The J.G.F. Treatment Center for Alcohol and Drug Dependence by Nikki Mancuso

The J.G.F. Treatment Center for Alcohol and Drug Dependence NIKKI MANCUSO

The J. G. F. Treatment Center for Alcohol and Drug Dependence NIKKI MANCUSO

INTD-487: Capstone Research and Programming | Professor Lisa Phillips | Fall 2014 Cover photograph courtesy of Johannes Woerpel

DEDICATED

in loving memory

John Guy Forcey, Jr. 1961-2005

Beloved son, brother and uncle

Contents

Project Objectives | 8-23

Historiography & Global Context | 24-43

Case Studies | 44-91

Design & Technical Criteria | 92-109

Topical Explorations | 110-139

Existing Site, Context, Climate & Zoning | 140-153

Program Development & Documentation | 154-165

Building Analysis, Code, Regulations & Standards 166-191

Final Project Research Summary | 192-195

Bibliography & Appendix | 196-201

“Expectthedawnof anewbeginning in the dark nights of life.” LLOYD JOHN OGILVIE

PART ONE Introduction

PART TWO Design Considerations

PROJECT OBJECTIVES

PART ONE: Introduction

â&#x20AC;&#x153;God grant me the to

change,

the the

things

serenity I

courage

cannot to

change the things I can, and the

wisdom to know the difference.â&#x20AC;?

This statement is called the Serenity Prayer, a soothing mantra, one by which many people live their daily lives. What you may not realize is that this powerful statement has saved thousands of lives. It is the addictâ&#x20AC;&#x2122;s ray of light, recited daily around the world in drug and alcohol addiction rehabilitation facilities.

3 3

The idea of designing a drug addiction rehabilitation facility was inspired by a family member who struggled with addiction to alcohol and prescription drugs for over thirty years and subsequently passed away from a fatal overdose. The main goal of this project is to help raise awareness in the field of addiction, to help others recover from battles with their own demons and prevent others from suffering from the same fate. This project is necessary because addiction has earned a rather negative connotation within the media and today’s society, mainly because of the harmful activities associated with it. Many addicts are homeless

criminals who live in a perpetual state of blurred reality, doing just about anything for their next high, which is viewed extremely disdainfully in society’s light; rightfully so, to an extent. Possibly the largest problem currently facing drug and alcohol addiction (officially known as substance dependence by the Diagnostic and Statistical Manual of Mental Disorders) is that society as a whole does not truly understand it. It is simple for a normal person to look at an addict and say, “Can’t you see the problems you are causing? Don’t yousee that you are killing yourself? Why don’t you just stop?” The difficulty surrounding addiction

is that addicts cannot stop. Simply put, addiction is a disease of the mind, body and spirit. It is a neurological disorder that is caused by a genetic dispensation – that is, a part of a human gene that is passed down through generations. The biological trait is more commonly known as “addictive personality.” The trait is usually triggered by some kind of trauma, such as neglect, abuse, rape, abandonment, etc., all of which is unfortunately far too prevalent in today’s world. What most sober people do not understand is that although addiction is a disease, it is first and foremost a mental disorder that cannot be cured with medicine. Addiction recovery is a lifelong

treatment, and it is common for recovering addicts to relapse a couple times before finding the strength to stay clean. But even then, for most addicts, the only cure is abstinence, which can be extremely difficult in todayâ&#x20AC;&#x2122;s world where major cities have a bar on every corner and the media broadcasts alcohol and drugs in virtually every outlet. Treatment essentially consists of, following detoxification of the body ifnecessary, mindfulnessbased stress reduction (MBSR) that focuses on yoga and meditation, physical fitness, and therapy as part of the 12-Step

Program, which is a set of guideline principles for recovery set by the group Alcoholics Anonymous. In addition to being an extremely dangerous and detrimental disease, addicts also spend extravagant amounts of money in order to maintain the habit. According the National Institute of Drug Addiction (NIDA), drug and alcohol abuse costs the United States around $193 billion and $235 billion annually, respectively. Depending on the facility, amenities provided, location, and length of stay,a month of treatment (the usual length of stay) can cost anywhere between $7,500 and $120,000 per patient.

Many rehabs are non-profit organizations funded by patientsâ&#x20AC;&#x2122; health insurance companies, and unfortunately most large insurance companies do not care about their patients. They will only provide coverage for what they think is enough treatment for the patient, which is usually much less than the patient requires. Because insurance companies oftentimes decide to release patients against their and the doctorsâ&#x20AC;&#x2122; wills, the chances of relapsing are unsettlingly high. Thus it is a continuously vicious cycle.

4 4

13 1.2

Where life is seen as a burden, full of unpleasant and useless struggles, addiction is a way to surrender. - Richard McKenzie Neal

PART TWO: Design Considerations

The general goal of this project is to design a serene yet practical rehabilitation center whose attendance is affordable and whose reputation is solid. To accomplish this, the project must address research goals and methods. the role of the designer, environmental and sustainability options, the client, the users, socioeconomic conditions and demographics.

RESEARCH GOALS AND METHODS The first task will be to research the disease itself. The project will gather information from books and scholarly medical articles by doctors, scientists, therapists, and accounts from the patients themselves. Another crucial task will be to research how rehabilitation facilities work and the program within. Since facilities of this nature implement an extremely strong doctor-patient confidentiality system, gaining access to the buildings will be a challenge. Valuable information from advisors, including a rehab counselor, a designer who has

worked on both healthcare and hospitality projects, and a therapist who has written a few books on his experiences in rehabs, will be implemented.

THE ROLE OF THE DESIGNER A diverse interior design education will be very useful because addiction rehabs are a unique blend of healthcare and hospitality. A past studio project dealing with a healthcare facility will serve as preparation for

research on medical programming. As the patients experience livein treatment, both medical and spiritual, providing the correct spaces while simultaneously creating a calming environment will be crucial. The interior designer is responsible for ensuring health, safety, and general welfare of the end user, so minimizing safety hazards that could interrupt treatment must also be of primary focus.

CLIENT The client will be a non-profit healthcare organization whose

1.518

8 goal is to build an affordable yet comfortable rehabilitation facility located outside of a major city. The largest challenge will be to design the entire space within a set budget. outside of a major city. The largest challenge will be to design the entire space within a set budget.

ENVIRONMENT& SUSTAINABILITY As clean, healthy living is such an integral part of addiction recovery, sustainable features will be an important presence in the project. Environmental conscience

designing will also help to create a serene, peaceful environment, and allow addicts who have spent their entire lives feeling worthless and detrimental to society to feel as though they are making a difference in the world simply by utilizing the buildingâ&#x20AC;&#x2122;s features. This, along with the abundance of natural daylight and fresh air, will improve the recovering mentality of the patients as well as their physical well-being. The building selected as the shell for the project, the Chesapeake Bay Foundationâ&#x20AC;&#x2122;s headquarters in Annapolis, MD, is already a LEED-Platinum certified building located in a suburban area on the Chesapeake Bay. It is surrounded by a beach, a forest,

and a road with some aesthetically pleasing homes. Given the location, it will be possible to harness solar and wind power as energy alternatives.

SOCIO-ECONOMIC CONDITIONS AND DEMOGRAPHICS Addiction can affect anyone in any age group, of any ethnicity, and in any location. Therefore, the facility will be located in a suburban area to remove the patients from temptation, but will not be aimed toward any particular demographic group. Many addicts are homeless, and pay for treatment through their insurance companies. If possible, the facility will be accessible by the middle and lower classes.

USERS The end users will be addicts undergoing in-patient and detoxification treatment, medical professionals such as doctors and therapists, and administrative personnel. Secondary users will be family members of the patients who enter the facility to visit on designated days.

“You don’t decide to be an addict. One morning you wake up sick and you’re

an addict.” -William S. Burroughs

End Notes and Bibliography

Image Sources 1 - http://www.wallpaper4k.com/it/sfondi/bokeh/ wpcqbsrh.html?p=4 2 - http://www.taringa.net/buscar/ mi/?q=%23fotoblur 3 - http://djpariah.blogspot.com/2013/08/ femdelacreme-official-review.html 4 - https://prideinmadness.wordpress.com/ category/self-help-books/the-hurt-yourself-lessworkbook/ 5 - https://www.flickr.com/people/94991188@ N05/ 6 - http://8tracks.com/amidstblackskies/an-idiotsin-love-playlist 7 - https://kleantreatmentcenters.com/studydrinking-at-a-young-age-causes-more-problems 8 - http://wedorecover.com/images/Symptomsof-Drug-Addiction---A.jpg 9 - http://livehealthprotocol.com/category/ bodyfit/ 10 - http://arealmancan.com/author/richard/ 11 - http://bluewaterdetox.com/drug-detox/ methadone-detox/ 12 - http://picssr.com/photos/greg-pths/page5

“Wine haththan drowned more men the sea.” THOMAS FULLER

PART ONE

History of Alcohol and Drugs

PART TWO

History of Treatment

HISTORIOGRAPHY & GLOBAL CONTEXT

PART ONE: History of Alcohol and Drugs

In order to begin to understand how a rehabilitation facility works, historical precedents in the field must be examined by looking at cultural, demographical, socioeconomical and site conditions. Before learning about the history of substance abuse treatment, however, we must first learn about the origins of the substances themselves â&#x20AC;&#x201C; namely, a brief history of alcohol and drugs.

Alcohol Humans throughout history have produced fermented beverages from sugar sources in many areas of the world. Fermentation is a phenomenon that has been used as an analgesic, disinfectant, food preserver and enhancer as well as a mind-altering substance. The earliest instance of fermented beverages is a mixture of rice, honey and fruit found through chemical analysis in pottery jars from a Neolithic village in ancient China, which deduces that the origins of alcohol dates back to around 7,000 B.C.1 As urban life in ancient times became more complex, likely after the Neolithic period (3000 B.C.), or “New Stone Age,” the amylolysis fermentation system came about and created more specialized beverages. This became the standard method for rice and millet wine production by saccharifying rice and grains with fungi as opposed to honey and fruit.1 The written word was invented a few thousand years later, and thus documentary evidence of early alcoholic discoveries was recorded. The first instance of beer was found written in a Sumerian pictograph around 3200 B.C. Judgingby the clarity of the ancient pictographs, it is assumed that beer production was already fairly commonplace in ancient Mesopotamia (presentday Middle East) and the brewing process had been developed around that time period.

more important to the early human race than the life staple bread?

3 Three vases discovered in the ancient Chinese village of Jihan that were found to contain traces of the first evidence of wine production. Image courtesy of the Univeristy of Pennsylvania.

Although it has been mentioned that a form of wine originated in ancient China four thousand years before, the first evidence of wine production in Mesopotamia was found to be from around 3,000 B.C. Beer was featured in temple rituals for two thousand years, so it seems evident that although Sumerians possessed the technology to produce wine, they preferred beer. Their standard of life staples seem to have put more emphasis on beer than foods like bread because the world’s first recorded recipe was found to be for Sumerian beer. However, this is probably because beer is very strongly connected with Sumerian gods. It is important to note that in these early civilizations, many new technologies were being discovered, including the aforementioned written word and breadmaking. It has been said that beer is “the earliest art of primitive man,” and as was mentioned before, theworld’s first recorded recipe was for beer. Since bread was produced from the same ingredient as beer – that is, grain – a consideration arises: was beer

There is much debate over this idea. It is unlikely that the foundation of civilization was formed by illfed humans living in a state of perpetual intoxication, purposely foregoing nutritional foods in favor of a substance for which they had no physical need2. However, many historians believe that although beer manufacturing and drinking has been established as one of the earliest cultural behaviors around the world, grains intended for making bread or gruel may have been unintentionally fermented into alcohol. However, the alcoholic brews, whether the result of intention or accident, were not poured away; they were drunk because, we must assume, they were enjoyable.2 It is worth noting that the human drive for intoxication was heavily present in ancient times just as it is today. On the Indian subcontinent and particularly present-day Pakistan, distillation technology was first

4 Ancient stone tablet depicting the Sumerian recipe for beer. Image courtesy of ABC Radio International.

5 The idea that grain was used in ancient times primarily for beer as opposed to bread is greatly debated among historians. Photograph courtesy of James & Deverett.

6 A pictograph of ancient Egyptians harvesting grapes for wine. Photograph courtesy of Pixgood.

used to create medicine but then became a method for producing alcoholic beverages starting around 500 B.C. They produced a drink called ‘soma,’ which was evidently produced around a thousand years earlier and was seemingly extremely intoxicating based on its ingredients. In around 350 B.C. the Greek philosopher Plato wrote about wine consumption among the ancient Greeks’ social and intellectual circles. It is common knowledge that wine is very much a part of everyday life in Greece, and many parts of Europe – however, despite thepresence of alcohol in Greece at this time, alcohol was not produced in the rest of Europeuntil about the first century A.D., and distilled beverages came about much later in the 1200s.

7 A bust of the ancient Greek philosopher Plato. Photograph courtesy of Philip Atkinson.

8 The opium plant is beautiful on the outside, but the interior is deadly. Image courtesy of ListCrux.

Opium, Morphine and Heroin Opium, which is a depressant and analgesic, comes from the seedpod of the opium poppy just before it is fully ripe. For centuries the opium poppy leaves were used as a potherb and salad, and the highly nutritional seeds were either eaten whole or baked into goods. The profitable amount of vegetable fat contained in the oily seeds is presumably what first attracted early humans to the flower. There is no certainty on when and where the plant originated – some sources say that it was used for

medicinal and religious ceremonial properties in Western Asia and the Eastern Mediterranean around 2000 B.C.; some say the Sumerians around 4000 B.C. Regardless, the general consensus is that opium originated in the Asia/Middle East area and was introduced to Europe and then Egypt where it was used as an analgesic. Opium was brought to East Asia by Arab merchants, though the Orient’s notorious endemic use of opium did not come about until the 1700s A.D. when European merchants created a trade commerce from it.3 Opium has always been used both medicinally and recreationally,

but recreational use became popular in the eighteenth and nineteenth centuries by English intellectuals who referred to the “divine luxuries of opium eating and opium drinking,”3 and opium smoking in the United States was popularized by Chinese immigrants. Medically, opiates were the primary ingredient in ‘patent’ medicines, but were prescribed to patients will all kinds of symptoms, not necessarily relevant to the opium’s effect. Thus many people began using opiates believing that it would cure them, when they may not have been sick at all in the first place; but since scientific medical treatment was not

yet discovered for many ailments, the feeling of well-being was psychologically beneficial.3 A German pharmacist named Frederick C. Serturner discovered morphine sometime between 1799 and 1806 when he poured liquid ammonia over opium, resulting in a white powder that was much more powerful than opium. Naturally he named it after Morpheus, the Greek god of sleep and dreams, as it acts as a pain reliever. One ounce of morphine is derived from ten ounces of opium. At first, the medical professional field viewed morphine as an opiate devoid of negative

side effects, so by the 1850s morphine products were made available without prescription. Injecting morphine directly into the bloodstream via needle was introduced to U.S. medicine in 1856. The Civil War played a major role in the increased prevalence of morphine in American medicine through its use to treat battlefield injuries. By the 1870s, morphine products were cheaper than alcohol and used on just about every ailment imaginable.

heroin, named so by the German pharmaceutical company Bayer after the German word heroisch, meaning “large and powerful.” Originally, heroin was marketed as a safe, powerful and nonaddictive alternative for morphine and codeine – most notably, and somewhat humorously, as a sedative for coughs.3

From an experiment with morphine by a British scientist in 1874, the most powerful opiate came into being: diacetyl-morphine, or

“Pain can be alleviated by morphine, but

Medical morphine. Photograph courtesy of Olivier Dogot.

the pain of social ostracism cannot be taken away.” - English film director Derek Jarman

Cocaine and Marijuana Human interaction with cocaine, which is a stimulant derived from an alkaloid only found in two species of the coca shrub indigenous to South America, dates back 5,000 years to the ancient Incas in present-day Peru. The coca shrub was of divine origin and only reserved for those close to the gods; the effects (stamina and energy) were experienced by chewing on the leaves, which was adopted by European explorers in the nineteenth century.3 How the coca shrub became cocaine by chemically isolating the alkaloid is disputed, but it is generally believed that it was first accomplished by the German chemist Gaedecke in 1855. Scientists noted that it produced anesthetic properties and so it was originally manufactured to

also hastened the death of his friend.

10 An original Coco-Cola poster, when the soft drink still contained traces of cocaine. Image courtesy of Historiareklamy.

treat morphine addiction. In 1884, Sigmund Freud experimented with cocaine and prescribed it to his friend as a cure for his morphine addiction; however, the following year, the friend suffered from toxic psychosis and Freud sadly noted that the cocaine use not only failed to cure the morphine addiction, but

Despite this, the general attitude towards cocaine across the United States was enthusiastic. Cocaine was even being produced in wine and soda, the most famous being Coca-Cola, first bottled in 1894; though the coca plant was removed from beverages in 1904 following criticism from a presidential commission for putting habit-forming substances in soft drinks. After the initial buzz, cocaineâ&#x20AC;&#x2122;s popularity gradually began to fade as it gained a reputation for inducing bizarre behavior. It became associated with the urban underworld and as opium was socially identified with the Chinese immigrants who introduced it, cocaine was identified with southern blacks, who became a target for class conflict

Cocaine is well-known for being snorted illegally. Photograph courtesy of Huffington Post UK.

12 The Cannabis sativa L. plant, from which marijuana is derived. Photograph courtesy of ABC News.

with drug use as a main point of tension. In 1922 Congress officially defined cocaine as a narcotic and prohibited further importation of coca leaves.3 The cannabis sativa L. plant, from which marijuana and hashish is derived, grows wild throughout most tropical climates around the world and has been harvested for over 5,000 years for multiple purposes, including rope and paint. As noted in the last section, racism played a large role in the prevalence of opium and cocaine, and perhaps the most influential role in marijuana legislation was racism towards the Mexican culture, as a reaction to immigration. “Chicanos,” as Mexican immigrants were colloquially referred to, were believe to incite violence by smoking marijuana. It was also believed to have been brought about as an addictive substitute for the narcotics banned by Congress.

n the 1930s, anti-marijuana Icampaigns became seemingly hysterical, and marijuana was blamed for madness, murder, and suicide. Congress passed the Marijuana Tax Act in 1937 which

13 Hysterical advertisement and motion picture campaigns, like this one for “Reefer Madness,” in the 1930s painted marijuana in an extremely negative light. Image courtesy of CinemaGumbo.

placed a heavy tax of $100 per ounce on the substance, rather than outlawing the substance itself. Marijuana was treated as another narcotic as states increased their penalties for marijuana possession and trafficking.3 In the 1960s, however, the nonconformist counterculture of rebellious people from the white middle class, termed “hippies,” created a change in public attitude towards marijuana and other drugs like hallucinogens (LSD). It was found to tie together diverse interests such as civil rights, antiwar, and antiestablishment, which led to scientific investigation of marijuana’s properties. It was found that, no matter the side effects, it was definitely not in the same league as cocaine and heroin as far as its danger factor. Harsh penalties still exist for possession and trafficking marijuana, but in comparison they have been somewhat mollified since the early twentieth century.

PART TWO: History of Treatment

Addiction treatment is historically a fairly novel concept because most people did not understand addiction as being a disease rather than simply a dangerous activity. Over the course of about 250 years, rehabilitation facilities evovled into how we perceived them today.

Until the 1870s, the concept of addiction was not widely known or understood.3 However, there is evidence of early controls on alcohol. Early Egyptian writings include prohibitions on alcohol consumption, but only by social pressure as opposed to a law. Conversely, Hammurabi’s Code, a law which dates back to around 1,720 B.C., limited alcohol consumption in taverns by setting the price and credit terms for purchase; if the tavern keepers charged more than what was set by the code, their punishment was drowning. Additionally, the code placed an obligation on the tavern keepers to keep criminalsaway from the premises – with the threat of execution by burning – in an effort to curb alcohol-related disorders.2 Even then, addicts were viewed negatively as merely criminal figures and not victims of a terrible disease.

