Therapeutic Space Research Articles

Walking and talking for well‐being: Exploring the effectiveness of walk and talk therapy

AbstractDespite the rising trend of integrating nature and movement into talking therapy, the extent of empirical support remains limited. This study explored the effects of a walk and talk intervention on adult mood and well‐being using a multiple baseline design with pre, post and follow‐up assessments. Five adults (3 males and 2 females) from a technology company took part in a walk and talk intervention lasting approximately 6–8 sessions. They completed self‐report measures at baseline, post‐intervention and follow‐up, with semi‐structured interviews conducted at follow‐up. Results showed a reduction in psychological distress and an increase in well‐being for all participants from baseline to follow‐up. Qualitative data from a thematic analysis supported these findings: participants found the natural, calming effect of the outdoors, combined with the movement of walking, facilitated a sense of freedom to express themselves and, in doing so, maximise the benefits of the therapeutic space. These included gaining a broader perspective, heightened self‐awareness and greater acceptance of oneself, others and life's challenges. This study offers real‐world evidence supporting walk and talk therapy as an effective intervention for adult well‐being and mood.

Assessing the state of cognitive performance of employees and determining the range of thermal comfort of different genders in Ilam hospitals

Introduction: Thermal comfort is essential for a productive work environment and affects the well-being and performance of employees, so maintaining optimal levels of satisfaction, productivity, and efficiency, especially in indoor spaces, is essential. Therefore, the present study's aim is to evaluate the state of cognitive performance. Employees and determination of the thermal comfort range of different genders of employees in the hospitals of Ilam city were done. Methods and Materials: This research was conducted by survey and field method to identify the state of thermal comfort and cognitive performance of people in the real conditions of therapeutic spaces. For this purpose, the responses of 400 employees of five hospitals in Ilam City were recorded by simple sampling from the beginning of August to November 1402. The reliability status of the questionnaires was confirmed using Cronbach's alpha, and the thermal comfort status of the people was determined through the regression model. Linearity and correlation analysis between measured variables were analyzed through SPSS27 software. Results: The analysis of the linear regression model showed that the range of thermal comfort between men and women differs by 1.79 degrees Celsius, and this difference is a tendency for warmer temperatures in men and a tendency for colder temperatures in women, the average scores obtained at Zagros Hospital In the visual-spatial/executive component (7.00), attention (4.34), memory (3.08) has the best performance, Imam Khomeini Hospital (RA) has the best performance in the verbal component (2.95), Hazrat Qaim Hospital (A) In the abstraction component (2.02), it has the best performance and awareness of time and place in all hospitals equal to 6.00. Conclusion: The level of coverage and activity rate among women significantly affects the feeling of thermal comfort, cognitive performance, and productivity of employees at work. The results of this research show the need to revise the current standards of workplace clothing, attendance time, and employee activity rate. Moreover, changes in cognitive performance among hospital staff highlight the need to consider targeted cognitive enhancement strategies to increase staff efficiency.

Growing sustainable therapeutic third spaces – a therapeutic sensory garden’s impact on university student self-reported quality of life and affect

Growing sustainable therapeutic third spaces – a therapeutic sensory garden’s impact on university student self-reported quality of life and affect

Reflections from LGBTQIA+ individuals of their past experiences of psychotherapy and counselling and the use of creative therapy—A qualitative study

AbstractBackgroundPrevious literature tends to suggest that the LGBTQIA+ community face higher rates of mental disorders and illnesses. This appears to be due to minority stress as a result of the discrimination and hostility towards the community from society. In relation to psychotherapy and/or counselling, affirmative therapy has been found to be helpful; however, it is clear from the literature that the LGBTQIA+ population do not feel accepted or understood when accessing mental health support.MethodParticipants were invited to take part in an interview consisting of open‐ended questions relating to the topic of interest. Following this, a thematic analysis was completed.FindingsThe thematic analysis revealed four main themes: these were ‘sexuality and gender within the therapeutic relationship’, ‘desirable characteristics and attributes in a therapist’, ‘undesirable characteristics and attributes in a therapist’ and ‘creative therapy’.Implications for PracticeThe results could be used to inform mental health practitioners of the importance of cultural competency in relation to the LGBTQIA+ community, as well as helping aid how to approach sexuality and/or gender in a therapeutic space. The conclusions also highlight the need for practitioners to explore context with LGBTQIA+ clients rather than solely emotion focus.ConclusionThis study indicated that the LGBTQIA+ community prefer working with LGBTQIA+ therapists due to a shared lived experience and perceived baseline understanding of each other. It was also found that context was important for them in therapy, rather than emotion focus, and creative therapy was also shown to be useful for the community.

