http://login.ezproxy.lib. vt.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=103580132&scope=site Addiction Treatment - Recovery Options for Drug Addiction. (n.d.). Retrieved December 01, 2018, from https://www.addictioncenter.com/treatment/ Bosch, S. J. (2012, October). The Center for Health Design (Rep.). Retrieved November, 2018, from KI JAIN MALKIN INC. website: https://www.healthdesign.org/system/files/CHD%20Color%20Paper%20 FINAL-5.pdf Home - City of New Orleans. (n.d.). Retrieved December 01, 2018, from https://www.nola.gov/ Munro, D. (2015, March). Inside The $35 Billion Addiction Treatment Industry. Forbes. Retrieved from https://www.forbes.com/sites/danmunro/2015/04/27/inside-the-35-billion-addiction-treatmentindustry/#55231a3c17dc National Institute on Drug Abuse. (n.d.). Treatment Approaches for Drug Addiction. Retrieved December 01, 2018, from https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drugaddiction National Institute on Drug Abuse. (n.d.). What is drug addiction treatment? Retrieved December 01, 2018, from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-basedguide-third-edition/frequently-asked-questions/what-drug-addiction-treatment U.S. Census Bureau QuickFacts: New Orleans city, Louisiana. (n.d.). Retrieved December 01, 2018, from https://www.census.gov/quickfacts/neworleanscitylouisiana Visit New Orleans | Official New Orleans Tourism Website. (n.d.). Retrieved December 01, 2018, from https://www.neworleans.com/
Precedence Rehabilitation Centre Groot Klimmendaal / Koen van Velsen. (2011, April 08). Retrieved https://www. archdaily.com/126290/rehabilitation-centre-groot-klimmendaal-koen-van-velsen Sister Margaret Smith Addictions Treatment Centre / Kuch Stephenson Gibson Malo Architects and Engineer Montgomery Sisam Architects. (2011, February 15). https://www.archdaily.com/109414/sistermargaret-smith-addictions-treatment-centre-montgomery-sisam-architects Therapeutic Community Sananim / SPORADICAL. (2018, March 18). https://www.archdaily. com/804333/therapeutic-community-sananim-sporadical
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Site Home - City of New Orleans. (n.d.). Retrieved December 01, 2018, from https://www.nola.gov/ [Photograph found in New Orleans]. (n.d.). Retrieved from https://www.flickr.com/photos/47776062@ N03/14511313257 U.S. Census Bureau QuickFacts: New Orleans city, Louisiana. (n.d.). Retrieved December 01, 2018, from https://www.census.gov/quickfacts/neworleanscitylouisiana Visit New Orleans | Official New Orleans Tourism Website. (n.d.). Retrieved December 01, 2018, from https://www.neworleans.com/
Program 2010 ADA Standards for Accessible Design. (2012). DOJ. Health Archives. (n.d.). Retrieved December 01, 2018, from https://www.steelcase.com/resources/ space-planning-ideas/industry/healthcare/ ICC. (n.d.). 2018 International Building Code. Retrieved December 01, 2018, from https://codes.iccsafe. org/content/IBC2018?site_type=public
Research 14 Patterns of Biophilic Design. (n.d.). Retrieved December 01, 2018, from https://www.terrapinbrightgreen. com/report/14-patterns/ Addiction Treatment Center. (2014). Healthcare Design, 14(7), 101. Retrieved from http://login.ezproxy.lib. vt.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=103580132&scope=site Gómez San Luis, A. H., & Almanza Avendaño, A. M. (2018). Barriers to addiction prevention and treatment in communities with organized crime: the perspective of health providers. Salud Mental, 41(2), 73–80. https://doi-org.ezproxy.lib.vt.edu/10.17711/SM.0185-3325.2018.010 Lashley, M. (2018). The impact of length of stay on recovery measures in faith‐based addiction treatment. Public Health Nursing, 35(5), 396–403. https://doi-org.ezproxy.lib.vt.edu/10.1111/phn.12401 Marsa, L. (2018). Joining the Opioid Battle. U.S. News - The Report, 30. Retrieved from http://login. ezproxy.lib.vt.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=f5h&AN=132062 627&scope=site Rossi, M., PhD. (2006, September). Creating Safe and Healthy Spaces: Selecting Materials that Support Healing. Retrieved October, 2018, from https://www.healthdesign.org/system/files/Creating%20 Safe%20and%20Healthy%20Spaces.pdf The Well Building Standard (n.d.). Retrieved December 01, 2018, from https://v2.wellcertified.com/ What is WELL? (n.d.). Retrieved December 01, 2018, from https://www.usgbc.org/articles/what-well
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