Addiction treatment essentially began with Native Americans tribes. When Europeans colonized the newly discovered North American continent, they brought new ideas, technology, and, unfortunately, alcohol. It is not clear why, but Native Americansbecame more susceptible to the negative aspects of alcohol consumption. Perhaps because they had a much weaker tolerance for the substance than the seasoned Europeans, or the stress and oppression of the invaders may have driven them to drink. In any case, sometime between 1750 and early 1800, alcoholic mutual aid societies – or “sobriety circles” – were formed among various Native American tribes, namely in present-day Delaware. They were conducted by tribal leaders who had been through the difficulties of alcoholism themselves, and was essentially

a self-help group where one alcoholic helps another, guided by the leader, who acted as sponsor. Recovering touch with ancient heritage and beliefs that an addict may have lost in his addiction was encouraged by these tribal leaders, as the sobriety circles understood that addicts require a higher power to look up to in order to begin the recovery process. The Native American system provides much of the basis forAlcoholics Anonymous, which is the cornerstone of treatment programs around the world. In 1784, Dr. Benjamin Rush published a paper titled An Inquiry into the Effects of Ardent Spirits upon the Human Body and Mind, which cataloged the consequences of chronic drunkenness and argued that the condition is actually a Europeans are believed to have introduced Native Americans to alcohol during the colonialization period. Photograph courtesy of Wikimedia.

36 36

disease that physicians should be treating. He called for a “sober house” to care for “confirmed drunkards.”5 These remarks began the Temperance movement in America when around 200 farmers in Connecticut, apparently strongly influenced by the argument, banded together in 1789 to ban the production of whiskey. Over the next twenty years, similar associations were formed in Virginia (1800) and New York (1808), and a decade later there were temperance groups formed in eight states.7 Rather than abstinence, the groups advocated levelness and control over alcohol consumption. A decade after the term ‘alcoholism’ was officially coined by Swedish physician Magnus Huss in 1849, and the disease duly named Alcoholismus Chronicus,” the very first treatment center in America, the New York State Inebriate Asylum in Binghamton, was opened. It was the first single-purpose hospital designed and constructed to treat alcoholismas a disease and mental disorder. The building is located on an elevated site east of the town of Binghamton, on a 250acre farm, and constructed from stone and brick in Tudor castellated architectural style.8 The facility allowed the patients to, for the first time, separate themselves from the pressures and taxations of society while undergoing treatment. The Civil War in the 1860s put the Temperance movement on hold, as both sides in the war taxed brewers and distillers heavily

weekly rations by two ounces per week, and injections of a substance called “gold chloride” four times a day and a tonic every two hours; the gold chloride has been found to be a mysterious mixture of alcohol and a few other chemicals. This was called the “Keeley Cure” or the “Gold Cure.” The patients were free to stroll the ground of the institute and the nearby village; it has been called an early therapeutic community and treated thousands of patients.9

16 The American Temperance movement. Photgraph courtesy of Ghosthunting Cornwall.

to finance the conflict. However, by the end of the Reconstruction period in 1870, temperance had once again gained notoriety and began enlisting support from religious sanctions around the country. That same year, theAmerican Association for the Study and Cure of Inebriety was founded under the principle “Inebriety is a disease.”5 In 1879, Dr. Leslie Keeley, an American physician, declared, “Drunkenness is a disease, and I can cure it.” Thus he opened the Keeley Institute, which was a sanatorium for people addicted to immoderate uses of alcohol and opium. The program cost $160 plus room and board for a stay of 31 days, headquartered in Dwight, Illinois, although by 1893 there were 92 Keeley Institutes across the United States, Canada, and Mexico. The program was comprised of gradually tapering off of the substance by decreasing the

In 1901, Dr. Charles B. Towns founded a hospital in Manhattan for suffering alcoholics. It was the first privatized treatment facility for alcoholism in America and focused on detoxification and treatment; however, as it was privatized, only the wealthy could afford the $200-350 price tag

17 Dr. Leslie Keeley, an American physician who famously declared, “Drunkenness is a disease, and I can cure it!” Photograph courtesy of Wikimedia.

for a five-day stay. It was successful during the Roaring Twenties as a result of the increase in money and alcoholism due to the Prohibition movement, which was a nationwide Constitutional ban on the sale, production, importation and transportation of alcoholic beverages from 1920 to 1933. However, following the Stock Market Crash of 1929, admissions had declined as very few people could afford attendance. Following the closing of his facility, Towns was influential in securing jobs for addicts by encouraging corporations to help alcoholics while they were still on the job. He blamed society for the abundance of alcohol-related problems and

believed that it needed to take responsibility for those who had lost control due to drinking, and that enlightenment on the subject was more beneficial than punishment. Additionally, he was very influential in the formation of Alcoholics Anonymous by lending founder Bill Wilson the funds to write the Big Book following his stay in Townsâ&#x20AC;&#x2122; hospital. Between the years of 1935 and 1975, addicts could be sent to the United States Narcotics Farm located in Lexington, Kentucky. It was the first coed institution primarily for addicted prisoners; thus it was a hybrid of hospital and prison set on 1,000 acres of farmland. For forty years it wasa groundbreaking facility that brought

awareness to addiction as a disease and also a gathering for jazz musicians like Chet Faker and Sonny Rollins. Writer William S. Burroughs, a severe opiate addict, spent time there and praised the Farm for their great work with addicts. However, the facility was shut down in 1975 amiss scandal over its program, which recruited prisoners as guinea pigs for drug experimentation.10 It became apparent that the most efficient way to treat addiction was to followthe 12 Steps to Sobriety set by Alcoholics Anonymous. The group was founded in 1935, two years after the end of the Prohibition movement, when alcohol still carried a negative social stigma of immortality. The United States Narcotics Farm in Lexington, Kentucky. Image courtesy of Points Blog.

19 Alcoholics Anonymous was founded by Bill Wilson and Dr. Bob Smith in 1935. Image courtesy of Time Magazine.

Co-founders William Wilson, a stockbroker, and Dr. Robert Smith, a surgeon, both suffered from alcoholic dependencies. Wilson admitted himself to the Charles B. Towns Hospital after drinking four beers – his last alcoholic drink – and experienced a bright flash of light, believing it to be God revealing himself. Smith worked with Wilson for thirty days before 10th, 1935, the date marked by the group for anniversaries. In 1939, Wilson and the other members members wrote the “Big Book,” initially called Alcoholics Anonymous: The Story of How More Than One Hundred Men Have Recovered from Alcoholism. The book puts forth the twelve-step

program in which addicts essentially admit that they are powerless over alcohol and must seek help and guidance from God or a higher power through prayer and meditation. The second half of the book is comprised of personal stories told by members. The book has been revised many times over the past 75 years, but the Twelve Steps have remained virtually unchanged since the 1939 edition.

20 The “Big Book,” as it is affectionately called by Alcoholics Anonymous members. Image courtesy of God, Thugs and Drugs.

The first treatment center to cater to the Twelve-Step Program was the Hazelden Foundation, which opened in Minnesota in 1949. It is one of the most prestigious rehabilitation centers in America, the most respected private, nonprofit center, and was the first to

The Twelve Steps of addiction treatment

Step 1 – We admitted we were powerless

over our addiction – that our lives had become unmanageable.

Step 2 –

Came to believe that a Power greater than ourselves could restore us to sanity.

Step 3 – Made a decision to turn our will

and our lives over to the care of God as we understood God.

Step 4 –

Made a searching and fearless moral inventory of ourselves.

Step 5 – Admitted to God, to ourselves and to another human being the exact nature of our wrongs.

Step 6 – Were entirely ready to have God remove all these defects of character.

veer away from the previous asylum design.12 The facility still exists today and has merged with the Betty Ford Foundation in southern California which was founded by former First Lady Betty Ford in 1982, years after she bravely addressed the nation regarding her struggles with substance dependence. The Betty Ford Foundation focuses on the struggles of women, although they reserve fifty percent of its beds for men and the other half for women.13 Today rehabs are coed but gender specific, so men and women are kept in separate halls to avoid distraction to focus on their recoveries.

Step 7 –

Humbly ask God to remove our shortcomings.

Step 8 – Made a list of all persons we had harmed, and became willing to make amends to them all.

Step 9

– Made direct amends to such people wherever possible, except when to do so would injure them or others.

Step 10

– Continued to take personal inventory and when we were wrong promptly admitted it.

Step 11

– Sought through prayer and meditation to improve our conscious contact with God as we understood God, praying only for knowledge of God’s will for us and the power to carry that out.

Step 12 – Having had a spiritual awakening

as the result of these steps, we tried to carry this message to other addicts, and to practice these principles in all our affairs.11

Below: A typical bedroom in the Clearview Treatment Center in California. Image courtesy of ClearView Treatment.

22 Above: The Betty Ford Center in southern California, where many celebrities like Lindsay Lohan have received treatment. Image courtesy of Daily Mail UK.

Below: Entrance of Hazelden Foundation Treatment Center. Image courtesy of AfterPartyChat.

End Notes From “Fermented beverages of pre- and proto-historic China” by Patrick E. McGovern et. al. Proceedings of the National Academy of Sciences of the United States of America. Dec. 8th, 2004. 1

From “Social and Cultural Aspects of Drinking: A report to the European Commission” by The Social Issues Research Centre. March 1998. 2

From Drug Abuse: An Introduction by Howard Abadinsky. Nelson-Hall Series in Law, Crime and Justice, Chicago, 1989. 3

From Treating Addiction: A Guide for Professionals by William R. Miller, et. al. The Guilford Press, New York, NY. 2011. 4

From Recovery in America by William White. 1998.

From “New York State Inebriate Asylum” on the National Historic Landmarks Program website. 6

From page 16 of American Temperance Movements: Cycles of Reform by Jack S. Blocker. Boston: Twayne Publishers, 1989. 7

From “Our Whole Country: Or the Past and Present of the United States, Historical and Descriptive” by John W. Barber and Henry Howe, 1861. 8

From the article “Keeley cure,” Time magazine, September 25, 1939.

From NPR Radio Show special “America’s First Drug-Treatment Prison Revisited” between Andrea Seabrook, JP Olsen, and Dr. Nancy Campbell. November 2008. 10

From “Top 10 Things You Didn’t Know About Alcoholics Anonymous” by Time Magazine, June 2010. 11

From the Hazelden Betty Ford Foundation’s official website.

From the Betty Ford Foundation’s official website.

Image Sources

1 - http://www.pbinstitute.com/help-loved-one-refuses-help/ 2 - http://commons.wikimedia.org/wiki/File:Underwater_world.jpg 3 - http://benedante.blogspot.com/2013/09/neolithic-alcohol-in-china.html 4 - http://internationaltradersegypt.com/ancient%202.jpg 5 - http://www.abc.net.au/radionational/programs/rnfirstbite/fresh-but-ancientbeer/4839868 6 - http://galleryhip.com/ancient-egyptian-wine.html 7 - http://i1.wp.com/www.jamesandeverett.com/wp-content/uploads/2013/04/beer_ bread_5.jpg 8 - http://www.ourcivilisation.com/smartboard/shop/warnerr/plato.htm 9 - http://listcrux.com/top-10-countries-known-for-producing-opium/ 10 - http://olivier-dogot.blogspot.com/p/photos-8250-8300.html 11 - http://1.bp.blogspot.com/_JfWPgMk_xGs/TPAO3IPu3YI/AAAAAAAACdM/ w4Nr7SgJ2K0/s200/cocaine.jpg 12 - http://i.huffpost.com/gen/1408052/thumbs/o-COCAINE-facebook.jpg 13 - http://cinemagumbo.squarespace.com/journal/2014/4/10/three-on-a-reefer-antimarijuana-propaganda-of-the-1930s.html 14 - http://render.otoy.com/newsblog/?p=166 15 - http://www.absoluteastronomy.com/topics/Adriaen_van_der_Donck 16 - http://www.authentichistory.com/diversity/native/is2-drunk/1894_Bill_Nye_History_of_ The_US_pg74-Temperance_Indians.jpg 17 - http://en.wikipedia.org/wiki/Leslie_Keeley 18 - http://pointsadhsblog.wordpress.com/2012/02/29/lessons-of-narco-part-one/ 19 - http://content.time.com/time/specials/packages/ article/0,28804,2001284_2001057_2001042,00.html 20 - http://seattletimes.com/html/localnews/2012095021_alcoholic12m. html?prmid=related_stories_section 21 - http://www.clearviewtreatment.com/substance-abuse-residential-treatment-centerquestions.html 22 - https://www.addictioncenter.com/treatment-center/betty-ford-center/ 23 - http://afterpartychat.com/hazelden-review/ 24 - http://www.angryboar.com/index.php/underwater-painting-exhibition-sunken-ship/

“Sometimes you can only find Heaven by slowly backing away from Hell.” CARRIE FISHER

3 Mirmont Treatment Center

PART TWO

Livengrin Treatment Center

PART THREE

CASE STUDIES

PART ONE

Salvation Army Harbour Light

The

PART FOUR

Tides

Santa

Barbara

PART ONE: Mirmont Treatment Center

â&#x20AC;&#x153;If

I had to describe Mirmont in one phrase, I would say that

Mirmont is a place of healing.â&#x20AC;? - Tom Cain, President

Overview Mirmont Treatment Center is located in Media, PA, a suburb of Philadelphia, down the road from Pennsylvania State University’s Brandywine satellite campus. The treatment’s 33-acre campus is situated in a quiet, wooded area with a moderate amount of surrounding trees. It is accessible by a small road branching off from a larger road, which leads to a large parking lot and a circular drive leading to the front door. The entire structure is one story but incorporates a few different wings for dormitories and the detoxification unit. The owner of the facility is Main

Line Health, a not-for-profit health system serving Philadelphia and its suburbs. The corporation includes four of the region’s most respected hospitals – Lankenau Medical Center, Bryn Mawr Hospital, Paoli Hospital and Riddle Hospital – as well as the physical rehabilitation facility Bryn Mawr Rehab Hospital.1 The client is staff employed by Main Line Health – namely, administration, trained counselors and nurses, and doctors in the detoxification area. The users are the addicts themselves, hailing from all demographics and age groups. The facility provides medically monitored detoxification of the body from alcohol and drugs,

including Suboxone therapy for opiate withdrawal, which is similar to an Intensive Care Unit (ICU) in a hospital. The patients may only enter rehabilitation treatment after their detoxification process is cleared. In-patient rehabilitation focuses on Mindfulness-Based Stress Reduction (MBSR), which address the physical mental, emotional and spiritual aspects of the disease. The general program consists of individual therapy with trained counselors, group therapy supervised by a trained counselor, family counseling, 12-step meetings, pain management, exercise program in a fully-equipped Right: Outdoor area of Mirmont’s campus. Image courtesy of Mirmont Treatment Center’s official brochure.

SITE AND LOCATION (Sources: Stamen Maps and Google Earth) Location: Media, PA, a southeastern suburb of Philadelphia.

M 4848

Mirmont is located off of Yeardsley Mill Road.

Mirmont’s campus is in a wooded area surrounded by trees.

individual therapy with trained counselors, group therapy supervised by a trained counselor, family counseling, 12-step meetings, pain management, exercise program in a fullyequipped fitness center, daily yoga practice, morning acupuncture sessions, nutritional counseling, outdoor smoke breaks and smoking cessation program, educational sessions, and meditation. The facility also offers intensive outpatient services for patients who have been released or require less urgent care. These patients visit the facility three times a week for structuredgroup therapy, in either morning or night sessions to accommodate work schedules.

The pain management program, which is necessary to battle withdrawal symptoms and ultimately addiction itself, consists of integrated therapies such as acupressure, MBSR meditation, Reiki ( a Japanese form of massage), therapeutic touch, yoga, reflexology (a form of massage for the feet and hands) and visualization. Most of the facility, including dormitories, lounges, cafeteria tables, and outdoor smoking areas are separated by gender. This is done purposely with the mindset that members of the opposite sex contribute to distractions from individuals’ recovery processes. Family members are only permitted

to visit their respective patients once a week, on Sundays from 1-3 PM. This is allowed only after the family members attend a session on Saturday run by the counselors, teaching them how to properly interact with the patients so as to aid them in their recoveries rather than hurt or enable. The only televisions in the building are located in the CEO’s office and the multi-purpose space, where the patients may watch a program with family members when they come to visit on Sunday afternoons. This is done to prevent further distractions on the patients’ behalf. The lounges are equipped with board games, literature and chessboards. Below: Lounge. Image courtesy of Mirmont Treatment Center’s official brochure.

5 Above: Yoga room. Image courtesy of Mirmont Treatment Centerâ&#x20AC;&#x2122;s official brochure. Below: Fully-equipped fitness gym. Image courtesy of Mirmont Treatment Centerâ&#x20AC;&#x2122;s official brochure.

6 Above: The lobby. Image courtesy of Mirmont Treatment Center’s official brochure.

Design Concept and Style The building’s exterior is essentially comprised of brick and wood paneling. The interior features brick walls, stone floors and exposed dark wood beams in the lobby, but carpeted hallways and rooms and painted drywall in the rest of the building, excluding a few specialty rooms like the yoga room which boasts hardwood flooring. The hallways and some of the specialty rooms, such as the yoga room, lounges, and lobby, are well endowed with windows but they are inoperable except

5252

for cleaning purposes. On the whole, the building’s construction seemsto justify a medium budget.The lobby, which is the first accessible area of the building, features glazed stone tile flooring, brick walls, ceiling rafters painted dark brown and exposed ventilation. The wall separating the room from the circular drive is made completely of three foot-by-three foot windows that correspond with the ceiling rafters once above the main door. Suspended rectangular pendant lights and track lighting illuminate the space somewhat, and spotlights point upwards to enhance the sight of the ceiling rafters, but due to number ofwindows the space enjoys an abundance of natural daylight.

One of the main attractions of the room is the fireplace, which is situated across from the halfspherical reception desk. There are over twenty seats in the waiting area, set in a square formation, accented by large potted plants. The hallways and administration areas connect to the lobby, and there is a clear view of the meditation garden. The meditation garden is essentially a courtyard surrounded by the lobby on the west side, two hallways, and the counselor’s row on the north side, with a completely unrestricted view of the sky above. It iscomprised of medium-sized bushes and small green plants, a small fountain, large white rocks that

53 53

make up a stream-like formation, a small bridge crossing the stream, and a statue of the Buddha. The pedestrian surface is essentially square stone tiles over brown mulch. The walls throughout most of the facility are a warm yellow color, accented by a light brown carpet, which gives the interior a generally earthy, calming feel. In the bedrooms, the walls are painted with the same yellow color but feature an orange accent wall.

patients’ belongings, although they are only permitted certain items – no electronics such as cell phones, for instance. There are 109 beds in total, and the dormitories are separated into wings by gender – Wing 200 for women, and Wing 300 for men.

The dormitories are set up in a style in which there are two beds per room and a shared bathroom. The rooms also include cabinets for the Below: A typical two-person dorm-style bedroom. Image courtesy of Mirmont Treatment Center’s official brochure.

8 Above: Meditation garden. Image courtesy of Mirmont Treatment Centerâ&#x20AC;&#x2122;s official brochure. Below: Cafeteria. Image courtesy of Mirmont Treatment Centerâ&#x20AC;&#x2122;s official brochure.

PART TWO: Livengrin Treatment Center

â&#x20AC;&#x153;Hope,

help

healing

and

found here. â&#x20AC;?