We exist and resist as woven patches: Collective narrative practices in an activist context challenging and responding to an anti-lesbian hate crime

This article describes a participatory process in which a group of feminist, lesbian feminist and dissident activists came together to respond therapeutically to the impacts of anti-lesbian hatred. The therapeutic context was created gradually with the deployment of a set of metaphors related to textile art, inspired by the re-authoring conversations proposed by Michael White. The process included the creation of a collective document that acknowledges and honours the participants’ wisdom, knowledge and particular ways of responding to anti-lesbian hatred. This work was embodied in three different forms: a patchwork quilt, a video and a fanzine. Collectivised through a definitional ceremony, these forms embraced manual-artistic creation and the materiality of fabric as valued means of expression, beyond the limits of the verbal. This work contributed to the visibility, externalisation and politicisation of acts of injustice, acknowledging forms of resistance, care and protest. The process invited us to reflect on the importance of collectivisation, fluidity and flexibility in structuring the therapeutic space, and allowed us to question the roles of therapist and activist as predefined identities.

Creative reflections on embodied filmmaking: in, through and between the senses and spaces of the medicalized body

ABSTRACT This artist’s reflection further explores the imagined and sensorial encounters of the body in medicine through a creative practice-led feminist, embodied, and intersubjective approach to filmmaking. It uses “corporeal parenthesis” as form and content to destabilize conventional readings associated with medicalization. The sensations we feel on the inside of the body shape our imagined anatomical understanding. This extension of proprioception is a sensorial way of seeing and experiencing the inside of one’s own body. The visceral body, which entwines our real and imagined bodily inside, is positioned as a site for sense-making. This emphasizes knowledge as imaginative, intuitive, and lived to resist the standardization experienced within medicine. However, the passive horizontal body in the clinical encounter and the presumed intimacy of the therapeutic space, assumes the body to be accessible and consenting. This alters the ways in which we experience senses associated with pleasure and non-pleasure. By focusing on the artist’s moving image work O (Symptom), creative practice is used to examine in, through, and between the spatial and sensorial boundaries of the medicalized body.

치유적 모빌리티와 네트워크의 얽힘 - 서울시민 힐링 프로젝트 속마음버스를 사례로

Health geography has been developed through various concepts, ranging from therapeutic landscapes to therapeutic spaces, places, mobilities, networks, and assemblages. However, much of the research within health geography has predominantly analyzed therapeutic geographical phenomena using a single conceptual framework. This study argues that these concepts do not exist separately but rather intersect and coexist, as demonstrated through a case study of the Seoul Healing Bus. The research findings reveal that the Seoul Healing Bus exemplifies a case where therapeutic mobilities and therapeutic networks intertwine to create a synergistic therapeutic effect. These findings underscore the need to analyze therapeutic geographical phenomena from multiple perspectives rather than from a singular viewpoint, suggesting the importance of designing therapeutic geographical environments where different concepts intersect.

Evaluation and Development of Healing Garden Based on Biophilic Design Approach in Harapan Kita Cardiovascular Hospital

Abstract The need for gardens in health facilities became the concern of Harapan Kita Cardiovascular Center Hospital (RSJPDHK). Landscape architecture research has identified the importance of therapeutic green space as a rehabilitation strategy on the physical and psychological resilience that can affect health and work performance. Therefore, the possibility to develop green space need to be designed in conjunction with the restorative function through the healing garden concept with biophilic approach. This research aims to identify the potentials and constraints of 3 chosen sites on RSJPDHK building; evaluate the healing garden value on site 1, which is an existing roof garden; and develop a biophilic-based healing garden design on sites 2 and 3, which are undeveloped roof and corridor yard. The research stages were carried out with reference to modified Booth (1984). The results showed that site 1 is suitable as a healing garden with standard criteria. Meanwhile, design development was carried out on sites 2 and 3 with the concept of healing garden and biophilic approach, entitled ‘rejuvenate’ which produced the output of design recommendations for RSJPDHK.

Release: The acupuncture clinic as a therapeutic, health-enabling place

This paper critically reappraises the work of Wilbert Gesler (1992) on ‘therapeutic landscapes’ to explore the dual role of the acupuncture clinic as experienced by couples undergoing fertility treatment. Drawing on qualitative research in Ireland, I argue that the acupuncture clinic acts as a therapeutic space in two senses. First, the patient-acupuncturist relationship contributes to patient emotional support and wellbeing, with the clinic providing emotional sanctuary. Second, the clinic provides a therapeutic complement to allopathic approaches to fertility treatment, with the acupuncturist providing informational support which informs patient decision-making and, in some cases, arguably contributing to the treatment itself. In exploring the therapeutic and health-enabling importance of the acupuncture clinic, this paper adds important qualitative depth to an aspect of assisted reproduction that has become an essential complement to the medical process to many couples, but has arguably remained neglected in academic research.

