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An increased focus on doing and performance, the domination of the medical model, and the fast-paced nature of the workplace are some of the primary factors contributing to an overall reduction in the focus on the therapeutic value of the physical environment in occupational therapy practice (Rowles, 1991; Stewart & Law, 2003). It is within the occupational therapist's scope of practice to assist in creating environments of care in which staff and consumers feel comfortable and supported. Therefore, we must ask ourselves whether mental health environments of care support nurturance, wellness, and recovery as universal themes (Champagne, 2003). Further, in demonstrating the active creation and therapeutic use of the physical environment to positively influence performance skills and patterns, consumers increasingly may become aware of the importance of considering contextual elements as an essential part of the treatment and discharge planning processes (for home, work, and school applications). Hence, the occupational therapist's role in environmental design and enhancement is quintessential in mental health. Additionally, it must be recognized that in settings based on the medical model, this approach requires much more than merely redecorating.
Hasselkus (2002) elaborated on the differences between space and place and stated that one of the primary differences is meaning-both private and shared. The term space alludes to neutrality and physical boundaries, whereas the term place emerges from the meaningful experiences and memories created within. In this way, a therapeutic place enables therapeutic experiences (occupations) and facilitates a safe sense of containment and the emergence of meaning (Hasselkus, 2002). Thus, in all areas of practice, including mental health, the importance of place must not be avoided or minimized. Rather, thoughtfulness in the use of space and place is essential. Whether beginning this journey through the creation of specialized rooms where place is a specific focus (a sensory room), through therapeutic gardens (Furgeson, 2003) rich in cultural symbolism, or in taking such steps throughout an entire health care organization, the potential opportunities for enhancing the ability to offer person-centered and recovery-focused therapeutic places in health care settings are endless.
It is important to point out that all therapeutic places will differ when developed collaboratively with the interdisciplinary staff and consumers of each organization. Although furnishings, activities, themes, and equipment may be common...