- Livengrin Foundation

Overview Livengrin Foundation Treatment Center is located in Bensalem, a town just outside of Philadelphia in Bucks County, PA. The 40-acre property is surrounded by trees in a quiet, naturally lush area. The facility was founded by advertising executive and entrepreneur Standish Forde Hansell, who purchased the lot in 1966 as a fifty-year-old country estate with the original intention of renovating it as a retirement community where men could “live and grin” into their golden years.

However, he changed his mind on the advice of a few trusted friends, including actor Orson Welles, believing that there was a greater need for a nonprofit treatment facility aiding suffering individuals in the Philadelphia region. The “live and grin” mantra evolved into the name of the facility, Livengrin. Livengrin became a trailblazer in the field of addiction treatment through their unique innovations launched during the 1970s: a Family Education Program and extensive Aftercare and Outpatient Services. The organization also collaborated with the business and labor

communities by offering treatment options for employees in the workforce that were silently suffering from addiction. Today, the organization is comprised of residential rehabilitation and detoxification on the main Bensalem campus, and family and outpatient services satellite facilities located nearby regions such as Fort Washington, Allentown, Doylestown, Haverford, and Levittown, PA, as well as center city Philadelphia.

Left: Hansell Hall. Image courtesy of Livengrin Foundation’s official website.

SITE AND LOCATION (Sources: Stamen Maps and Google Earth) Location: Bensalem, PA, a northwestern suburb of Philadelphia.

5858

Livengrin is located off of Hulmeville Road.

Livengrin’s campus is in a wooded area surrounded by trees.

59 59

12 Above: Welcoming sign with Livengrin logo. Image courtesy of Livengrin Foundationâ&#x20AC;&#x2122;s official website.

In many cases, detoxifying the body of toxins is the first step in the recovery process. It is a cleansing period in which the symptoms of withdrawal are medically managed and minimized over a few days and conducted in a medical unit by experiences nurses and physicians. Pain and discomfort experienced during the process varies depending on the patient and their individual drug use history, but in almost all cases the pain is managed and lessened with pharmaceutical therapies. The detoxification patients participate in their own groups, separated from the residential

rehabilitation patients, until the detoxification process is complete and they are ready to join them. However, the rehab clinical staff and some rehab patients who are close to discharge often visit the detox unit to speak with the patients regarding expectations for residential rehabilitation, the next step in recovery. The programâ&#x20AC;&#x2122;s typical length of stay is 21 days, which a shorter span of time than the average facility; however, the patients are allowed to stay up to four weeks as per their health insurance plan coverage. Financial guidance is provided upon admission, and

insurance companies must be contacted in order to be authorized for admission. A typical day for residents consists of structured therapy sessions and personal time, including community lectures, small therapy groups, and focus groups aimed at addressing obstacles such as grief, trauma and loss.

13 Above: Site plan of the main campus with proposed new residences. Image courtesy of Stampfl Associates Architecture + Planning. Below: Floor plan of the main buliding. Image courtesy of Stampfl Associates Architecture + Planning.

Design Concept and Style Livengrin’s main building was originally an estate house that included a farm, so the campus embodies an old, fairly residential feel. Originally, the patients were housed solely in the two upper floors of the manor, and then in the two dorm-style wings – one for men’s residential rehabilitation, and one with 21 beds that served as the detoxification unit – that were constructed in the 1960s and 1970s. These dorms include two beds per room and a

shared bathroom, which is typical for residential rehabilitation facilities. However, in 2010, three suburbanstyle homes were built on the hillside near the manor house to accommodate the growing client base and the fact that women began entering treatment. The houses are about 6,000 square feet each, designed by Doylestownbased architects Stampfl Hartke Associates. The houses, which sleep 20 patients each, are comprised of a kitchenette, a lounge area with a television, a formal meeting area, laundry facility, and outdoor deck facing

the woods as well as 5 two-person bedrooms. They provide a “family dwelling” feature of recovery that is less institutional than the dormitory style, and enhance the community activity that occurs within residential rehabilitation in that the patients still share food service facilities and social areas. Two homes house male patients, and one home houses female patients; there are currently three, but a fourth and fifth dwelling are projected to be built.

Below: Suburban-style homes serve as residential facilities. Image courtesy of Livengrin Foundation’s official website.

6262

16 Above: Formal lounge within the homes. Image courtesy of Livengrin Foundationâ&#x20AC;&#x2122;s official website. Below: Typical two-person bedroom. Image courtesy of Livengrin Foundationâ&#x20AC;&#x2122;s official website.

63 63

Most of the buildingsâ&#x20AC;&#x2122; interior walls are painted a warm cream color, but are fairly devoid of decoration. This may have been done purposefully to avoid all manners of distraction, but in that case it is interesting that access to televisions in the lounges and computers in the library is allowed, albeit limited. Men and women are separated to prevent further distraction, as is the case in most rehabilitation facilities. Hansell Hall, which is the central main space where patients partake in meditation, reading, video presentations,

personal journal work, and social time, features hardwood floors and green carpet tiles. The ceiling is wooden in the octogonal area, and acoustical ceiling tiles (ACT) are used in the rest of the building. Mediumsized octagonal windows allow natural daylight to penetrate the space, in particular the easternmost glass wall that features an exit to the meditation garden beyond.

and a stone table with bench seats. Wooden benches are surrounded by small green plants, and a wooden bridge spans over mulch and stones in a mock stream setting. Since the entire campus is situated essentially in the woods, the area is very quiet and peaceful - ideal for patients to participate in holistic treatment such as meditation and tai chi exercises.

The meditation garden features an arched stone and plaster structure that patients can admire and sit beneath. There are large decorational stones in the center,

Below: Library with computers for patients. Image courtesy of Livengrin Foundationâ&#x20AC;&#x2122;s official website.

6464

19 Above: Meditation garden. Image courtesy of Livengrin Foundationâ&#x20AC;&#x2122;s official website.

Below: Fitness facility. Image courtesy of Livengrin Foundationâ&#x20AC;&#x2122;s official website.

65 65

PART THREE: Salvation Army Harbour Light

â&#x20AC;&#x153;Since

1960...Harbour Light has stood at the corner of Jarvis and

a beacon of hope.â&#x20AC;?

Shuter streets as

- The Salvation Army

Overview The Salvation Army Harbour Light is located in the downtown east side of Toronto, Ontario, one of the largest cities in Canada. The sevenstorey building’s total area is 86,000 square feet and was designed in 2010 by Canadian firm Diamond Schmitt Architects. It houses a community church, transitional housing, a residential addictions recovery program, and community and family services. The site, at a busy crossroads of urban activity, was carefully selected by the Salvation Army to serve as a beacon of hope against the wider backdrop of a

cityscape that feels impersonal and frightening to vulnerable individuals like addicts, to wordlessly reach out to those seeking help. The facility helps people re-integrate back into society without taking them too far away from it. The design of Harbour Light intends to reflect the Salvation Army’s unique ability to blend faith and pragmatism, strategy and salvation, and the pastoral and the practical1, particularly in the flexible community church space. The Chapel is an independent volume that is situated north of the residence wings. The exterior base construction is solid brick masonry, but the top half is clad in polycarbonate panels that are

SITE AND LOCATION (Sources: Stamen Maps and Google Earth) Location: Toronto, ON, near the border between USA and Canada.

Harbour Light is located on the corner of Jarvis and Struter Streets.

backlit to produce light, as the center’s mandate of serving as a beacon of hope. The panels cut back to reveal an illuminated veil behind two large crosses incised in the brick, which allow natural light to penetrate the space. The north wing features a shortterm residential addiction recovery facility that houses 48 single, double and triple dwelling rooms over six floors. This includes 36 beds, and provides a communal habitation setting.

Left: Exterior evening view. Image courtesy of ArchDaily.

Harbour Light’s campus is located in an urban setting.

23 Above: Front daytime view. Image courtesy of ArchDaily.

Communal rehabilitation is offered to men over the age of 18 suffering from mental health disorders (anxiety, bipolar, depression, schizophrenia, and personality disorders) as well as alcohol and drug addictions. The treatment staff uses the holistic approach to recovery, which focuses on biopyscho-social and spiritual factors. The counselors also work closely with family members by offering support sessions and education. The program includes individual counseling, group therapy, pyscho-educational groups, spiritual awareness, 12-Step meetings, exercise, relaxation, a healthy diet, development of

social and communication skills, coping with past trauma, and classes in areas such as Life Skills and Relapse Prevention. The treatment staff includes an intake worker, five primary counselors, nine floor counselors, a family wellness counselor, a chaplain and a nurse, as well as a weekly visiting doctor. The maximum length of stay for patients is 14 weeks, which at three and a half months is quite a long time in comparison with other rehabilitation facilities. After a period of time in thecommunal setting, the residents graduate to the 98 transitional apartments in the south wing of the building. The rent-geared-to-income bachelor

apartment units, where individual adults can stay up to 11 months, allow addicts who may have come to the facility homeless and jobless to transition to stable housing and meaningful participation in the community.2 The transitional rehabilitationâ&#x20AC;&#x2122;s program includes client support (as in an assigned caseworker per resident), life skills courses, financial literacy, healthy relationships and boundaries, G.E.D. preparation classes, workshops in areas such as anger and anxiety, English and French classes, nutrition workshops and cooking classes, pot-lucks and social activities, and volunteer opportunities.

24 Above: Floor plan. Image courtesy of ArchDaily.

Below: Front elevation. Image courtesy of ArchDaily.

Design Concept and Style As the Salvation Army is a nonprofit institution, costs are a great concern, so the design of the building aimed towardtaking maximum advantage of materials and methods so as to save funding for their programs. The building envelope consists primarily of concrete and brick to provide superior insulation and durability. Because the interior air system is tempered as opposedto conventional air conditioning and heating, the facility is highly energy efficient and sustainable.

The chapel â&#x20AC;&#x201C; called the Sanctuary â&#x20AC;&#x201C; fits comfortably around the corner of the intersection and in the area, as most of the buildings in the neighborhood are also brick-clad. The ground level includes a central corridor that links together program rooms, classrooms, amenity spaces, a dining room where patients can share meals with their visitors, two landscaped courtyards and the Sanctuary. The courtyards are formed by brick masonry screens, which protect the patients from the general public on the streets. The upper six floors hold the housing facilities. The Sanctuary anchors the residential buildings and frames the inner courtyard.1

The interior of the Sanctuary features a warm, wood-lined chamber illuminated by strategically placed thin, horizontal windows as well as the two aforementioned large cross-shaped veiled openings. This further imparts a glow onto the hardened streetscape.1

Left: Education space. Image courtesy of ArchDaily. Below: Foyer. Image courtesy of Diamond Schmitt Architects.

7272

73 73

Throughout the rest of the facility, there is an extensive use of wood in flooring, millwork, doors and cabinetry, which lessens the buildingâ&#x20AC;&#x2122;s institutional qualities. The combination of wood-lined ceilings and large windows framed by steel mullions creates a warm yet modern and light feel to the spaces. Some areas, such as the communal kitchen and the lobby, feature brightly colored walls and furniture which induces an energetic feel.

The most interesting aspect of the facility is the juxtaposition between its location â&#x20AC;&#x201C; in the middle of a major city â&#x20AC;&#x201C; and its purpose. The center essentially allows the homeless and addicted to live in dignity during their recoveries, which is a fascinating consideration since these individuals are normally viewed very negatively in society due to their circumstances. For many addicts, the opportunity to live comfortably independent

and learn life skills such as cooking and housekeeping is a novel opportunity, which is difficult for the rest of society to comprehend. The project will take these ideals into consideration, but the largest obstacle will be the American healthcare system, as insurance companies are the main source of income for non-profit rehabilitation centers.

Below: The Chapel. Image courtesy of the Salvation Army.

29 Above: Addictions floor kitchen. Image courtesy of ArchDaily.

Below: Lobby. Image courtesy of ArchDaily.

75 75

PART FOUR: The Tides Santa Barbara

“At the beach, life is different. Time doesn’t move hour to hour, but mood to moment. We live by the currents, plan by the tides and follow

the sun.”

- Anonymous

Overview The Tides Santa Barbara is an addiction treatment and recovery facility located in Santa Barbara, California, along the western coast of the United States. Santa Barbara is known as the “American Riviera” as it boasts one of the most pleasant yearround climates in the country and breathtakingly beautiful scenery. Temperatures range from the mid60s to mid-70s Fahrenheit throughout the entire year, reaching only into the 80s during the summer,and the area habitually receives around18 inches of rainfall per year.

What makes this region so aesthetically pleasing is the eclectic blend of dramatic mountain ranges and subsequent valleys with the many beaches and islands along the Pacific Ocean. Probably inspired by the landscape, the city is a hotspot for visual artists, featuring world-class performances of music, dance, opera and theater year-round, and as such is one of the top five art colonies in the western United States.

The temperate climate allows for outdoor activities such as golf, tennis, polo, horseback riding, cycling, hiking, and various water sports. Santa Barbara is also known for its chic boutiques and luxurious spas. In short, Santa Barbara is the type of city that would serve as a haven of health and refreshment for an addict seeking recovery of their mind, body and spirit.

Delineating from Spanish roots, the city also features world-class dining and boasts many restaurantsper capita, a feat not many other cities in the world have attained.

Left: Pool and spa deck. Image courtesy of The Tides Santa Barbara’s official website.

SITE AND LOCATION (Sources: Stamen Maps and Google Earth) Location: Santa Barbara, CA, near Los Angeles and Long Beach.

The Tides is located on Austin Road overlooking the Pacific Ocean.

T 7878

The Tides’ is a five star oceanfront property.

79 79

33 Above: Exterior daytime view. Image courtesy of The Tides Santa Barbara’s official website.

The facility’s program revolves around five-star residentialbased treatment of alcoholism and drug abuse. The focus is on addiction ranging from alcohol, pharmaceutical drugs, cocaine, heroin, methamphetamine and other chemicals, as well as eating disorders and gambling, and mental disorders such as depression, anxiety, and Obsessive-Compulsive Disorder (OCD), which is known as Dual Diagnosis. The facility also provides detoxification of opiates. Treatment of alcoholism requires several steps – the first being detoxification that is carefully controlled by relaxant medications

such as Valium. However, this step may be complicated by the fact that many alcoholics also suffer from addiction to such drugs. Following detoxification, support in the form of therapy groups is used to educate against the “maladaptive behavior” from which alcoholism stems. Interestingly, alcohol detoxification does not actually involve removing toxins from the body, as its name suggests. It is simply the abrupt cessation of alcohol coupled with cross-tolerant drugs in an attempt to prevent withdrawal. Alcohol detoxification is not always necessary for each

patient, depending on factors such as age, medical status, and history of alcohol intake. Alcoholism treatment at The Tides focuses more on the psychological aspect of addiction. However, drug detoxification deals with a physical dependency to drugs by purging the body of the substances, but in a manner in which the physical effects of withdrawal are lessened. Following detoxification, drug addiction is treated essentially the same way as alcoholism; that is, with group therapy and physical exercises.

34 Above: Second floor plan. Image courtesy of The Tides Santa Barbara official website. Below: First floor plan. Image courtesy of The Tides Santa Barbara official website.

The staff is comprised of an independently affiliated physician, a psychotherapist, a clinician’s assistant’s supervisor, an acupuncturist, a yoga instructor, and a waterdance therapist instructor. The Tides Santa Barbara also puts a strong focus on aftercare, which is continued treatment after the patient has been released from the rehabilitation facility. Aftercare is provided by Southworth Associates International, a limited liability corporation (LLC) that provides interventions, consulting, and monitoring services around the world. The monitoring program is aimed towards holding patients

accountable for their own actions, thus developing responsibility for one’s own sobriety. It also provides updates and assurance for family members and employers of the patient, and ultimately provides a higher success rate regarding achieving lifelong sobriety.

Design Concept and Style The Tides Santa Barbara is in a luxurious manor an oceanfront property. The structure was designed by Santa Barbara architect Robert Foley, the interior design by Laguna Beach firm Tuvalu, and cabinetry by PJ Milligan, also centered in Santa Barbara. On the ground floor, there is a gourmet kitchen and dining area with a marble breakfast bar, as well as a casual dining area. Most of the kitchen is white with pale yellow walls, except for the exposed brick wall against the Below: Kitchen. Image courtesy of The Tides Santa Barbara’s official website

8282

83 83

8484

39 Left: The Sea Lion Suite. Image courtesy of The Tides Santa Barbara official website.

Above: Basement floor plan. Image courtesy of The Tides Santa Barbara official website. Below: Home theater. Image courtesy of The Tides Santa Barbara official website.

85 85

stove, and features a direct window view of the ocean that the patients can enjoy as they eat. Beyond the kitchen is the living room, featuring a coffered ceiling with exposed white beams, sea-themed decorations, and eclectic furniture lit by coral-esque chandeliers and large white French doors that open to the beach. Also on the ground floor is the Library and Master Suite, including a small seating area and spacious master bath. The second floor is accessible by a spiral staircase within a cylindrical structure whose exterior matches the rest of the house. The level includes four luxury suites with

ocean views, which are all named and decorated according to a beach-related theme for each. For example, the Sea Lion suite (pictured) is decorated based on a dark violet gray shade that resembles the color of a sea lion. Also located on this level is an observation deck featuring a spaand infinity pool, which is used for waterdance therapy exercises. In the basement, also accessible by the spiral stairs, is a deluxe home theater, recreation room and media center with arcade games and a large pool table, Life Fitness home gym, spa with a sauna and

steam room, walk-in humidor, and salt-water aquarium, and a health bar which serves nutritional snacks. Outside, there is a fire pit and barbecue featured in the outdoor dining areas and ocean view decks constructed with Brazilian hardwood. The house is also heated with radiant floors on all levels and protected by fire sprinklers and electric gates.

Below: Entertainment floor. Image courtesy of The Tides Santa Barbaraâ&#x20AC;&#x2122;s official website.

8686

42 Next page: The Master Suite (left) and Master Bath. Image courtesy of The Tides Santa Barbara official website.

Above: The Navigator Suite. Image courtesy of The Tides Santa Barbara official website. Below: Bathroom. Image courtesy of The Tides Santa Barbara official website.

87 87

8888

89 89

End Notes and Bibliography

Image Sources 1 - http://all-that-is-interesting.com/trinity-abandoned-lighthouse 2 - http://best-wallpaper.net/Summer-trees-bokeh-leavessunlight_1920x1080.html 3-9 - http://www.mainlinehealth.org/doc/Page. asp?PageID=DOC003304 10 - http://www.hdwallsource.com/beautiful-wheat-pictures-24068. html 11-20 - https://www.livengrin.org/ 21 - http://www.leafygills.com/guide-to-aquaponics/locating-yoursystem/ 22-30 - http://www.archdaily.com/260565/salvation-army-harbourlight-diamond-schmitt-architects/ 31 - http://www.goodfon.su/wallpaper/tropical-beach-palm-tree.html 32-45 - http://thetidessantabarbara.com/ 46 - http://www.flickriver.com/groups/1166371@N24/pool/interesting/

“Before you can break out of prison, you must realize you are locked up.”

ANONYMOUS

Many guidelines exist to inform a designer of appropriate human behavior and ergonomics factors. In this section, the project will gather relevant diagrams concerning physical and psychological needs of the end user.

DESIGN & TECHNICAL CRITERIA

Lighting The “life-giving” rays of the sun, or natural daylight, are known to provide human beings with vitality and overall healthy wellbeing. This idea is most important when designing a space to be used for therapeutic purposes, as the patients’ main goal in the program is self-healing and general rejuvenation. The most important effect of sunlight is deinstitutionalization of the space, allowing the patients to feel as though they are receiving treatment in a home-like environment as opposed to a padded cell.