Torture victims' perspective on dental treatment: "Every sign you make, every move you take" - A qualitative study.

Torture victims struggling with post-traumatic stress often experience elements in the dental treatment situation that may trigger trauma-related reactions. The aim of the study was to explore intervention strategies that will enable dental health workers to adapt dental treatment to the needs of torture survivors. Exploratory interviews were conducted with 10 torture-exposed resettled refugees with dental treatment experience in Norway. The data was analyzed using qualitative content analysis, which suggested that to minimize trauma-reactions, dental personnel should focus on creating a safe therapeutic space and strengthening the patient's sense of control. Four main categories of clinical advice were proposed: (i) Acquire knowledge about psychology, consequences of torture, cultural differences, trauma-informed care, and the patients' individual needs; (ii) Recognize the trigger-potential of busyness or delays; (iii) Avoid surprises, such as sudden moves or actions and explore triggers individually, but make sure not to evoke images of interrogation, and; (iv) Provide overview both with respect to visibility in the clinical room, and to predictability regarding the dental treatment. Although undergoing dental treatment may be challenging for torture-exposed individuals, it is possible to reduce the predicaments considerably by making feasible adaptions to the treatment and adopting a trauma-informed approach.

DESIGNING FOR THE SENSES: MULTISENSORY APPROACHES IN THERAPEUTIC CLINICAL SPACES

Spatial design significantly influences interactions with the built environment, engaging senses through visual, auditory, and tactile stimuli. However, in therapeutic clinical settings, the sensory experience is often overlooked in favor of aesthetic considerations, limiting the understanding of user responses to spatial cues. This study investigates the role and impact of multisensory design on user responses in therapeutic clinical environments. By analyzing design parameters such as lighting, acoustics, materials, and textures, the research aims to establish a framework for creating therapeutic clinical spaces that prioritize multisensory stimulation. Through case studies, interviews, and surveys, the study assesses user perceptions and psychological responses to different sensory stimuli in clinical settings. The findings indicate a preference for environments that engage multiple senses, with factors such as layout, color tones, forms, lighting, and finishes playing crucial roles in shaping user experiences. The proposed framework offers practical guidance for designers and architects, emphasizing the importance of sensory design in enhancing interactions between users and clinical environments, ultimately contributing to a more holistic and immersive therapeutic experience.

Controlled mitral valvuloplasty using steerable catheter- waist- formed balloon system: A clinical case series.

As the general population ages, the incidence of degenerative mitral stenosis (MS) among patients has increased. Percutaneous mitral valvuloplasty (PMV) has emerged as a well-established option for mitral rheumatic stenosis with specific characteristics. However, a blank therapeutic space must be filled with the treatment options for degenerative or rheumatic mitral stenosis in patients with many comorbidities and contraindication for valvuloplasty. We here present a comprehensive overview of the current possibilities, despite their scarce success. That is the reason why we propose a case series to facilitate a better understanding of our innovative technique in this challenging clinical context.

Therapeutic utilization in chronic lymphocytic leukemia: A cross-sectional analysis of the Lymphoma Coalition’s 2022 Global Patient Survey.

e19026 Background: Chronic Lymphocytic Leukemia (CLL) is a highly prevalent disease with heterogenous prognostic trajectories. With a multitude of treatment options, we sought to explore therapeutic utilization trends from a global perspective in order to gain a more in-depth understanding of how different treatment regimens are utilized in different health systems. Methods: In 2022, The Lymphoma Coalition designed and globally deployed a survey to patients with lymphoma and CLL in order to gather patient reported outcomes and patient reported experience measures. Data were collected and enumerated with relevant contingency analyses performed to determine associations with a particular treatment regimen in the context of CLL. Results: The entire cohort of patients with CLL was 1289. The median age of the cohort was 65 and ranged from 26 to 97 years old. Biological sex was equally distributed with 50.5% of respondent indicating that they were female. Respondents were derived from 29 countries. The top three contributors to each region were China (50%), Australia (25%) and New Zealand (18%) for Asia-Pacific (N = 227); France (50%), Italy (13%) and Sweden (7%) for Europe (N = 950); Canada (75%) and The United States (25%) for North America (N = 112). Of those, 636 indicated that they received at least one therapy. The use of chemo-immunotherapy was most common (42%) followed by targeted therapy (32%), immunotherapy alone (18%), and chemotherapy alone (16%). Neither age nor biological sex was a significant predictor of therapy. Europe had the highest rates of chemo-immunotherapy utilization (45%) with North America and Asia-Pacific indicating 32% respectively (p = 0.01). Targeted therapy was used at a higher rate in North America (45%) but failed to demonstrate a significant difference against Asia-Pacific and Europe (31%); (p=0.10). Both immunotherapy and chemotherapy alone failed to demonstrate significant differences across regions. Conclusions: The data support that the majority of patients with CLL who require treatment are most likely to receive combination chemo-immunotherapy utilizing rituximab. However, we acknowledge that the data presented here is two years old and that the use of targeted molecular therapy is likely increasing. We found it reassuring that we could not identify any biases in the administration of the therapeutic regimens across the demographics of age and biological sex. Our research in this space will continue as we have deployed the 2024 version of the Global Patient Survey and have focused on increasing respondent participation from North America. With this new data, we plan on producing a time-dependent model to investigate how emerging therapies enter and expand in the CLL therapeutic space.