Lighting will ultimately fall into direct conjunction with the aesthetic design because it directly affects colors and textures through highlight and shadow. It provides the end user with the means to reveal volumes and thus interact with the environment intended through the design. Sufficient lighting is particularly important in areas of mental concentration, such as a counseling spaces, meditation rooms or classrooms. Sunlight, as well as positively affecting one’s mood and energy level, constantly changes the dynamic of color and shadow in

the interior space, which contributes to a healthy mental and physical well-being by providing kinesthesis exercises through stimulation of the eye and, therefore, the mind. An abundance of natural daylight – and thus, access to nature – will allow public areas, such as waiting areas or group therapy spaces, to transform into a more sensory-positive environment. A convenient way for a designer to achieve this with the waiting area would be to simply place it in an atrium or adjacent to a courtyard, since it will essentially be servicing the main entrance. The manner in

An example of a daylighting analysis diagram. Image courtesy of SmithGroupJJR Architects.

which corridors are lit must also be considered, since they are the main source of way finding and circulation. Patient rooms should have general lighting and a night light, which will be controlled at the room entrance but are fixed a heights above patient access. Corridors in nursing units should have general illumination with provisions for reducing light levels at night. Additionally, approaches to buildings and parking lots will have lighting fixtures that can be illuminated as neccessary.

3 Above: A hand-sketched sun path diagram. Below: An interior rendering of an atrium space featuring an abundance of natural daylight Image courtesy of MonsterCommercial.

Sustainable Design, Thermal Comfort Criteria & Building Systems

heating, and steam systems. In addition, all mechanical ductwork shall be mounted on vibration isolators in order to prevent structural vibration.

The mechanical system of the facility is the most basic yet essential aspect of sustainable design. A well-designed system can achieve energy efficiency yet still provide patients with optimum comfort levels, but it should be noted that under no circumstance will patient care and safety be sacrificed for energy conservation. Different geographic areas have climactic and use conditions, so maximum sustainability largely depends on the location of the building. However, general sustainable mechanical system design can be achieved by examining a few basic areas.

The energy-saving potential of a VAV system, which essentially varies the airflow of heating, ventilation, and air conditioning (HVAC) at a constant temperature, includes more precise temperature control, reduced compressor wear, lower energy consumption by system fans, less fan noise, and additional passive dehumidification. This is achieved by linking the system

Energy-saving mechanisms such as variable-air valve (VAV) systems, load shedding, and programmed controls for unoccupied periods (nights and weekends) should be considered. Air-handling systems will be designed with an economizer cycle to use outside air, where appropriate. System valves at supply and return ends of equipment will isolate the various sections of the cooling,

VAV System

5 Diagram depicting a vibration isolation system. Image courtesy of Farrat Isolevel Ltd.

to a thermostat, granting it the ability to control the temperature in a space, independent of other spaces. Providing the ductwork design of each space is similar, the VAV system can be easily transferred into different spaces, making it highly flexible, and since traditional VAV systems do not require piping or coils, the required simple electrical installation is inexpensive. Disadvantages to the system include a considerable space requirement – 18” vertically, and the length three times the diameter of the inlet – inconvenient access in spaces where a plaster ceiling is present, and decreased air velocity unless an expensive fan is used. However, these factors are much less relevant than the efficiency advantages presented by the VAV system. The VAV system will be ideal for all spaces except laboratory rooms, where air pressure control and optimization is critical. The airflow can be easily programmed for occupied periods in spaces such as the administration area, which are largely unused on nights and weekends. The typical dimensions of a VAV box passing a maximum of 250 cfm measure 16”Lx10”Hx10”W, and for a box passing 8000 cfm, 28”Lx17.5”Hx32”W.

6 As a space requires cooling because of a large cooling load, the damper in the VAV box will be placed in the â&#x20AC;&#x153;full openâ&#x20AC;? position, to allow the maximum volume of air to enter the room, as shown in the left picture. As the space comes closer to its setpoint temperature, the damper inside the VAV box begins to close, thus decreasing the volume of air delivered to the room, as shown in the second illustration.

Furniture, Finishes Equipment & Materials Flooring surfaces should be easily cleaned and maintained, but allow for ease of ambulation in medical areas. There should be smooth transitions between different flooring materials, and slipresistant products will be used in kitchen and bath areas as well as ramps and stairways. Additionally, in food areas, the floors will be resistant to food acids, and construction

will minimize gaps to prevent Furniture that is not easily moved by personnel or there is insufficient harboring of pests. In food and laundry areas, either a sealed monolithic and scrubbable gypsum board ceiling or a lay-in ceiling should be present. If it is a layin ceiling, it should incorporate a rust-free grid and tiles that weigh at least one pound per square foot and are capable of withstanding cleaning with harsh chemicals â&#x20AC;&#x201C; i.e., smooth, nonabsorptive and nonperforated. Seclusion treatment rooms shall have a ceiling height of 9 feet.

space to clean under and behind must be sealed against floors and walls. Equipment such as refrigerators, medicine and clean supply dispensing units, and kitchen equipment will be installed so that they can be routinely moved for cleaning. Furniture in medical areas will be upholstered with impervious materials. As common elements, the lobby must be equipped with a reception counter or desk, public waiting area, public toilet facilities, access to

make local phone calls, and provision for drinking water. The administration area will include an interview space for social service and financial consultations, individual offices, a multipurpose room, and equipment and supply storage. Hand-washing basins in medical areas will be made of porcelain, stainless steel, or solid-surface material. If the basins are set into a plastic laminate countertop, the substrate must be at minimum marine-grade plywood, or an equivalent material with an impervious seal. The sinks will be equipped with valves that can be operated without the use of hands. Provisions for drying hands will be required at all hand-washing stations except for scrub sinks. This includes a hand-drying device that blows hot air, provided the space has been cleared for air recycling. Shatter-proof mirrors will only be installed in patient bathrooms, not in the medical area. Window treatments, namely blinds and shears, will be provided in patient rooms to control light level and glare. They should not compromise patient safety and should be easy for both patients and staff to operate. The windows themselves will be comprised of shatter-resistant safety glass. Other glass used in the space, including glass doors,

lights, sidelights, borrowed lights, wall openings in active areas such as recreation and exercise rooms, and door panels located within 12 inches of the jamb shall utilize the same

glass type. Shower doors and bath enclosures will utilize either tempered safety glass or plastic glazing.

Dining Areas The cafeteria will be a large, public space that will have to seat the maximum number of patients in the building. Although chairs can be pushed under tables, thus creating more circulation space, a certain amount of square footage must always be allotted between chairs and tables. At least 25 square feet must be allotted per patient.

100

Proper seating arrangements will prove to be essential in the cafeteria area, both to optimize seating occupancy and accomodate disabled patients. Sufficient circulation depends on clearances between chairs and tables, as seen in the diagram to the right. Food service stations must also be accessible to all patients, as depicted below.

14 13

101

Patient Toilet Rooms ADA or ANSI-compliant grab bars are required in ten percent of all private/semi-private patient toilet rooms. Grab bars in toilet rooms for handicapped patients may be removable. The space between the wall and the bar must be filled to prevent a cord from being wrapped around it for hanging purposes.

That being said, towel bars, shower curtain rods and typical lever handles are not permitted as per suicide preventative measures. Wall fixtures such as soap dishes must be anchored sufficiently so as to sustain a concentrated load of 250 pounds. Ceiling fixtures such as sprinklers must be recessed and tamper-resistant.

Each patient toilet room must contain a toilet and a handwashing station, and some vestibule for bathing - either a shower or bathtub. The doors will be equipped with locks that are accessible by staff in case of emergency, and must either swing outward or be double-acting.

102

103

Patient Closets and Bedrooms The maximum number of patients in each bedroom should not exceed two. The rooms will have a minimum clear floor area of 80 square feet for multiple-bed rooms, and each will have a window that is in accordance with the requirements for glass and security measures. 23

Each patient will have access to a toilet room from their bedroom witho ut having to enter a corridor, so each bedroom will include one toilet room. The toilet rooms may serve mo re than one bedroom, but no more than two rooms and four patients. Within the room, each patient will have his own personal wardrobe or closet for storing personal articles. Shelves must be used instead of hanging arrangements for security precautions. Provided storage must be sufficient for a daily change of clothes for seven days.

104

105

Patient Laundry Facility One of the lessons that will be taught in the facility is how to properly wash a load of laundry. Through this, the patients will also learn the responsibility of taking care of their possessions.

27 26

106

Staff Areas Some of the spaces within the facility are meant for usage primarily by the staff, such as the conference rooms and administration offices. A massage room is included in case the project wishes to add such into the program, as the size of the room, layout, and furniture dimensions all constitute necessary knowledge.

107

End Notes and Bibliography

108

Image Sources 1 - http://speciesandclass.com/2014/09/16/the-us-a-prison-state-for-bothpeople-and-animals/ 2 - https://prezi.com/z29shg59cqly/week-3-electrical-energy-use-andrenewable-net-power-genera/ 3 - http://imgkid.com/sun-diagram-architecture.shtml 4 - http://www.monstercommercial.com/effective-daylighting-in-buildingspart-2-daylighting-dimensions/ 5-7 - http://www.pages.drexel.edu/~jmd27/myweb/vav-2.htm 8 - http://princetonbaby.org/personal-pregnancy-experience/ 9 - http://www.andreadaniels.net/medsurgsemiprivateroom.html 10-30 - The Time Saver Standards for Building Types by Joseph DeChiara

109

“We need drugs, apparently, because we have lost each other.” WENDELL BERRY

110

PA R T O N E Human Behavior and Color

PA R T T W O Meditation, Yoga and Their Roles in Treatment

PART THREE

TOPICAL EXPLORATIONS

The Role of Family in Recovery

111

PART ONE: Human Behavior and Color

112

One of the most important aspects of design is the effect it elicits to other human beings. It can be difficult to determine how architecture and interior design can affect individual end users, but there are some general ideas pertaining to human behavior in a space and the color decor it incorporates that all designers must consider.

113

Human Behavior When designing a space, it is essential to consider aesthetics, or the idea of being visually appealing or pleasing, thus yielding a pleasurable response from the end user. Aesthetics are important in determining human behavior, but can also conflict with behavioral considerations. Function and aesthetics play equally important roles in design, and although both can be highly subjective factors, a successful design finds a way to sufficiently incorporate and balance both. In addiction treatment, aesthetics are highly important because everything in the space should contribute to the idea of healing, and must take great care to prevent any negative feelings that can severely impact an already fragile mind, body and spirit. Physical aspects of design take the form of formal aesthetics, focusing on dimensions (shape, proportion, scale, novelty, and illumination), enclosure (spaciousness, density, and mystery),complexity (visual richness, diversity, and information rate of environmental stimuli), and order (unity and clarity). Formal aesthetics typicallydepend upon the Gestalt theory of perception, which states that peopleâ&#x20AC;&#x2122;s perceptions of stimuli affect their responses. If two people are exposed to the same stimulus, their reactions will be different because both are based on their individual past experiences.

114

SHAPE

Does this room have a shape that is appealing for its intended use?

PROPORTION

Are items in the room sized so that no single object dominates the scene?

SCALE

Do furnishings and accessories fit the room without looking too large or too small?

NOVELTY

Are there elements or components of uniqueness or fascination?

ILLUMINATION

Is lighting sufficient and appropriate for the room?

SPACIOUSNESS

Does the room give the appearance of having space and not being cluttered?

DENSITY

Is the floor-to-space ratio ample in relation to objects occupying the room?

MYSTERY

Do elements within the room inspire or beg for exploration?

VISUAL RICHNESS

Are there interesting items to view while maintaining the roomâ&#x20AC;&#x2122;s unifying theme?

DIVERSITY

Are a variety of objects or architectural features present within the room?

INFORMATION RATE

Do all aspects of the room register with the viewer at an equal rate?

UNITY

Is there a unified theme among all parts of a room?

CLARITY

Is the purpose or function of the room and objects obvious?

Symbolic aesthetics complement formal aesthetics by moving beyond physical objects and straight to their deeper meaning, whether denotative (function or style) or connotative (implying an association, such as welcoming or forbidding). Sources include naturalness, or the level in which natural elements are used in the design; upkeep, or the level in which designs can be easily maintained; intensity of use, or the intensity or presence of particular design features; style, or the overall design arrangement. A person who puts on a pair of tight pants will automatically assume that they have gained weight. Conversely, that same person may take advantage of their expanded dessert threshold if the pants they put on felt loose. A weight loss clinic, or clinic that treats eating disorders, employs the mission of helping people lose weight but also feel more positively abouttheir bodies, so they might furnish the waiting room with more narrow chairs to remind clients of why they are there. Larger chairs could be placed in the counseling spaces so that the client can recognize gradual accomplishments.1

Environmental Stimuli Inadequate

Neutral Zone

DARKNESS EXTREME SILENCE STAGNANT AIR EXTREME COLD

Excessive

GLARE EXTREME NOISE DRAFTY AIR EXTREME HEAT

COMFORT RANGE

8 Information courtesy of Ambient Environments.

115

Locus of Control How people view themselves and their opportunities is known as an individual locus of control. Someone with a strong external locus of control (ELOC) believes that he is controlled by external forces, such as fate, luck and chance, rather than their own actions. Conversely, someone with a strong internal locus of control (ILOC) believe that their actions, choices and pursuits control their destinies. From a design perspective, end users with ELOC tend to prefer large, interpersonal spaces, whereas ILOC people, who believe that they

can influence their own outcomes and do not appreciate invasion of their personal space, tend to prefer spaces with a higher density. One’s locus of control develops from the environment of his youth. Internals normally grow up in families that emphasize education and responsibility, while externals usually come from a more oppressive place with limited resources. In this perspective, it is assumed that most addicts have an external locus of control: they never learned how to take responsibility and control of their own lives and instead depend upon outside sources – such as drugs

– to get them through each day. By extension, it can also be assumedthat rehabilitation centers and Alcoholics Anonymous, through employing the Twelve Steps to Recovery, attempt to change addicts’ locus of control from external to internal. Control over a space is a comforting feeling to human beings – satisfaction is found in spaces with desired control levels, whereas discouragement and frustration is encountered when humans are not in control of what happens to

Individuals with an ILOC believe that they control their own destinies and balk from invasion of their personal space. Image courtesy of Flickr.

116 116

10 Simply looking out of a window and seeing greenery can serve as a restorative space. Image courtesy of Forbes.

them. The most important aspect of control is that of privacy â&#x20AC;&#x201C; when humans can control their own levels of intimacy, it elicits a positive psychological effect. Privacy is made up of audio and visual control, and to humans who are inherently social animals, restriction on what is heard by others is far more valuable. Within any set of spaces, there should be several privacy zones that will function as areas of complete solitudeor small intimate gatherings. This is applicable in an addiction treatment center, where the program is largely comprised of confidential counseling sessions between patients and therapists and doctors or small group therapy sessions.1

Restorative Spaces

11 Julian B. Rotter developed the concept of locus of control in 1954. Image courtesy of LearningInfo.

When mentally exhausted, humans become distracted, irritable and impulsive â&#x20AC;&#x201C; all things that addiction treatment facilities strive to improve. Professors Stephen and Rachel Kaplan of the University of Michigan have determined the sort of places that help restock mental energy â&#x20AC;&#x201C; they are known as restorative. The first feature of a restorative place is that of feeling away, as a restorative place seems mentally a long way from the source of exhaustion. Looking out of window, at a painting of a natural scene, or into a fish tank can provide a small mental break. Second, restorative places serve as a source of fascination; it must be

117

12 An example of an English country garden. Image courtesy of JardinDesign.

pleasurable and effortless to think about. Third, restorative places must be easily visitable so people are able to anticipate what will happen in them. They do not have to be large spaces, so long as they are interesting worlds that humans can explore without concern. For example, an English country garden, though small in size, are restorative because they feature many different plants and elements on which one can focus his attention. Additionally, restorative spaces allow humans to easily do what is necessary, incorporating easily legible signage and symbols. Restorative spaces elicit their effects within a few moments of exposure.

118

Although many restorative s p a ces , w hi ch ca n ta ke countless forms, are green and natural in nature, any scene viewed can be made pleasant, such as a museum display. Or the space could be very simple, such as a quiet space with a comfortable chair, fish tank, some potted plants, and large window with a pleasant view to the outdoors. The outdoor view is also important, as humans are naturally more inclined to relish the sight of large, gently rolling hills with some clumps of trees. It is also essential that the person is able to move away from a stressor into a restorative environment without feeling trapped in either space.1

Smells In some ways, smell is humansâ&#x20AC;&#x2122; most basic sense. It also directly affects brain activity, and oneâ&#x20AC;&#x2122;s mood can be greatly affected by pleasant or unpleasant smells. For example, anxiety levels can be improved by burning incense in the form of marjoram, rose, lavender, bergamot and cypress. Spiced apple scents can also reduce blood pressure levels. Other prime examples are located to the right.2

Lavender

can sedate humansâ&#x20AC;&#x2122; central nervous system. For this reason, many hospitality firms spray their bed sheets with lavender scent, or place small bundles of the herb in their client rooms. 13

Peppermint

The smell of can improve physical performance. A fitness area scented with peppermint, for example, could yield more effortless workouts and thus generally more positive feelings. 14

Jasmine

allows for an improvement in sound sleep. People who are exposed to jasmine as they sleep will wake up feeling more refreshed and alert and less anxious. 15

Orange, Lemon and Lime 16

help reduce anxiety levels, particularly for women. People who can smell lemon in their environment are more likely to report feeling in better health. This can be especially useful in doctor and counselor offices, perhaps in the form of cleansing agent or a fruit tree.

Nutmeg

The smell of can serve as a relaxant, and can be commonly found in outdoor gardens. A room with a window opening to an outdoor garden can be particularly effective.2 17

119

Colo r

Red

Color in interior design can have an extreme impact on the way that human beings interact with and feel within a space. Different colors can affect moods and even medical ailments, to a mental extent. Although individual users are affected differently by each color, there are general psychological traits to each color way.

The color of power, passion, energy and strength, as well of aggression, anger, and death. As it is a dramatic color, it is often chosen by outgoing, active types (especially children) because it has the shortest wavelength and appears to leap out at the viewer. It stimulates the brain and appetite and raises the heart rate and blood pressure. It is best used in rooms where stimulated activity will occur, such as a study room or exercise room. Red is also flattering on oneâ&#x20AC;&#x2122;s complexion, so it is useful in a room meant for socializing, such as a dining room. In terms of therapy and human factors, red can help poor circulation, chilblains, poor appetite, fatigue and low blood pressure. Its complementary color is blue.

Orange A warm, friendly color that is cheery and full of energy. Orange is often chosen by fun-loving, energetic, warm and friendly people, however, like red, it is a very assertive color and can be overpowering when used in large amounts. It is a good choice for kitchens and dining rooms because it stimulates the appetite, and for social areas and exercise rooms as it exudes energy and motivation. Orange can provide a gentle energy boost and calm the digestive system. It is thought that orange helps asthma, menstruation pains, persistent phlegm and wet coughs, and counteracts depression, loneliness and fear. Its complementary color is indigo.

120

Green 21

Ye l l ow A bright, optimistic color that reminds human beings of sunshine. As it brings a bright, welcoming feel, it is particularly beneficial in corridors and entries. Yellow is also said to improve the memory and intellect while bringing about greater levels of creativity, communication and positivity, so it would be useful in an office setting. Designing with yellow is said to be great for the central nervous system, and can help arthritis and exhaustion and stimulate clear thinking. It also aids in cleansing the body of toxins, and is good for constipation, urine infections, water retention and bloating. Its complementary color is violet.

A restful and reassuring color that brings balance, serenity, and harmony, often favored by caring and empathetic people. Green has strong connotations with nature and the natural world, and because of its calming and restful effect, is best used in areas where relaxation is desired, such as living rooms, bedrooms and bathrooms. However, too much green can become bland and cause boredom. Pale green can be unflattering to human skin because it gives the appearance of being sickly, but this can be avoided by adding a few blues or oranges to relieve the green.

23 Using a palette with green can help balance blood pressure, the central nervous system and the heart. It is generally positive for neuralgia and relieving tension and stress through its relaxing and calming nature. Its complementary color is pink.

Blue A soothing and calming color that gives off stability, serenity and peace, often chosen by quiet, intellectual and reserved individuals. Blue is the color of calm and healing and elicits the feeling of rest, so it is beneficial in a room meant for relaxing. Additionally, blue stimulates the intellect and brings clarity of thought, so it is best for offices and study rooms. It is associated with water, so it works well in bathrooms and kitchens. However, too much blue can become cold and formal and may lead to feelings of withdrawal and isolation, but can be warmed with touches of yellow, orange or green. For humans, blue is beneficial in treating eating disorders and soothing emotional issues, as well as helping heal inflammations and fever through its cool and calming effect.

121

Pink

Violet 25

Indigo A cooling and purifying that is said to be good for soothing stress, releasing fears, and helping mental complaints. It is beneficial in bedrooms and sleeping areas because it is known to cure insomnia, as it is the color of the night sky. Medically, it can help soothe fevers, rheumatism, arthritis, eczema, night sweats, and itches, among others. Indigo can be paired with its complement orange to help chest and lung problems.

122

A feminine color that is associated with love, nurturing and soothing qualities that is often favored by understanding, sympathetic and nurturing individuals. Pink should be blended with warm neutrals and deep berry shades so as to not overdo the color and become physically exhausting.

A powerful, dignified and regal color that is associated with spirituality. Pale lilacs can be used for relaxing and calm environments; as such, they are excellent for meditation spaces. Deeper purples give off an aura of luxury and decadence, but are tiring to the eye and should be used sparingly.

Violet usage in design is beneficial for purifying the blood and helping cure nervous headaches, eye and ear issues, snoring, lower back pain, and infertility.

Gray

A sophisticated, formal color that is associated with productivity but can also be seen as dull, lifeless and depressive. To prevent this, plenty of texture must be used to add interest and life to the color, and it is best used in formal and modern environments with other colors.

Black The color of glamour and sophistication that has an air of mystery. It is powerful and dramatic, and can be seen as intimidating, negative or depressing. Black is usually best used sparingly as an accent color, and serves as an excellent foil to other colors in order to show them to their best effects. Black and white together has an extremely striking effect.

34 31

A warm, sophisticated, neutral color of earth and nature, brown suggests solidity and security. It can be used as an alternative to black without the heaviness and negative impact, and looks good against all other colors as a neutral.3

White The color of purity and simplicity. It is highly reflective, so it can be used to create the illusion of more space. It is suitable in work environments where precision and accuracy are required, but too much white can become cold, sterile and unfriendly. When used as a background, white sets other colors well, making them look fresh and clean and modern. Pure, all-white is difficult to pull off in an interior application; different shades of off-white and textures must be used.

Brown

123

PART TWO: Meditation, Yoga and Their Roles in Tre

124

Both meditation and yoga employ relaxing and healing properties that are beneficial to a recovering addict seeking clarity in his life and a blank slate on which to begin again.

eatment

125

Meditation A Brief History The earliest records of the existence of meditation exercises were found in wall art in the Indus Valley, dating back to around 5,000 B.C. The images depicted what we today would recognize as meditation poses, like figures with crossed legs, hands resting on knees, and eyes slightly narrowed. It is clear that meditation originated with the Indian culture, as there are descriptions of meditation techniques found in Indian scriptures dating back some 3,000 years ago.

A few centuries later, most of the worldâ&#x20AC;&#x2122;s religions adopted the basic concepts of meditation. Although each culture employs their own exercises, the central belief remains the same across the globe: that meditation is an essential cornerstone of spiritual development. Meditation was introduced in the United States during the 1960s. Despite being practiced by almost every major religion, meditation is not necessary considered a religious exercise. Adherence to a particular faith is irrelevant, as the main goal of meditation is clearing oneâ&#x20AC;&#x2122;s mind of extraneous thoughts so that they may listen to God.4

Benefits of Meditation Meditation induces a cleansing and nourishing effect from within the body and brings calmness when one feels overwhelmed, unstable, or emotionally shut down. Assimilation of it in everyday life brings about a more rapid evolution of consciousness. When one perceives the world as part of himself, love flows strongly between the person and the world, thus turning anger and disappointments into fleeting emotions. The confluence of knowledge, understanding and practice make life complete.

126

On a physical level, meditation lowers blood pressure, reduces anxiety and tension, increases serotonin production that affects mood and behavior, and improves the immune system. Mental benefits include increased creativity and happiness, improved emotional stability and intuition, and peace of mind.

It allows one to live in the moment and forget about the past. As such, it is beneficial forrecovering addicts who are attempting to restart their lives with a clean slate. When a blank and meditative state of mind is achieved, memories, emotions and behaviors can be examined introspectively and objectively, allowing the addict to come to

terms with what exactly caused his addiction in the first place. This also allows him to realize what is necessary to maintain sobriety by illustrating the true destruction of substance use and abuse.5

127

Yoga A Brief History The earliest archaeological evidence of yoga’s existence lies in stone seals found in the Indus Valley from around 5000 B.C. that depict figures of yoga poses. However, many scholars argue that yoga actually existed long before that, perhaps within Stone Age Shamanism as they both aim to heal community members and the practitioners act as religious mediators. Despite the common misconception that yoga is rooted in Hinduism, Hinduism came about well after the practice of yoga began. Although yoga currently focuses more on the self, it began as community-oriented, passed on from teacher to student through oral teaching and practical demonstration. Because of this, yoga exercises are based upon the collective teachings of many people, and there is not one correct format. What is referred to today as Classical Yoga came from one of the earliest texts on yoga compiled by a scholar named Patanjali called Yoga Sutras, possibly as early as the 1st century B.C. He wrote about the eight limbs of yoga, which are comprised of the following:

Yama, or “restraint” – refraining from violence, lying, stealing, casual sex, and hoarding

Niyama, or “observance” – purity, contentment, tolerance, study, and remembrance

Asana, or physical exercises

Pranayama, or breathing techniques

Pratyahara, or “withdrawal of the mind from the senses”

Dharana, or concentration – being able to hold the mind on one object for a specified time

Dhyana, or meditation – the ability to focus on one thing (or nothing) indefinitely

Samadhi, or absorption – the realization of the essential nature of the self

128 128

Modern yoga classes generally focus on the third, fourth and fifth steps. Yoga probably arrived in the United States during the late 1800s, but did not become widely used until the 1960s, when interest in the East was at an all-time high.6

Benefits Yoga aims to unite the mind, the body, and the spirit; therefore, it is considered a therapeutic exercise. People practice yoga to feel fitter, more energetic, happier and peaceful, and to create strength, awareness and harmony in the mind and body. According to Dr. Natalie Nevins, DO, an osteopathic family physician and certified Kundalini Yoga instructor in Hollywood, practicing yoga can provide the human body with medical benefits. “The relaxation techniques incorporated in yoga can lessen chronic pain, such as lower back pain, arthritis, headaches and carpal tunnel syndrome,” she explains. “Yoga can also lower blood pressure and reduce insomnia.” Other physical benefits include increased flexibility, muscle strength and tone, improved respiration and energy, maintenance of a balanced metabolism, weight reduction, cardio and circulatory health, improved athletic performance, and protection from injury.

Besides physical benefits, yoga is also extremely helpful for managing stress. “Stress can reveal itself in many ways, including back or neck pain, sleeping problems, headaches, drug abuse, and an inability to concentrate,” says Dr. Nevins. Yoga’s incorporation of meditation and breathing

help a person improve his or her mental well-being by creating mental clarity and calmness, increased body awareness, and sharpened concentration. Yoga can be practiced to enhance overall health and is a great way to get in tune with the inner self; for that reason it is extremely beneficial

“Yoga can be very effective in developing coping

for recovering addicts who are struggling with their sense of identities and the haze everpresent in their minds. Yoga classes are a regular daily class taught in addiction facilities by trained professionals.7

skills and reaching a more

positive outlook on life.” - Dr. Natalie Nevins

12129 9

PART THREE: The Role of Family in Recovery

130

cause

You didn’t addiction.

the

control

You can’t the addiction.

You

cure

can’t addiction.

the

- “The Three Cs of Dealing with an Addict”

131

Alcoholism and drug addiction is a disease that affects the entire family. No matter who the addict is – a child, a parent, a spouse, a relative, or friend – the whole family suffers by being stressed to the breaking point in a number of ways: the stability of home, mental health, physical health, finances, and overall family dynamics and unity. Although no family is born with the knowledge of how to effectively deal with addiction, it is imperative that a suffering family seek and learn recovery so as to minimize the disruption of family life and harmful effects that likely last a lifetime.

Addiction in families strains relationships and causes anxiety, mistrust, fatigue a nd an overwhelming sense of hopelessness. It can take years to rebuild and restabilize. However, one of the largest obstacles for families to overcome through recovery is the belief that everything will be better again so long as they simply “fix” their loved one. Families must come to understand that just as addicts are responsible for their recoveries, the family members themselves are responsible for their own.8

In order to move on, families must learn a variety of skills and support, such as the following:

1. End the isolation and connect by joining an education or support group. 2. Education on addiction and the family: understanding how addiction affects both the addicted person and the family. 3. Learn communication skills. 4. Learn to detach with love and focus on assuming responsibility for one’s own behavior. 5. Stop old behaviors: enabling, denial, blaming and minimizing the problem. 6. As a parent, engage the children through providing support and protection while encouraging them to take responsibility in their recovery. 7. Build personal and family strengths on resilience earned from surviving addiction. 8. Engage in personal and family activities as a source of fulfillment, such as volunteering. 9. Understand and prepare for relapse, both the addicts in their addictions and family members into their old habits and behaviors.8

132

Codependency In recovery, every family member has a role. However, some roles can seem helpful while actually supporting the addictive behavior of a loved one. These enabling roles cause stress and other problems for themselves and their relationship with the addict. One of these enabling roles within families is that of codependency. It is defined as a dysfunctional style of relating to others where the person feels overwhelmed by life circumstances and thus is incapable of taking care of themselves. They make futile attempts at controlling situations, such as buying their husband a new car to encourage him to get to work on time, or buying their child a new backpack to help him earn better grades. Codependent people do not realize that money and talking cannot completely cure substance abuse and psychological illness. Since human beings cannot be controlled by other humans, this behavior only leads to destruction of self and of others. Most treatment centers now provide codependency counseling to family members.8

“It’s very simple, you just need to get through it. You’re a juggler and one of the best. You flip and spin endless family incidents and there’s nary a chip to be seen, at least not while you’re moving. If your footwork’s right, it falls in place most of the time. You’re the one who pushes the chaos out. You’ve got a handle on the situation. All of these are symptoms of co-dependency. As soon as you got the news, you took action. Your son had been behaving badly, so you fixed his car and bought him that tattoo. You both had long talks. He agreed it was a better idea to focus on his studies and take that job. But since he switched schools his grades have suffered, and now he skips classes and sneaks out at night. He thinks you don’t know, but you can tell by the way he shelters his eyes. You also called the school. These are codependency symptoms. This is the solution: if your husband would just stop drinking, your house would become a home. His son needs a father, especially now. It’s easy: he should just stop like you did. So you throw the liquor out. But your husband doesn’t listen like your son – he just heads to the bar. So you lash out. And private arguments become explanations to the police. But you can take care of that, too. These, too, are symptoms of codependency.” - The Recovery Village

133

Relapse Relapse is a normal part of recovery, but it can be either a good thing or a bad thing depending on the individual. If the addict is using relapse as an excuse to delay his total commitment to sobriety, then it is obviously a bad thing. However, if an addict has relapsed into his drug habits but has learned from the slip and embraced a more formidable recovery, then it can be beneficial in the long run. It is extremely important that family members understand this difference and employ patience with their loved one during their recovery. There are four components of relapse that should be considered by both the addict and the family members.

Recovery Expectations Unfulfilled expectations, whether realistic or unrealistic, can easily open the floodgates to relapse. Both the addict and his family can get swept up in what they believe is a fast and easy recovery, which becomes a honeymoon period reflecting a happy work environment and fairytale relationships. However, when these events and people do not turn out as expected, the addict turns to the only place he finds comfort – alcohol and drugs. People with an addictive personality – as addicts usually are – see the world in black and white, and the pendulum swings so far to either side that their highs are often too

134

high. At the same time, the lows can get so low that the addict does not know how to crawl out of the hole, dust themselves off, and move on. When this happens, the addict becomes self-berating and is not able to take the time to regroup.

These resentments must be dealt with through 12-step meetings and professional counseling – unfortunately there is nothing the family members can do about this aspect of recovery, because the resentments may involve them.

Additionally, as the recovery process continues, the addict begins to see how much he missed out on while he was busy living his life intoxicated. It can be difficult to deal with this new confusing emotion and relapse is often imminent for a person with no patience or willpower with which to work through it.

Boredom

Family members, after understanding that these roadblocks are often necessary to recovery, must be patient and supportive regarding expectations.

Resentments Resentment toward a person or a place can be so overwhelming in the mind of an addict that inorder to stop the internal anger or frustration, he self-medicates in the hopes of turning off the noise. Addicts use the residual effects from resentful anger to fuel their “pity pots,” which give them a reason to drink or use. For example, an addict who was neglected as a child will spend his whole life telling himself that whoever neglected him did not care for him, that therefore he does not deserve to be cared for, and the only thing that helps dull the pain is alcohol and drugs.

As the saying goes, “an idle mind is the Devil’s playground.” Routine and concrete scheduling is a lifesaver for a recovering addict because it provides him with a newfound sense of responsibility. Being held accountable to someone or something positive can provide a safe framework for the recovering addict to live with and depend upon. The family members can be instrumental in this regard by providing the addict with a structured schedule of things to do and places to be, within reason. They must be careful to not place too much stress on the person, however.

Fear Whether imagined or real, fear can cripple peoples’ ability to make important changes in their lives. This is applicable in the case of an addict, who may be aware that his current lifestyle is unacceptable, but lacks the courage to take a step toward a better life and a new identity. Overcoming fear requires strength and trust that a higher power will take care of the person, which is a mantra taught in addiction treatment centers. 9

Alcoholism Relapse Decision Matrix

The addict alone is responsible for his own decisions and cannot be forced to do anything. However, it should be noted how often a typical addict’s decisions involve consideration of his family.

Immediate Consequences

Delayed Consequences

Positive

Negative

Positive

Negative

Remain Abstinent

Improved selfefficacy and self-esteem, family approval, better health, more energy, save money and time, greater success at work

Automatic pleasure, reduced stress and anxiety, not feel pain, not worry about one’s problems, able to enjoy sports and drink with buddies

Greater control over one’s life, better health and longevity, learn about one’s self and others without being intoxicated, more respect from others

Resume Alcohol Use

Frustration and anxiety, denied pleasures of drinking, unable to go to bars, anger at not being able to do what one wants without “paying the price”

Feel weak from drinking, risk of accidents and embarrassment, anger of wife and family, arrive late to or miss work, hangovers, waste money

Maintain Possible loss of friendships family and job, with drinking deterioration buddies, able of health and to drink while early death, loss watching of nondrinking sports, not have or light-drinking to cope with friends, ridicule wife and family by others, low by staying out self-esteem10 drinking

Not able to enjoy drinking while watching sports, bored and depressed, not able to remain friends with heavydrinking buddies

135

Mutual Aid Groups Mutual aid, or self-help groups as they are often called, play an integral role in recovery for both addicts and their families. (See Section 2 for a brief history on mutual aid groups.) The groups are nonprofessional and members include sufferers of the same issues who voluntarily support one another. They do not provide formal treatment but rather social, emotional and informational support towards the addicts’ sustained health, wellness, and recovery.11 Some groups incorporate an open approach to meetings, in which

anyone can attend, while others limit their support to addicts who actively wish to recover. Although Alcoholics Anonymous is probably the best known mutual aid group for addiction recovery – see Section 2 for a brief background on the international fellowship – there are many other groups dedicated to supporting addicts.12

Al-Anon is a group dedicated to family members affected by alcoholism by a loved one. It also includes ALATEEN, a group that supports the children of alcoholics. Adult Children of Alcoholics (ACA) is different than Al-Anon and ALATEEN in that it focuses on people who grew up in alcoholic or

“I thought over and over about what I was going to do when [my daughter] overdosed and died. How would we go on?” -Dina Kucera

136

45 Mutual aid groups can assure family members that they are not alone in their struggles. Image courtesy of Alta Mira Recovery.

otherwise dysfunctional households and discover how their childhoods affect their present lives. Narcotics Anonymous is similar to Alcoholics Anonymous, but is, given its name, a fellowship dedicated to supporting recovery from drug abuse as opposed to alcohol. The only requirement to join is a genuine desire to stop using. In the same breath, Nar-Anon is a family support group dedicated to relatives or friends of addicts recover from the experience of living with an addict. Other smaller groups include Marijuana Anonymous, Cocaine Anonymous, Crystal Meth Anonymous, and Nicotine

Anonymous, among others. Dual Recovery Anonymous helps people with both addiction and an emotional or psychiatric illness by addressing how both illnesses affect all areas of life and supporting sufferers through the recovery process.13

As many addiction treatment centers include these support groups into their daily counseling methods, including separate family visitation and education days on weekends, the project aims to incorporate the idea of family into the final design.