COVID-19: When It Leaves Us Voiceless and Powerless.

Conversion disorder-called functional neurological symptom disorder in the DSM-5-has roots that trace back to antiquity. The term conversion, originating from psychoanalysis, signifies the appearance of physical symptoms as an effort to resolve or convey unconscious and distressing intrapsychic conflicts- "converting" them from manifesting in the mind to manifesting in the body. Despite efforts made in elucidating the neurobiological etiologies of functional neurological symptom disorder, a psychodynamic lens remains indispensable in understanding the patient. This article presents two patients who developed functional neurological symptom disorder, one after a COVID-19 vaccination and one in the context of long COVID. A discussion follows on the intrapersonal, interpersonal, and systemic etiological factors that predispose, precipitate, and perpetuate COVID-related functional neurological symptom disorder. We elaborate on psychodynamic psychological processes and conflicts that may unfold between patients with COVID-related functional neurological symptom disorder and their health care providers. We also share suggestions on how a consultation-liaison psychiatry team may offer support to the primary treating team to facilitate a therapeutic space within which patients with COVID-related functional neurological symptom disorder may recover.

A Viral Pedagogy: Undoing Things with Long COVID’s Autoimmunities

This article focuses on the scientific and political transformations that the COVID-19 pandemic continues to engender through its impact on the epistemological and ontological foundations of autoimmunity. By discussing an online seminar taught during the COVID pandemic winter of 2020–21, the article considers how the viral autoimmunities involved in severe and long-haul COVID pathogenic mechanisms have fostered transformative pedagogical and therapeutic experiences, spaces, and events. As a highly contagious viral disease, COVID highlights disparities in access to healthcare, whereby certain (racialized, disabled, ageing) bodies are unequally burdened with the labor of staying alive. Predicated on a foundational separation between inside and outside, or between the internal, vulnerable, visceral space of the individual(ized) “human” body and an external(ized), hazardous, contaminated, foreign environment, COVID measures for avoiding viral exposure became paramount, reciting a genealogy of distancing, protection, containment, and isolation. By examining how concepts and practices of autoimmunity animate cutting-edge biomedical research, this article asks, How does autoimmunity undo normative models of health predicated on a militarized model of immunity? How might the viral shift our understanding of autoimmunity and what might autoimmune conditions teach us about virality? In short, what can autoimmunity and the viral show us about uncertainty, care, and transformation in therapeutic and pedagogical contexts?

ЗАСТОСУВАННЯ СУЧАСНОЇ АРХІТЕКТУРИ У БУДІВЛЯХ ПСИХІАТРІЇ

The article highlights the importance of architecture to mental health and the impact of space design on emotional state and productivity. The study shows that architects are using innovative approaches, such as biophilic design, to create healing environments, and mental health is becoming more relevant in the context of current challenges, including the pandemic. The article also reveals the contribution of architect Thomas Story Kirkbride to the development of the concept of "moral healing" and the use of light and safe space planning as key elements in supporting mental health. It is suggested that the conscious use of design can contribute not only to the physical but also to the mental well-being of people. Considering the important aspects of architectural design that affect mental health. The use of natural light, the introduction of biophilic design and the creation of open, spacious layouts can have a positive impact on people's emotional state and overall mood. The article also highlights the importance of green spaces, noise reduction, and the choice of colours and materials for mental well-being. It is noted that therapeutic spaces and the concept of inclusive design are important components for creating psychologically supportive environments. Architecture is a key factor in solving mental health problems by understanding the needs of residents and taking into account their emotions and feelings.

Parent and oncologist perspectives on prognostic disclosure in advanced childhood cancer: communication pearls and pitfalls.