137

End Notes and Bibliography

138

Text Sources 1 - Environmental Psychology for Design 2 - Place Advantage: Applied Psychology for Interior Architectur 3 - http://www.interior-design-it-yourself.com/decorating_color_schemes.html 4 - http://www.pva.org/site/c.ajIRK9NJLcJ2E/b.6738073/k.9877/The_Psychology_of_Color_in_Healthcare.htm 5 - http://www.psychologytoday.com/blog/meditation-modern-life/201307/overview-meditation-its-origins-and-traditions 6 - http://www.artofliving.org/meditation/benefits-of-meditation 7 - http://www.choosehelp.com/topics/drug-treatment/the-benefits-of-meditation-in-drug-treatment 8 - http://www.americanyogaassociation.org/general.html 9 - http://www.osteopathic.org/osteopathic-health/about-your-health/health-conditions-library/general-health/Pages/yoga.aspx 10 - http://www.therecoveryvillage.com/drug-treatment-guide/codependency/ 11 - http://www.familyrecoverysolutions.com/articles/relapse/ 12 - http://webcache.googleusercontent.com/search?q=cache:5oOHg5-7vOwJ:https://ncadd.org/ get-help/mutual-aid-support-groups+&cd=1&hl=en&ct=clnk&gl=us 13 - http://pubs.niaaa.nih.gov/publications/arh23-2/151-160.pdf

Image Sources

1 - http://pubs.niaaa.nih.gov/publications/arh23-2/151-160.pdf 2 - http://akumahusorga.blogspot.com/2013/10/salamatus-sadr.html 3 - http://francotechnogap.com/ 4 - http://francotechnogap.com/ 5 - http://francotechnogap.com/ 6 - http://imgur.com/gallery/IAktpMU 7 - http://francotechnogap.com/ 8 - http://blog.thesietch.org/2008/10/26/sweating-the-big-stuff-get-your-priorities-right/ 9 - http://francotechnogap.com/ 10 - http://www.6sqft.com/inside-the-penthouses-of-10-of-manhattans-supertalls/ 11 - http://lavidaconvistasalaentropia.wordpress.com/ 12 - http://pixgood.com/english-country-garden.html 13 - http://www.giardinaggio.org/orto/aromatiche/lavanda-officinalis-.asp 14 - http://www.lepebydlet.cz/zahrada/pestujeme-bylinky-mata/ 15 - http://www.deccanchronicle.com/141216/technology-latest/article/plants-can-now-ask-watersending-tweets 16 - https://www.flickr.com/people/ritapolak/ 17 - http://en.wikipedia.org/wiki/Nutmeg 18 - http://www.helpscout.net/blog/psychology-of-color/ 19 - http://knockoutrenovation.wordpress.com/how-to-make-a-small-room-look-bigger/ 20 - http://www.giesendesign.com/design/890x563/orange-teen-ideas/orange-teen-room-decoration-54535.html 21 - http://www.heimdecor.net/detail/yellow-living/yellow-living-room-interior-inspiration-978.html 22 - http://wallpapers87.com/wallpapers/hdwallpapers/wallpaper-mirrors-edge-yellow-interior-designs-83814-58 23 - http://francotechnogap.com/ 24 - http://www.decosee.com/design/blue-elle-decor.html 25 - http://skyparlour.com.au/blogs/blog/10504645-blue-infused-living 26 - http://blog.decoratorsbest.com/2014/07/30/trend-alert/ 27 - http://francotechnogap.com/ 28 - http://www.glubdub.com/detail/colorful-modern/colorful-modern-bedroom-decoration-personal-sanctuary-peace-12799.html 29 - http://ideastodecor.com/modern-door-design-with-cool-graphic-and-colors/ 30 - http://www.homedesigz.com/ 31 - http://denoxa.com/bedrooms/ 32 -http://galleryhip.com/woman-reading-magazine-in-kitchen.html 33 - http://inspiringinteriorsideas.com/ 34 - http://loveisspeed.blogspot.com/2012/03/pipe-house-south-coast-of-crimea.html 35 - http://pickcute.com/view/23087/interiors-in-brown-www-decorhomeidea 36 - http://www.landscapehdwalls.com/forest-clearing-262/ 37 - http://wallpapersinhq.com/63093-meditation/ 38 - http://www.achangingwoman.com/?page_id=51 39 - http://midohiohousewife.com/tag/crying/ 40 - https://www.flickr.com/people/ritapolak/ 41 - http://www.neinstein.com/category/blogs/legal-news/ 42- http://pottercountylawyers.com/bankrutpcy/ 43- http://www.woodenurecover.com/category_index.asp 44 - http://www.rehab-clinic.com/can-i-get-admitted-straight-away/ 45 - http://www.altamirarecovery.com/aftercare/support-groups/heroin-anonymous/ 46 - http://www.woodenurecover.com/category_index.asp 47 - http://www.npr.org/blogs/health/2013/03/26/175283008/maybe-isolation-not-loneliness-shortens-life

139

“I bought salvation from a man on the street.

He said, ‘Go down to the beach and let the waves wash your feet.’” GABRIEL RHEAUME

140

Successful design considers and incorporates factors from the exterior environment into the interior. The following is an analysis of the city, neighborhood and street that the projectâ&#x20AC;&#x2122;s chosen building is located within.

EXISTING SITE, CONTEXT, CLIMATE AND ZONING

141

The City The building selected as the shell for this project is the Chesapeake Bay Foundationâ&#x20AC;&#x2122;s Philip Merrill Environmental Center, just outside of Annapolis, Maryland. It is situated on 31 acres of Chesapeake Bay shoreline, about a fifteen-minute drive southeast of the city. (More information on the building will be covered in Section 8.)

city is that of maritime. Many citizens own a boat used both for fishing and for recreation. However, according to the cityâ&#x20AC;&#x2122;s 2009 Comprehensive Annual Financial Report, the top employers include Anne Arundel Medical Center, the United States Naval Academy, the Home Depot, and various telecommunications systems.1 The city also has a large government base because of its proximity to Washington, D.C.

The city of Annapolis serves as the capital of the state of Maryland and the seat of Anne Arundel County. As various bodies of water primarily surround it, a large part of industry and trade in the

As of 2010, there were 38,394 people, 16,136 households, and 8,776 families residing in the Annapolis area. The average household size was 2.34 and the average family size was 3.02. 35.3%

of these households included married couples living together and 26.6% had children under the age of 18. About 20% of Annapolis residents were under the age of 18, about 66% were between the ages of 18 and 64, and about 13% were 65 years of age or older. The gender makeup was 47.8% male and 52.2% female, while the racial makeup is made up of predominately White with 26% African American, 16.8% Hispanic or Latino, and the remaining percentage of Native American, Asian, or other races.2

Left: Annapolis is almost entirely surrounded by water. Image courtesy of Gilliard Group, LLC. Below: Central Annapolis on a busy day. Image courtesy of Sail Pandora.

142

143

4 The United States Naval Academy. Image courtesy of Crosswinds Annapolis.

The mean family income in the Annapolis area is around $156,983 per year, making it a somewhat affluent area with few citizens requiring Supplemental Security. 87.7% of citizens use a private healthcare provider, and less than 6% are not covered by any health insurance.3

December 23rd, 1783, is the oldest continuous legislative use in the United States. Its building features the largest wooden dome built without nails in the United States, and it was also the location of the official ratification of the Treaty of Paris on Januaruy 14th, 1784, which ended the American Revolutionary War. As such, Annapolis is known as the first peacetime capital of the United States.4

Along with beautiful bay views, Annapolis is home to a few notable institutions, such as theUnited States Naval Academy founded in 1845, and the non-sectarian private St. Johnâ&#x20AC;&#x2122;s College that opened in 1789. Annapolis has important historical significance as one of the temporary locations of the American capital in 1783, and its Maryland State House, where George Washington famously resigned his commission before the Continental Congress on

144

5 The Maryland State House. Image courtesy of Preservation Maryland.

Annapolis enjoys a fairly warm temperate climate with chilly winters, hot summers and a good amount of rain â&#x20AC;&#x201C; about 47 inches of it per year. The least amount of rainfall occurs in January, while the most falls in July, gradually increasing in the spring and then decreasing in the fall. There is no dry season. However, all of the moisture in the air causes the overall climate

Source: Stamen Maps.

to be fairly humid. The average temperature during the warm season is 77 degrees, while the average during the colder months is around 50 degrees. The length of daylight varies throughout the year, but the shortest day is December 21st with 9:25 hours of sun, and the longest is June 20th with 14:55 hours. The earliest sunrise is at 5:39am on June 15th and

the latest is 7:36am on November 3rd, while the earliest sunset is at 4:43pm on December 10th and the latest sunset is at 8:36pm on June 26th. Daylight Savings Time as observed in this location begins on March 11th and ends on November 4th. The sky is cloudiest in the winter and clearest during the summer months. The Annapolis area also enjoys calm bay breezes that rarely exceed 20 mph. In the summer,

Warm Season Precipitation

the wind speed remains around 5 mph, while in the winter there is slightly more wind at a travel speed of around 15 mph. The wind normally comes from either the northern or southern directions.5 Factors like these are important to the project so that the maximum amount of natural daylight and wind power for both interior and exterior spaces as well as the facilityâ&#x20AC;&#x2122;s daily program is optimized.

Cold Season Precipitation

Relative frequency of various types of precipitation during the warm and cold seasons, respectively. Information courtesy of Weather Spark.

CLIMATE DATA FOR ANNAPOLIS, MD MONTH

JAN

FEB

MAR

APR

MAY

JUN

JUL

AUG

SEP

OCT

NOV

DEC

YEAR

AVERAGE HIGH (F)

42.7

45.5

53.2

63.9

72.9

81.6

85.8

76.9

66.3

56.9

46.8

64.8

AVERAGE LOW (F)

29.1

30.7

36.9

45.8

55.6

66.4

71.2

69.1

62.8

50.5

41.8

31.9

49.4

PRECIPITATION (INCHES)

3.32

2.94

4.53

3.66

4.2

4.17

4.56

3.88

4.76

3.89

3.8

3.56

47.27

AVG. PRECIPITATION DAYS

9.4

9.2

11.2

9.5

10.3

8.8

7.8

9.1

9.8

115.1

Chart depicting climate data for Annapolis. Information courtesy of MD Annapolis NAF Weather Station.

145

Architecture of the City As Annapolis, like most cities in the region of the United States, began as a British colony, the earliest houses were constructed in the grand English way. After the American Revolution, however, the emergence of Baltimore as a major port city left Annapolis with little of its former wealth and thus most of the homes built during the 19th century were of a modest scale. Machines allowed the mass production of decorative elements, so the citizens of Annapolis were able to adorn their houses with wood trim and large, Victorian-style windows. The 20th century brought new architectural styles to Annapolis, such as American Four Square.

18th Century Vernacular and/or Georgian Georgian Buildings of National Importance 1715-1800 1730-1800

Annapolis features the most Georgian buildings than any other American city, and most of them play some sort of important role in American history. These include the Maryland State House (pictured on page 6), the William Paca House (pictured above), and the Hammond-Harwood House (pictured below).

146

Greek Revival 1820-1860

Federal 1784-1840

A predominant style in mid-19th century America, Greek Revival was based on the austerity of ancient Greek architecture. Examples in Annapolis include homes with large square windows, square transom lights, restrained ornament, and temple-like door structures, like the homes pictured.

Victorian 1869-1901

The Federal style, which evolved from the work of English architect Robert Adam, refines Georgian motifs by using simpler, attenuated elements. The columns are slim and decorative details such as garlands and urns are adapted from those found in ancient Italy and Greece. The Federal-style buildings in Annapolis are relatively simple, like the home pictured above â&#x20AC;&#x201C; high style Federal homes are rare.

The Victorian style designates a range of romantic styles featuring elaborate massing and detail such as French Second Empire, Italianate, Queen Anne, Gothic Revival and Romanesque. These homes often feature exterior decoration in the form of brickwork, a many-hued color scheme, towers, elaborate brackets and consoles, arched and bay windows, and verandas. Examples include St. Maryâ&#x20AC;&#x2122;s Catholic Church, pictured above. 12

147

19th-20th Century Annapolis Vernacular 1837-1921

This style, which employs simplified classical, Federal and Italianate motifs, is unique to Annapolis. They are sometimes row or paired houses, and usually reflect local culture and building materials.

20th Century Distinctive 1901-1938

15 Annapolis Vernacular home on Conduit Street. Image courtesy of Trulia.

This style designates notable examples of the Beaux Arts, Colonial and Tudor Revival, and Craftsman styles.6 Examples include the American Four Square style home on Gloucester Street pictured above.

The Eastport neighborhood of Annapolis. Image courtesy of The Washingtonian.

148

Sources:StamenMapsandGoogleEarth.

The Neighborhood Since the building is located in the outskirts of Annapolis, the nearest established neighborhoods are Highland Beach, located southeast just across Blackwalnut Creek, and the Bay Ridge community located to the north. Highland Beach is a small town founded in the summer of 1893 by Charles and Laura Douglass, the son and daughterin-law of the famous abolitionist Frederick Douglass, after they had been turned away from a restaurant in nearby Bay Ridge because of their race. They purchased a 40acre tract of Chesapeake Bay beach and transformed it into a summer retreat for their family and friends. The area has been visited by notable figures such as W.E.B. DuBois, Booker T. Washington, and the poet Langston Hughes. It is now a high-end African-American community of about sixty homes, but there are no permitted commercial establishments.7

18 Above: Waterfront view. Image courtesy of Highland Beachâ&#x20AC;&#x2122;s official website. Below: Residents of Highland Beach circa 1970s. Image courtesy of Highland Beachâ&#x20AC;&#x2122;s official website.

149

To the north of the building site is a large bayside residential neighborhood that makes up the Bay Ridge Community. The peninsula is surrounded by the Chesapeake Bay, the Severn River and Lake Ogleton on the south, east and north sides, and then mainland Annapolis a ways to the west. It also features a somewhat thick natural forest that have been saved and protected from real estate development. Tree coverage ends shortly before the water reaches the shore, leaving only a few yards of sandy beach. It once served as a popular Victorian vacation destination for the people of Washington D.C. and other nearby major cities to escape for a weekend or so. Now the houses serve as permanent dwellings for around 400 families, and only a handful are still used as only summer vacation homes. There is a community marina on Lake Ogleton, a ballpark, and a small recreational center located next to the project building. The recreational center includes a pool and a clubhouse that features yoga classes, swimming lessons and private parties.8 The nearest health centers are the Spa Creek Center, an occupational therapy facility, and MedStar Health, a health and medical clinic, both within about a ten minute drive from the site. The nearest hospital that is open 24/7 is the Anne Arundel Medical Center, located about a fifteen minute drive away fromthe site in center city Annapolis.

150

20 A general map of the Bay Ridge Community. Image courtesy of the Bay Ridge Community’s official website.

There is no public transportation beyond the city commercial limits, which is about 1.5 miles from the project site.

21 A view of the Chesapeake Bay from the Bay Ridge peninsula. Image courtesy of the Bay Ridge Community’s official website.

22 The Bay Ridge community pool and clubhouse. Image courtesy of the Bay Ridge Community’s official website.

Property Values of Herndon Avenue and Surrounding Area

Herndon Avenue. The building is past the trees on the right side. Image courtesy of GoogleMaps.

The Street Herndon Avenue begins off of Bay Ridge Road, which is one of the main roads into center city Annapolis. It is heavily surrounded by trees, so much so that the building is barely visible from the street. The siteâ&#x20AC;&#x2122;s entrance from the street is fairly large, but may be somewhat easily missed due to the foliage. The building is also somewhat obscured by the Bay Ridge community pool, which also provides unwanted noise to the immediate site, as seen in the site analysis to the right. About 200 feet down from the site entrance, the trees become sparser to provide space for seven highend single-family dwellings homes. The shoreline begins about 700 feet from the entrance.

The site entrance, as seen through GoogleMaps. Image courtesy of GoogleMaps.

Site Analysis of the Building and Surrounding Area

151

End Notes and Bibliography

152

Text Sources 1 http://www.annapolis.gov/government/departments/finance/cafr/ cafr2009/StatDemog.pdf 2 http://www.census.gov/prod/cen2010/cph-2-1.pdf 3 http://factfinder2.census.gov/faces/tableservices/jsf/pages/productview.xhtml?src=CF 4 http://www.capitalgazette.com/tour_statehouse.html/ 5 https://weatherspark.com/averages/31014/Annapolis-Maryland-United-States 6 http://www.annapolis.org/uploads/Newsletters/marker16x9-5.pdf 7 http://www.highlandbeachmd.org/ 8 http://bay-ridge.org/

Image Sources 1 http://www.pinterest.com/rockrollrustic/us-mid-atlantic-demdnjnypa/ 2 http://www.sailpandora.com/?p=67 3 http://www.gilliardgroupllc.com/silveraerolimo/ 4 http://www.crosswindsannapolis.com/blog/ 5 http://blog.preservationmaryland.org/2012/04/ 6 https://weatherspark.com/averages/31014/Annapolis-Maryland-United-States 7 https://www.travelblog.org/Photos/5491220 8 http://www.201bb.com/attractions.html 9 http://commons.wikimedia.org/wiki/File:Hammond-Harwood_House_ (Md._Ave._Facade).jpg 10 http://www.annapolisexperience.com/blog/2011/08/03/a-walkalong-prince-george-street-in-annapolis-maryland/ 11 http://curbed.com/tags/annapolis-md 12 http://curbed.com/archives/2014/05/01/1827-farmhouse-comes-with150-acres-and-five-extra-houses.php 13 http://www.stmarysannapolis.org/page.aspx?pid=361 14 https://www.redfin.com/MD/Annapolis/95-Conduit-ST-21401/ home/10432649 15 http://www.trulia.com/rental/3169956930-107-Conduit-St-2-AnnapolisMD-21401 16 http://www.pinterest.com/annapolisexp/quintessential-houses/ 17 http://www.washingtonian.com/articles/homes/real-estate/bestplaces-to-live-if-youre-downsizing/ 18-19 http://www.highlandbeachmd.org/ 20-22, 24 http://bay-ridge.org/ 23 http://www.city-data.com/zips/21403.html

153

“Addicts never stand still.

They are either getting better, or they are getting worse.” ALCOHOLICS ANONYMOUS

154

Designing a building takes an enormous amount of time and rationalizing in the form of space planning. This step is one of the most important parts of the design process because it combines form and function in both a conceptual and practical manner. First and foremost, the designer must pull together all research into a cohesive program that determines the buildingâ&#x20AC;&#x2122;s spaces and their functions and adjacencies.

PROGAM DEVELPOMENT & DOCUMENTATION

155

The Spaces Detoxification Unit Detoxification occurs on an asneeded, per-person basis – usually for patients who are just beginning the recovery process and still have a strong physical dependence to the substance. Most inpatient rehabilitation clients must undergo the detoxification process in order to be cleared for entering rehabilitation. The unit as a whole can be somewhat compared to a hospital emergency room and should be separate from the residential rehabilitation. Reception and Small Waiting Area:

151 656

200 +/- sq. ft. – Patients who undergo detoxification are sometimes escorted to the unit by a family member or other relative. This area should include at least three (3) seats in the waiting area, and a receptionist to greet and take the patient’s information. As this unit is separate from the residential unit, it should have its own entrance and section of the parking lot. Administrative Offices: 150 +/- sq. ft each – Adjacent to the reception area should be offices for administration personnel, including admissions, case managers, a general manager and security office. Each office requires a workspace to accommodate one person with 12 linear feet of

storage for files, one desk and computer, and two guest chairs for consultations. Medical Control Area: 200 +/sq. ft. – A central area where inhouse doctors and nurses gather information and materials needed for the patients. Medical Supply Room: 100 +/- sq. ft. – A room used to store medicine, materials and equipment. The room must include counter space with overhead storage. Medical Waste: 50 +/- sq. ft. – A closed-off area used to dispose of medical waste. Because of biohazards, this area should be located away from sterilized areas.

Laboratory: 120 +/- sq. ft - A private room where nurses and doctors can run urine samples and other tests for the patients. Meeting Room: 250 +/- sq. ft. – Private conference area for nurses, doctors, case managers, etc. to meet and confidentially discuss patient needs. Men’s detoxification rooms: 120 +/sq. ft – Includes a standard medical bed, side table, body statistics reading equipment, and two (2) guest chairs. Must also include small private bathroom. Women’s detoxification rooms: 120 +/- sq. ft – Includes a standard medical bed, side table, body

statistics reading equipment, and two (2) guest chairs. Must also include small private bathroom.

Staff Unisex ADA Bathroom: 60 +/sq. ft. – A restroom strictly for staff members that complies with ADA.

Counseling Offices: 150 +/- each – Private offices for detox counselors. There should be one counselor for every four or so patients, should include a window, and must include 12 linear feet of storage for files, a desk with a computer, and at least two guest chairs.

Data Room: 60 +/- sq. ft. – A room for server and electronic communications; it should have a small desk for a computer monitor and accommodate the server, routers, etc.

Staff Lounge: 120 +/- sq. ft. – Requires 12 feet of counter space with upper and lower cabinetry and a table to comfortably accommodate 8 people. Equipment required includes a full size refrigerator, microwave, sink, faucet, garbage disposal, and trash can.

Janitor’s Closet: 50 +/- sq. ft. – Small closet for janitorial supplies. Total sq. ft.: 4,210 (assuming eight (8) men’s detoxification rooms, eight (8) women’s detoxification rooms, and four (4) counselor’s offices.

11 557

Residential Rehabilitation Facility Once the patient is cleared from detoxification, they can be admitted to the residential facility. As these units are often part of the same building, it can mean just a short walk down the hall. In many facilities, the residential areas are similar to a college dorm setting, including a cafeteria, lounge spaces, and shared bedrooms and bathrooms. The project will follow this, but considers the use of extra spaces detached from the building as the sleeping quarters. Vestibule: 100 +/- sq. ft. – Glass vestibule with double entrance doors.

Reception/Waiting Area: 500 +/- sq. ft. – The waiting area is primarily for visitors of patients or other patrons to the facility. It should accommodate approximately ten (10) waiting chairs, one (1) bariatric seat, and a small play area for children, as many patients are parents to young children. Administrative Offices: 150 +/sq. ft. each – Adjacent to the reception area should be offices for administration personnel, including the CEO, admissions, case managers, a general manager and security office. Each office requires a workspace to accommodate one person with 12 linear feet of storage for files, one desk and computer, and two guest chairs for consultations.

Conference Board Room: 750+/sq. ft. – A large conference room for meetings. Staff Unisex ADA Bathroom: 60 +/sq. ft. – A restroom strictly for staff members that complies with ADA. General Classrooms: 600 +/- sq. ft. each – Classroom spaces that can accommodate general courses such as finances, GED preparation, English language, or others corresponding to the facility’s program. The room should hold a maximum of 30 people including the instructor. One such classroom must include a small educational kitchen area for cooking classes. Cafeteria: 2,500 +/- sq. ft. – Communal space for eating. The

An example of a residential rehabilitation facility: Sister Margaret Smith Addictions Treatment Center located in Toronto, Ontario, Canada. Image courtesy of SAB Magazine.

158

cafeteria will accommodate all patients and staff in the facility, as well as weekly visitors who come to see the patients. The tables should seat at least six people at a time. Kitchen: 500 +/- sq. ft. – A commercial kitchen that is attached to the cafeteria. Patient Bedrooms: 400 +/- sq. ft.– A space that accommodates two (2) twin beds, a desk, and wardrobe storage for two patients, as well as some circulation space. The bedrooms will be separated by gender. Shared Bathrooms: 150 +/- sq. ft. – A bathroom equipped with at least one (1) toilet, one (1) bathtub/ shower combination, and two (2) counter sinks. The shower should

have sliding doors as opposed to a rod and curtain system, and a shower head that does not protrude very far from the wall for suicidal prevention reasons. The bathroom should accommodate four patients, and will be located between two bedrooms. Men’s Lounge: 300 +/- sq. ft. – Communal lounge space strictly for male patients. Women’s Lounge: 300 +/- sq. ft. – Communal lounge space strictly for female patients. Yoga/Meditation Room: 400 +/- sq. ft. – A large space used for meditation and yoga classes. The space should include windows for ample natural daylight and acoustical privacy from the rest of the facility.

Fitness Area: 2,500 +/- sq. ft. – Inhouse gym fully equipped with fitness equipment and ample exercise space. The space should include an infinity pool for water exercises on the ground level. Multi-Purpose Room: 2,500 +/- sq. ft. – A large, communal space used for lectures, presentations, and family education sessions. Should include storage for stacking chairs or folding tables. Counseling Offices: 150 +/- sq. ft. each – Private offices for counselors. There should be one counselor for every four or so patients, should include a window, and must include 12 linear feet of storage for files, a desk with a computer, and at least two guest chairs.

159

Spiritual Space: 400 +/- sq. ft. – A space where religious or spiritual sessions can be held. The space can be located indoors or outdoors.

be located in staff area for restriction to only faculty members, or near the lobby to provide access for visitors.

Bookstore: 200 +/- sq. ft. - Small store where patients or visitors may purchase self-help and inspirational reading, snacks, etc. Can be located near the lobby for visitor access, but is meant to be used primarily by the patients.

Storage: 150 +/- sq. ft. - General storage for items such as bed linens and toilet paper. 6

Janitor’s Closet: 25 +/- sq. ft. – Small closet for janitorial supplies. Public Elevator: 100 +/- sq. ft. – Elevator for patients, staff and visitors. Vending Area: 100 +/- sq. ft. - Small area with vending machines. Can

160

Building Mechanical Room: 600 +/- sq. ft. – A space for building mechanical equipment. Should be placed in a back-of-house area without windows and away from public areas. General circulation: 30%. Approximately 9600 sq. ft.

Total sq. ft.: 25,835 (assuming 20 bedrooms, 10 bathrooms, and 6 classrooms and offices.

161

Fitness Area (gym)

Test Fit Plans

Total sq. ft.: approximately 32,000

First Floor

Kitchen/Cafeteria

Reception/ Waiting Area

Fitness Area (pool)

161 262

Rehab Administration

Detox Medical Unit

Residences

Test Fit Plans

Total sq. ft.: approximately 32,000

Second Floor

Classrooms

Counseling Offices

Lounges, Yoga Room, etc.

Multi-Purpose Area (for presentations)

Fitness Area (gym)

Kitchen/Cafeteria

Reception/ Waiting Area

Rehab

Detox Medical Unit

11 663

End Notes and Bibliography

164

Image Sources 1 https://www.flickr.com/photos/30104391 2 http://www.thecourier.com.au/story/1402433/sticky-problem-for-ballarat-base-hospitals-emergency-department/ 3 http://www.pinterest.com/pin/190136415489358778/ 4 http://www.sabmagazine.com/blog/2013/04/02/sister-margaret-smith-addictions-treatment-centre-sustainable-design-improves-the-healing-process/ 5 https://plus.google.com/+PalmbeachGardensTreatmentCenterStuart/about 6 http://www.dekrantenkoppen.com/ds/2014_07_30.php 7 http://abcnews.go.com/Entertainment/top-rehab-facilities-america/story?id=15528513 8 http://www.bhpalmbeach.com/facilities/recovery-center-men-palm-beaches 9 https://www.flickr.com/search/?q=movement

165

“Do not be angry with the rain.

It simply does not know how to fall upwards.” VLADIMIR NABOKOV

166

PA R T O N E Building Analysis

PA R T T W O Code Regulations and Standards

BUILDING ANALYSIS, CODE REGULATIONS AND STANDARDS

167

Part One: Building Analysis

168

The existing building chosen for this project is the current headquarters of the Chesapeake Bay Foundation, located at 6 Herndon Drive, Annapolis, MD. The 32,000-sq.ft., two-level building, situated along the shoreline, is LEED Platinum certified.

169

Overview (From the official submittal by the building’s architects SmithGroup.) Prior to CBF’s purchase, the site served as a community pool and Inn and was planned for significant development, creating a negative impact to the Bay. The design began by master planning the 31 acre site – all but 4.5 acres were set aside under a conservation easement allowing the majority of the site to permanently remain undeveloped. The site was restored to the representative ecosystems found within the Bay’s watershed including woodlands, wetlands, and even an oyster reef. To minimize site disruptions, the building and

170

parking lot were sited over the footprint of the former pool house. The building design connects the Foundation to the bay. The form is strikingly simple. It does not try to compete with a rich site, but neither does it spread out and sink down apologetically. It is composed of two shed-roof structures oriented to the South, harnessing views of the bay, breezes, and the sun’s energy for light and heat. One shed is long and narrow, presenting its broad face to the bay, and houses the reception area, offices, and support functions. Another shed structure is pulled away from the south bay-side, equal in height, but much smaller with an entirely square footprint. It serves as the

conference space, with an attached staff lunchroom and kitchen. The two structures sit gracefully on slender pilings hovering above the landscape, and are connected by a large deck. Occupants can park under the building, thus minimizing site disruptions typically associated with parking. By expressing the conference space as a separate structure, the consistency of the longer, primary mass is relieved, and the resulting t-shaped building creates a degree of enclosure for the deck while focusing views to the bay. The north elevation integrates three huge rainwater storage tanks into its composition. Formally these provide relief to the expanse of the long north side of the building, marking an entry, but they also

function as signage, communicating to visitors the idea that this is not a conventional office building, but one with alternative technologies. The building interior is currently organized into four quadrants, two on each floor, each separated by the central lobby and exhibit space. Each quadrant accommodates a different department, whose layout of open workstations is unique to that department. Closed offices were minimized to promote an open exchange of ideas. Open workstations replace closed offices, allowing every employee views of the bay, as well as enabling sustainable strategies such as daylighting and natural ventilation. Meeting rooms and other shared spaces within each department provide opportunities for private dialogues. Just as the exterior of the building exposed many of the buildingâ&#x20AC;&#x2122;s environmental innovations, the interior continues this theme. Materials are left raw and unfinished, and ductwork is often exposed, minimizing the use and consumption of finish materials. Much of the time the sense of completeness is provided by choice of material and composition, rather than by conventional finish. None the less, when eco-sensitive finishes such as cork and engineered woods are used, they are able to achieve the same qualities of warmth and familiarity as their conventional hardwood counterparts.

171

172

173

Building Section: Natural Ventilation 1 – Building exposes maximum surface to breezes 2 – Awning windows promote airflow into the building at first and second floors 3 – Inlet and outlet openings are located in opposite pressure zones 4 – Openings on all sides force airflow to change direction, increasing ventilated area 5 – Larger outlet area than inlet area produces higher velocity: best for hot/humid climates.

In construction, the building incorporated a “cradle-to-cradle” rather than “cradle-to-grave” philosophy. This philosophy requires consideration of all materials not only for what they are made of, but what they can be made into at the end of their useful lives. Materials were selected for recycled content (galvanized siding made from cans, cars, and guns, for example). Likewise, materials from renewable or regenerable resources were incorporated (cork flooring comes from the bark of the cork oak tree which can be harvested without killing the tree and regenerates in 7 to 9 years). All wood was either certified by U.S. Forestry Stewardship Council as coming from sustainable

174

harvested forests, or was from renewable resources (like the main foyer’s bamboo flooring that is harvested from plants that regrow in approximately three years). Existing structures on the site were deconstructed rather than demolished and all materials were auctioned, salvaged, or recycled. The existing foundations were chipped and used as road base. Seven loads of chipped concrete were hauled off-site to be reused. The contractor used a construction recycling plan during construction of the building to minimize contribution to landfills. All cardboard, metals, concrete, CMU, asphalt, and land-clearing debris were recycled. Erosion

control measures were rigorously enforced to ensure construction sedimentation and erosion did not directly impact the Bay. An air quality management plan was used during the project’s construction to minimize dust and debris from collecting inside the mechanical system and to prevent VOC’s from being absorbed in porous building finishes. The building was commissioned in 2001 when it opened, and several small glitches in the mechanical controls were identified. Beyond formal commissioning, the center’s facility manager fine-tuned the building systems to be as efficient as possible without sacrificing comfort.

175

176

177

Exterior Building Analysis 1 – Southern Exposure: To reduce the need for electricity, the building is situated on the site to receive maximum southern exposure for natural light and warmth and to take advantage of prevailing winds for natural ventilation. 2 – Sun Shades and Window Glazing: A continuous 10-foot-wide porch in front of the South glazing has sun shade louvers made from salvaged pickle barrel staves. The spacing allows the winter sun into the building, but prevents summer sun from entering. The glazing was optimized to allow the winter sun’s natural heat. The louvers prevent unwanted summer solar heat gain without compromising the building’s natural day lighting.

178

3 – Solar Water Heaters: Arrays of solar tubing placed on top of the roof dormers provide heating for all the building’s domestic hot water, saving approximately 120 kilowatthours of electricity per day. Above: Solar water heaters located on the roof. Below: Galvalume siding.

4 – Roofing and Siding: Galvalume (galvanized recycled steel) metal siding has high recycled content. Both siding and roofing were left unpainted so that the material could more easily be recycled in the future (if the building is deconstructed or renovated). 5 – Siding: Hardipanel is a fiber cement siding material that is structurally stable and highly resistant to extended exposure to moisture and salt air. It is made from Portland cement, ground sand, cellulose fiber (20 percent postconsumer recycled), and water.

fall, and reflect, rather than absorb, the heat of the sun, reducing the impact on the site’s ecosystems.

6 – Northern Exposure: Dormers and a continuous clerestory window with smaller window areas add light from the north facade. 7 – Rainwater Cisterns: The galvanized metal shed roof allows for a single rain gutter, which drains rain water off the roof, through filters, and into storage cisterns. Each cistern holds 7,000 gallons of rainwater. Re-using rainwater avoids the need for a massive city water infrastructure upgrade. The system provides all of the building’s nonpotable water, used for irrigation, fire suppression, hand-washing, mop sinks, gear washing, and laundry. It also decreases runoff to the adjacent Bay and Black Walnut Creek.

Rainwater cisterns hold 7,000 gallons of rainwater each.

A diagram detailing the building’s geothermal energy system.

8 – Geothermal Wells: Under the gravel parking area, 48 geothermal wells extend 300 feet underground to take advantage of the earth’s constant temperature (about 54 degrees) as a heat source to heat the building and winter and as a heat sink to cool the facility in summer. 9 – Parking: Placing the building on piers allowed for underbuilding parking, which helped keep the building footprint small and reduced the use of impervious surfacing beyond the building. Two parking spaces provide charging for electric vehicles. 10 – Pervious Gravel: Gravel and reclaimed concrete cover the parking area. They are pervious, slow down the flow of heavy rain

Bioretention ponds capture stormwater runoff from the parking area.

11 – Bioretention Ponds: Bioretention stormwater treatment ponds capture stormwater runoff from the parking area. Stormwater passes through the ponds, which filter water and treat oils before the water enters the Bay or the adjacent Black Walnut Creek. Plant species were specifically selected to make the most use of excess nutrients in the stormwater runoff, such as nitrogen, phosphorous, hydrocarbons, and heavy metals. 12 – Native Plants: The landscape design takes into account the area’s highly erodible soils; plants have been selected that can help control future erosion. Droughttolerant native plants minimize the need for irrigation. Mowing meadow and grasslands only once a year reduces fuel use and pollution on site. A diversity of native trees and shrubs add to the restored habitat for a diversity of wildlife. 13 – Green Roof: Downspouts from the roof supply two rain barrels used for irrigation. 14 – Wetlands: Natural and manmade wetlands provide a natural filter for stormwater before it enters Black Walnut Creek, as well as habitat for aquatic life.

Hardipanel siding.

179

Southern sun exposure.

Below: Northern sun exposure.

180

Interior Building Analysis

window wall illuminates the entire building, substantially lessening what is usually an office’s most expensive energy cost. A day lighting control system uses light level sensors and dim artificial lighting to achieve the most desirable lighting level. The selection of light-colored and reflective interior finishes also increase the effects of day lighting.

(Note: The following analysis focuses on the existing building and its inhabitant, the Chesapeake Bay Foundation. The project included this information as inspiration for the imminent renovation.) 1 – Open Office Plan: An open office layout allows natural daylight to flood the interior and natural ventilation to move more freely through the building. This both minimizes the need for costly artificial lighting and makes what artificial lighting there is more uniform and efficient and provides more effective and efficient heating and cooling. 2 – Natural Light South: Natural daylight from the long southern

3 – Natural Light North: Dormers and a continuous clerestory window with smaller window areas add light from the north facade.

Natural daylight from the southern wall.

4 – Conference Facilities: Conference facilities that are used during off-hours and weekends are separated from the main building, which allows independent access and mechanical systems operation.

181

5 – Water Conservation: Cistern water is used for sinks, showers, and laundry. Water is conserved further through the use of water efficient fixtures, showerheads, and sensor faucets, along with flushless toilets. One of the first uses of flushless toilets in an office building, our 12 composting toilets and urinals use hardly any water--just one gallon a day for misting the composter. Human waste is composted naturally to produce topsoil for our landscaping. This saves water and reduces the load on sewage treatment plants that contribute to nutrient pollution in the Bay. This process also reduces maintenance and removes the possibility of damage related to toilet backups and overflows. 6 – Operable Windows: When

182

temperature and humidity sensors determine that outdoor conditions are suitable for natural ventilation, dormer windows open automatically, “Open Windows” lights turn on signaling staff that it is OK to open the operable windows, and the mechanical system shuts down. The office uses natural ventilation over 30 percent of the year. 7 – Efficient Building Materials: Extremely efficient structural insulated panels (SIP) used for the building’s walls and ceilings reduce energy demands and costs. As a result, building costs were reduced because traditional framing, insulation, and drywall were not required. Diagram detailing the plumbing’s water conservation strategy.

The panels have a foam core that is four to eight inches thick

11 â&#x20AC;&#x201C; Renewable Materials: Bamboo, used for beautiful hardwood flooring on stairs, landings, and the lobby, can be harvested every three to five years and replenishes itself naturally. 12 â&#x20AC;&#x201C; Renewable Materials: Posts, beams, and trusses are made from ParallamÂŽ (strand lumber made from fast growing wood).

The millwork and ceiling are made from recycled materials.

Cork flooring.

The millwork and ceiling are made from recycled materials.

183

(depending on the needed R value for insulation). The wall SIPs have an insulation value of R-25 and the roof is R-32. Unlike conventional framing, the panels maintain their strength without requiring wood studs inside the panel. As a result, there are no breaks in the insulation and much less lumber is used. Inside, the face of the structural insulated panel walls was left exposed, conserving resources, saving money, and serving as an education tool. The designers capitalized on the aesthetic effect of a raw-looking interior, intentionally emphasizing the beauty of the unfinished look. 8 â&#x20AC;&#x201C; Recycled Materials: Much of the millwork is medium density fiberboard, made from reused sawdust and formaldehyde-free resins. The ceiling tiles are made from 78 percent recycled mineral wood and cellulose fiber and the particleboard is 100 percent recycled and recovered wood fiber. 9 â&#x20AC;&#x201C; Recycled Materials: Tiles used in the bathrooms and kitchen are made from recycled glass. Other recycled items include cabinet door pulls made from champagne corks and kitchen dishes, which belonged to the old Bay Ridge Inn.

184

10 â&#x20AC;&#x201C; Renewable Materials: Cork flooring and wall panels come from cork oak trees. The cork bark is harvested without killing the tree and regenerates in seven to nine years.

13 – Renewable Materials: Other wood used throughout the building (deck material, plywood, and dimensional wood) is either certified by the Forest Stewardship Council (FSC) or drawn from sustainably managed forests. 14 – Natural Materials: Linoleum flooring is durable flooring made from all-natural materials. Linseed oil is boiled, mixed with ground cork or wood flour, ground limestone, and other natural materials. Mineral pigments provide the color. Indoor air quality is also enhanced by using natural and other products with no or very low volatile organic compounds. This reduces chemical vapors and creates a healthy working environment.

15 – Kitchen: Called the “Bay Cafe,” the Merrill Center’s kitchen and its outdoor deck provide a pleasant, sunny area where staff can gather for lunch, celebrations, or even casual meetings. The kitchen includes refrigerators, microwave ovens, toasters, and of course, coffee and tea. Making it easy to “eat in” reduces the carbon emissions otherwise created by staff having to drive into town. Staff have also added a “freecycle” table where everything from books to home decor can be exchanged.

185

Part Two: Code Regulations and Standards

186

One of the roles of the interior designer is to ensure the health, safety and general welfare of the public within their designs. To provide a safe, legal ly sound facility, the projectâ&#x20AC;&#x2122;s program has been cross checked with the 2012 International Building Code.

187

Project Data

Zoning Code Requirements

Project Name: The J.G.F. Center for Alcohol and Chemical Dependence

Land use zoning: Institutional

Address: 6 Herndon Drive, Annapolis MD 21403

Maximum allowable height: Two (2) stories

Owner: The J.G.F. Foundation

Existing parking spaces: Yes

Architect: SmithGroupJJR Date of Completion: 2001 Number of stories: Two (2) at +/16,000 s.f. each, approximately 57’x211’ (multiple column bays)

Use Group Classification Mixed Use: A-2, A-3, B, I-1, I-2, M

Total gross sq. ft.: 32,000

Means of Egress

Applicable Building Code Information

All means of egress shall be fully sprinklered.

Zoning Ordinance: R2 – Single family residence

Dead end limit for all means of egress: 50’-0”

Fire Code: International Building Code 2012

All groups allow for 200’ minimum travel distance to nearest exit unless otherwise noted.