For children with advanced cancer and their families, communication about prognosis is critical. Unfortunately, data demonstrate that prognostic communication occurs infrequently and inconsistently across advancing illness. Prior to developing an intervention to improve prognostic communication, we aimed to (1) characterize parent and oncologist perspectives on "best" approaches for prognostic communication, and (2) explore similarities and differences between parent and oncologist perspectives. Children with poor-prognosis solid tumors, their parents, and oncologists were followed prospectively for 24months or until death. Matched semi-structured interviews were conducted with parents and oncologists 0-7days after medical encounters at timepoints of disease progression or relapse. Reflexive thematic analysis was conducted to describe parent and oncologist impressions of communication quality. A total of 68 interviews were conducted following serial disease reevaluation encounters involving 13 parents and five oncologists. Nine main themes were identified as "best" approaches: (1) speaking with honesty and clarity, (2) leaving room for hope, (3) leaning into a long-standing relationship, (4) personalizing language, (5) empowering the patient and family, (6) collaborating with the multidisciplinary team, (7) providing anticipatory guidance, (8) setting the scene, and (9) creating a therapeutic space. Parents and oncologists generally agreed on themes related to helpful communication approaches, while parents more explicitly described communication pitfalls. Parents and oncologists described clear recommendations for helpful communication strategies and pitfalls to avoid during difficult prognostic disclosure. Future work should integrate patient perspectives in the design and testing of an intervention to improve prognostic communication in advanced childhood cancer.

Comment on ‘Sexual relationships in group analysis: Theoretical investigations and clinical applications’ by Anastassios Koukis

With respect to the article by Koukis (2024) the author questions important points concerning self-exclusion, working through, external group events, boundary incidents and bodily experience. He concludes that it is necessary to restore boundaries and facilitate the therapeutic space.

Élever la bizarrerie à la dignité du style. Pour une éthique de l’accompagnement des patients autistes

ObjectivesThis article aims to identify how the analytical framework can lead an autistic subject to create an artisanal solution that allows him to enter the world. MethodThe Lacanian theoretical conceptualization is based on clinical observations collected during the treatment of a young autistic boy. ResultsWe argue that engaging in therapeutic work with an autistic patient can offer him a potential environment – which we distinguish from potential space – in which his particular quirks can be elevated to the dignity of a style that the autistic child will himself shape and that will allow him a certain social bond. DiscussionWe qualify the therapeutic space offered by the analytical framework as a potential environment, which we define as the coordinates of the encounter set up by the clinician bringing into existence a Stimmung from which the child can experience his or her instinctual movements. Stimmung is to be understood as the phenomenological quality of the potential environment, simultaneously including tuning, invocative address, disposition, and atmosphere, i.e. a possible relationship with the Other. Clinical intervention would allow the child not to represent himself in this potential environment – which is the nature of potential space –, but to present himself to the world. It is the clinician's responsibility to bring into existence an Other who can isolate and put into circulation the subject's oddity – which could be considered a failure – bringing forth a singularizing sign and elevating it to the dignity of style that the autistic child will shape. ConclusionThe style, thus obtained, corresponds to the possibility of a singular enunciative position – inscribing a presence in the world by tempering the weight of the subject –, which, in autism, always requires a certain amount of tinkering in order to arrive at a solution.

Incorporating Creativity into Relational Cultural Theory in Couples Counseling

This article explores the integration of creativity into relational-cultural therapy (RCT) with couples, emphasizing the potential for creative interventions to enhance clients’ understanding of self and others while promoting relational growth. RCT, rooted in the acknowledgment of chronic disconnection as a source of human suffering, focuses on meaningful interdependence and connection as essential for well-being. Despite the documented benefits of creative techniques in couples therapy, there is a gap in the literature regarding the use of creative interventions within RCT couples counseling. The article argues that incorporating creativity within RCT couples counseling facilitates the development of a common language and understanding of RCT concepts among couples. It provides an overview of RCT concepts, discusses the rationale and research supporting the integration of creativity with RCT and couples work, and offers five creative RCT-based interventions: Reflecting on the relationship, creating a context constellation, honoring strategies of disconnection, visualizing relational images, and exploring shame and authenticity. Each intervention is designed to align with RCT principles, encouraging clients to explore their identities, relational dynamics, and strategies of disconnection in a creative and experiential manner. The article emphasizes the importance of creating a safe and non-judgmental therapeutic space, where clients and counselors can collaboratively engage in these creative activities. Overall, the integration of creativity into RCT couples counseling aims to promote vulnerability, mutual empathy, and strengthened connection within the therapeutic relationship and the couple's dyad.