Building Code & Date: International Building Code 2012 Elevator code (if applicable): N/A Energy code: N/A

188

A-3: Assembly Fitness Area Total gross SF: 2,500 SF per occupant: 50 gross Number of occupants: 50 Min. corridor width: 96” Swimming Pool (Indoors) Total gross SF: 3,750 SF per occupant: 50 gross Number of occupants: 75 Min. corridor width: 44” Multi-Purpose Room Total gross SF: 2,500 SF per occupant: 15 net Number of occupants: 167 Min. corridor width: 72” Spiritual Space Total gross SF: 400 SF per occupant: 15 net Number of occupants: 27 Min. corridor width: 36” Yoga/Meditation Room Total gross SF: 400 SF per occupant: 5 net Number of occupants: 80 Min. corridor width: 44”

A-2: Assembly

Lounge Total gross SF: 300 SF per occupant: 15 net Number of occupants: 20 Min. corridor width: 36”

Cafeteria Total gross SF: 2,500 SF per occupant: 15 net Number of occupants: 167 Min. corridor width: 72”

Conference Board Room Total gross SF: 750 SF per occupant: 15 net Number of occupants: 50 Min. corridor width: 44”

B: Business Classrooms Total gross SF: 600 SF per occupant: 20 net Number of occupants: 30 Min. corridor width: 36” Offices Total gross SF: 150 SF per occupant: 100 gross Number of occupants: 2 Min. corridor width: 36” Laboratory Total gross SF: 120 SF per occupant: 100 gross Number of occupants: 1 Min. corridor width: 24” I-1: Institutional (for Alcohol and drug center) Residence Rooms Total gross SF: 400 SF per occupant: 200 gross Number of occupants: 2 Min. corridor width: 36” I-2: Institutional (for detoxification facility) Detoxification Rooms Total gross SF: 120 SF per occupant: 100 gross Number of occupants: 1 Min. corridor width: 96” Travel distance to exit: 250’ M: Mercantile Bookstore Total gross SF: 500 SF per occupant: 30 net Number of occupants: 16 Min. corridor width: 36”

Sanitation Within each group classification, the space with the largest square footage and/or occupancy load was used. A-2: Assembly Cafeteria 2 W.C.s for males 2 W.C.s for females 1 lavatory 3 drinking fountains A-3: Assembly Swimming Pool (Indoors) 1 W.C. for males 2 W.C.s for females 1 lavatory 3 drinking fountains

16 W.C.s for males/females 16 lavatories 1 bath/shower 1 drinking fountain 1 service sink

M: Mercantile Bookstore 1 W.C. for males/females 1 lavatory 1 drinking fountain

Fire Protection Requirements Fire Exit Enclosures: 2 hours Shafts and Elevator Hoistways: 2 hours

B: Business

Tenant Space Separations: 2 hours

Classrooms 1 W.C.s for males 1 W.C.s for females 1 lavatory 3 drinking fountains

Smoke Barriers: Assume 30 Minutes

I-1: Institutional (for Alcohol and drug center) Residence Rooms 1 W.C. for males/females 1 lavatory 1 bath/shower 1 drinking fountain 1 service sink I-2: Institutional (for detoxification facility) Detoxification Rooms

Corridor Fire Resistance Rating: 0 hours for classification groups Incidental Use Areas: 1 hour rated for all I-2 areas

Building Limitations National Historic Registry: No Health Department/Food Services: No Urban Redevelopment Requirements: No

189

End Notes and Bibliography

190

Image Sources 1 - http://d-u-d.deviantart.com/art/sunday-morning-rain-is-falling-209234405 2 - http://www.get-free-wallpapers.com/3d-and-digital-art-wallpapers/4/abstract-wallpapers/f12104-walking-alonein-rain-wallpaper.html 3 - http://husigimystery.info/allan/?p=177 4 - http://whotalking.com/flickr/raining All building images- http://www.cbf.org/

191

“Now that you don’t have to be perfect, you can be good.” JOHN STEINBECK

192

FINAL PROJECT RESEARCH SUMMARY

193

Executive Summary To me, in the mind of an addict, the most overwhelming aspect of recovery doesn’t seem to be the possibility of losing the substances to which your very life and soul cling. What is truly frightening is when you feel whole and clean and new again, and you walk out the doors of the building that saved your life, you realize that now you are on your own and you do not know how to live a normal life. Granted, with the 12-Step program, you will have a sponsor to help you. You may even have family to take you in. But what about those who don’t? What about the people who have never had a parent to show them how to wash a load of laundry, or cook a grilled cheese sandwich? Or balance a checkbook? Or learn how to spell?

My design aims to help these types of people get back on their feet and survive in today’s society through cooking, language, housekeeping and financial classes, among others. This was inspired largely by the Salvation Army Harbour Light case study (see Section 3: Part Three), where the holistic approach to recovery includes more than just meditation and exercise. However, since Canadian healthcare is different than that of the United States, and likely provides more funding to programs such as the one I propose, the project may have to be changed from a nonprofit organization to a private owned and funded organization. The idea of designing the residential facilities as separate from the main building was inspired by the advice of Professor Lisa Phillips and the Livengrin case study (Section 2: Part Two), where the residences are modern homes housing multiple

people. This allows for the patients to experience both a community and a home-like setting - as opposed to a dorm or institution - in preparation for facing the reality of society. With this project, I hope to raise some awareness over the issue of addiction treatment: how it is carried out, and how it is viewed in the light of society. I want to show people that addiction is not a crime - it is a terrible disease of the mind, body and spirit, and therefore should be treated as such. This project is the largest and most special accomplishment of all that I have done during my time at Philadelphia University. It is my pride and joy and I am immensely excited to see it reach its full potential. Thank you for joining me on this journey.

“I wondered if that was how forgiveness budded; not with the fanfare of epiphany, but with pain gathering its things, packing up, and slipping away unannounced in the middle of the night.” - Khaled Hosseini, The Kite Runner

194

195

“Recovery begins from the darkest moment.” JOHN MAJOR

196

BIBLIOGRAPHY & APPENDIX

197

Bibliography Section 1 Images

1 - http://www.wallpaper4k.com/it/sfondi/bokeh/ wpcqbsrh.html?p=4 2 - http://www.taringa.net/buscar/mi/?q=%23fotoblur 3 - http://djpariah.blogspot.com/2013/08/femdelacremeofficial-review.html 4 - https://prideinmadness.wordpress.com/category/selfhelp-books/the-hurt-yourself-less-workbook/ 5 - https://www.flickr.com/people/94991188@N05/ 6 - http://8tracks.com/amidstblackskies/an-idiots-in-loveplaylist 7 - https://kleantreatmentcenters.com/study-drinking-at-ayoung-age-causes-more-problems 8 - http://wedorecover.com/images/Symptoms-of-DrugAddiction---A.jpg 9 - http://livehealthprotocol.com/category/bodyfit/ 10 - http://arealmancan.com/author/richard/ 11 - http://bluewaterdetox.com/drug-detox/methadonedetox/ 12 - http://picssr.com/photos/greg-pths/page5

Section 2 Images

1 - http://www.pbinstitute.com/help-loved-one-refuseshelp/ 2 - http://commons.wikimedia.org/wiki/File:Underwater_ world.jpg 3 - http://benedante.blogspot.com/2013/09/neolithicalcohol-in-china.html 4 - http://internationaltradersegypt.com/ancient%202.jpg 5 - http://www.abc.net.au/radionational/programs/ rnfirstbite/fresh-but-ancient-beer/4839868 6 - http://galleryhip.com/ancient-egyptian-wine.html 7 - http://i1.wp.com/www.jamesandeverett.com/wpcontent/uploads/2013/04/beer_bread_5.jpg 8 - http://www.ourcivilisation.com/smartboard/shop/ warnerr/plato.htm 9 - http://listcrux.com/top-10-countries-known-forproducing-opium/ 10 - http://olivier-dogot.blogspot.com/p/photos-8250-8300. html 11 - http://1.bp.blogspot.com/_JfWPgMk_xGs/ TPAO3IPu3YI/AAAAAAAACdM/w4Nr7SgJ2K0/s200/ cocaine.jpg 12 - http://i.huffpost.com/gen/1408052/thumbs/oCOCAINE-facebook.jpg 13 - http://cinemagumbo.squarespace.com/ journal/2014/4/10/three-on-a-reefer-anti-marijuanapropaganda-of-the-1930s.html 14 - http://render.otoy.com/newsblog/?p=166 15 - http://www.absoluteastronomy.com/topics/Adriaen_ van_der_Donck 16 - http://www.authentichistory.com/diversity/native/is2drunk/1894_Bill_Nye_History_of_The_US_pg74-Temperance_ Indians.jpg 17 - http://en.wikipedia.org/wiki/Leslie_Keeley 18 - http://pointsadhsblog.wordpress.com/2012/02/29/ lessons-of-narco-part-one/ 19 - http://content.time.com/time/specials/packages/ article/0,28804,2001284_2001057_2001042,00.html 20 - http://seattletimes.com/html/localnews/2012095021_ alcoholic12m.html?prmid=related_stories_section 21 - http://www.clearviewtreatment.com/substanceabuse-residential-treatment-center-questions.html 22 - https://www.addictioncenter.com/treatment-center/ betty-ford-center/ 23 - http://afterpartychat.com/hazelden-review/ 24 - http://www.angryboar.com/index.php/underwaterpainting-exhibition-sunken-ship/

198

Section 3 Images

1 - http://all-that-is-interesting.com/trinity-abandonedlighthouse 2 - http://best-wallpaper.net/Summer-trees-bokeh-leavessunlight_1920x1080.html 3-9 - http://www.mainlinehealth.org/doc/Page. asp?PageID=DOC003304 10 - http://www.hdwallsource.com/beautiful-wheatpictures-24068.html 11-20 - https://www.livengrin.org/ 21 - http://www.leafygills.com/guide-to-aquaponics/ locating-your-system/ 22-30 - http://www.archdaily.com/260565/salvation-armyharbour-light-diamond-schmitt-architects/ 31 - http://www.goodfon.su/wallpaper/tropical-beachpalm-tree.html 32-45 - http://thetidessantabarbara.com/ 46 - http://www.flickriver.com/groups/1166371@N24/pool/ interesting/

Section 4 Images

1 - http://speciesandclass.com/2014/09/16/the-us-a-prisonstate-for-both-people-and-animals/ 2 - https://prezi.com/z29shg59cqly/week-3-electricalenergy-use-and-renewable-net-power-genera/ 3 - http://imgkid.com/sun-diagram-architecture.shtml 4 - http://www.monstercommercial.com/effectivedaylighting-in-buildings-part-2-daylighting-dimensions/ 5-7 - http://www.pages.drexel.edu/~jmd27/myweb/vav-2. htm 8 - http://princetonbaby.org/personal-pregnancyexperience/ 9 - http://www.andreadaniels.net/ medsurgsemiprivateroom.html 10-30 - The Time Saver Standards for Building Types by Joseph DeChiara

Section 5 Images

24 - http://www.decosee.com/design/blue-elle-decor.html 25 - http://skyparlour.com.au/blogs/blog/10504645-blueinfused-living 26 - http://blog.decoratorsbest.com/2014/07/30/trendalert/ 27 - http://francotechnogap.com/ 28 - http://www.glubdub.com/detail/colorful-modern/ colorful-modern-bedroom-decoration-personal-sanctuary-peace-12799.html 29 - http://ideastodecor.com/modern-door-design-withcool-graphic-and-colors/ 30 - http://www.homedesigz.com/ 31 - http://denoxa.com/bedrooms/ 32 -http://galleryhip.com/woman-reading-magazine-in-kitchen.html 33 - http://inspiringinteriorsideas.com/ 34 - http://loveisspeed.blogspot.com/2012/03/pipe-housesouth-coast-of-crimea.html 35 - http://pickcute.com/view/23087/interiors-in-brown-www-decorhomeidea 36 - http://www.landscapehdwalls.com/forest-clearing-262/ 37 - http://wallpapersinhq.com/63093-meditation/ 38 - http://www.achangingwoman.com/?page_id=51 39 - http://midohiohousewife.com/tag/crying/ 40 - https://www.flickr.com/people/ritapolak/ 41 - http://www.neinstein.com/category/blogs/legal-news/ 42- http://pottercountylawyers.com/bankrutpcy/ 43- http://www.woodenurecover.com/category_index.asp 44 - http://www.rehab-clinic.com/can-i-get-admittedstraight-away/ 45 - http://www.altamirarecovery.com/aftercare/support-groups/heroin-anonymous/ 46 - http://www.woodenurecover.com/category_index. asp 47 - http://www.npr.org/blogs/ health/2013/03/26/175283008/maybe-isolation-not-loneliness-shortens-life

Section 6 Images

1 - http://www.pinterest.com/rockrollrustic/us-mid-atlantic-demdnjnypa/ 2 - http://www.sailpandora.com/?p=67 3 - http://www.gilliardgroupllc.com/silveraerolimo/ 4 - http://www.crosswindsannapolis.com/blog/ 5 - http://blog.preservationmaryland.org/2012/04/ 6 - https://weatherspark.com/averages/31014/Annapolis-Maryland-United-States 7 - https://www.travelblog.org/Photos/5491220 8 - http://www.201bb.com/attractions.html 9 - http://commons.wikimedia.org/wiki/File:Hammond-Harwood_House_(Md._Ave._Facade).jpg 10 http://www.annapolisexperience.com/ blog/2011/08/03/a-walk-along-prince-george-street-in-annapolis-maryland/ 11 - http://curbed.com/tags/annapolis-md 12 - http://curbed.com/archives/2014/05/01/1827-farmhouse-comes-with-150-acres-and-five-extra-houses.php 13 - http://www.stmarysannapolis.org/page.aspx?pid=361 14 https://www.redfin.com/MD/Annapolis/95-Conduit-ST-21401/home/10432649 15 - http://www.trulia.com/rental/3169956930-107-ConduitSt-2-Annapolis-MD-21401 16 - http://www.pinterest.com/annapolisexp/quintessential-houses/ 17 - http://www.washingtonian.com/articles/homes/real-estate/best-places-to-live-if-youre-downsizing/ 18-19 - http://www.highlandbeachmd.org/ 20-22, 24 -http://bay-ridge.org/ 23 - http://www.city-data.com/zips/21403.html

Section 7 Images

1 https://www.flickr.com/photos/30104391

2 - http://www.thecourier.com.au/story/1402433/ sticky-problem-for-ballarat-base-hospitals-emergency-department/ 3 - http://www.pinterest.com/pin/190136415489358778/ 4 - http://www.sabmagazine.com/blog/2013/04/02/ sister-margaret-smith-addictions-treatment-centre-sustainable-design-improves-the-healing-process/ 5 - https://plus.google.com/+PalmbeachGardensTreatmentCenterStuart/about 6 - http://www.dekrantenkoppen.com/ds/2014_07_30.php 7 - http://abcnews.go.com/Entertainment/top-rehab-facilities-america/story?id=15528513 8 - http://www.bhpalmbeach.com/facilities/recovery-center-men-palm-beaches 9 - https://www.flickr.com/search/?q=movement

Section 8 Images

Section 2 Sources

Section 5 Sources

1 - “Fermented beverages of pre- and proto-historic China” by Patrick E. McGovern et. al. Proceedings of the National Academy of Sciences of the United States of America. Dec. 8th, 2004. 2 - “Social and Cultural Aspects of Drinking: A report to the European Commission” by The Social Issues Research Centre. March 1998. 3 - Drug Abuse: An Introduction by Howard Abadinsky. Nelson-Hall Series in Law, Crime and Justice, Chicago, 1989. 4 - Treating Addiction: A Guide for Professionals by William R. Miller, et. al. The Guilford Press, New York, NY. 2011. 5 - Recovery in America by William White. 1998. 6 - “New York State Inebriate Asylum” on the National Historic Landmarks Program website. 7 - Page 16 of American Temperance Movements: Cycles of Reform by Jack S. Blocker. Boston: Twayne Publishers, 1989. 8 - “Our Whole Country: Or the Past and Present of the United States, Historical and Descriptive” by John W. Barber and Henry Howe, 1861. 9 - The article “Keeley cure,” Time magazine, September 25, 1939. 10 - NPR Radio Show special “America’s First Drug-Treatment Prison Revisited” between Andrea Seabrook, JP Olsen, and Dr. Nancy Campbell. November 2008. 11 - “Top 10 Things You Didn’t Know About Alcoholics Anonymous” by Time Magazine, June 2010. 12 - The Hazelden Betty Ford Foundation’s official website. 13 - The Betty Ford Foundation’s official website.

1 - http://d-u-d.deviantart.com/art/sunday-morning-rain-isfalling-209234405 2 - http://www.get-free-wallpapers.com/3d-and-digital-art-wallpapers/4/abstract-wallpapers/f12104-walkingalone-in-rain-wallpaper.html 3 - http://husigimystery.info/allan/?p=177 4 - http://whotalking.com/flickr/raining All building images- http://www.cbf.org/

Section 10 Images

1 - http://familyfusionaz.com/addiction-recovery-therapy/ 2 - https://plus.google.com/+Benchmarkcenter/posts

Cover Sequence Images Cover: http://www.flickr.com/

Section 9 Images

1 - https://www.tumblr.com/search/ this+is+one+of+the+best+quotes 2 - http://www.flickr.com/

1 - Environmental Psychology for Design 2 - Place Advantage: Applied Psychology for Interior Architectur 3 - http://www.interior-design-it-yourself.com/decorating_color_schemes.html 4 - http://www.pva.org/site/c.ajIRK9NJLcJ2E/b.6738073/k.9877/The_Psychology_of_Color_in_Healthcare.htm 5 - http://www.psychologytoday.com/blog/meditation-modern-life/201307/overview-meditation-its-origins-and-traditions 6 - http://www.artofliving.org/meditation/benefits-of-meditation 7 - http://www.choosehelp.com/topics/drug-treatment/ the-benefits-of-meditation-in-drug-treatment 8 - http://www.americanyogaassociation.org/general.html 9 - http://www.osteopathic.org/osteopathic-health/aboutyour-health/health-conditions-library/general-health/ Pages/yoga.aspx 10 - http://www.therecoveryvillage.com/drug-treatmentguide/codependency/ 11 - http://www.familyrecoverysolutions.com/articles/ relapse/ 12 - http://webcache.googleusercontent.com/search?q=cache:5oOHg5-7vOwJ:https://ncadd.org/get-help/mutual-aid-support-groups+&cd=1&hl=en&ct=clnk&gl=us 13 - http://pubs.niaaa.nih.gov/publications/arh23-2/151160.pdf

Section 6 Sources

1 - http://www.annapolis.gov/government/departments/ finance/cafr/cafr2009/StatDemog.pdf 2 - http://www.census.gov/prod/cen2010/cph-2-1.pdf 3 - http://factfinder2.census.gov/faces/tableservices/jsf/ pages/productview.xhtml?src=CF 4 - http://www.capitalgazette.com/tour_statehouse.html/ 5 - https://weatherspark.com/averages/31014/Annapolis-Maryland-United-States 6 - http://www.annapolis.org/uploads/Newsletters/marker16x9-5.pdf 7 - http://www.highlandbeachmd.org/ 8 - http://bay-ridge.org/

Section 8 Sources

The 2012 International Building Code

With thanks Professor Lisa Phillips, for her sage advice and patient criticism. Mom, Julianne and Nana, for their unwavering support and enthusiam. William, for his encouragement and wisdom. Ingrid Wulf and Jessica Vuocolo, for sharing their professional knowledge and experience. Patrick of Mirmont Treatment Center, for graciously showing me my first rehab. Dianne Zotter-Mill, for introducing me to the field of graphic design. And to Uncle Guy, in the hopes that others may overcome their demons through your experiences, this project is for you.

199

200

201

202