Date of Award

January 2020

Document Type


Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Trace Kershaw



Treatment spaces for substance use disorders (SUD) are diverse with respect to treatment modality and population served. However, there is a lack of literature describing the design of treatment spaces and treatment engagement. This project aims to identify how the built environment of SUD treatment spaces play a role in treatment acceptability, retention, and outcomes.


We conducted 15 semi-structured interviews with individuals in outpatient SUD treatment in southern Connecticut. These interviews explored individuals’ experience with the built environment of treatment spaces and facilities, including architectural and design-related features (e.g., functionality, spatial arrangement), and how space influences adherence to treatment.


Two themes emerged from analyses identifying two types of space: 1) Engaged spaces include staff engagement with the built environment which creates “lived-in spaces” consisting of plants, artwork, and personal artifacts, and patient engagement with spaces experienced as warm and inviting. Engaged spaces increase individuals’ interest in treatment, thus increasing connectedness. 2) Disengaged spaces are experienced as sterile and unwelcoming. Aspects of disengaged spaces include plain décor, design elements of institutionalized settings, and the presence of common recovery messages. Disengaged spaces distract from therapeutic experience resulting in feelings of disconnectedness.


Architectural elements and design of treatment spaces can promote commitment to and interest in recovery. Participants describe greater willingness and desire to engage with treatment in spaces they feel comfortable. Further work is necessary to understand how participants experience the built environment of substance use treatment spaces and identify design elements of these spaces that facilitate recovery from SUD.


This thesis is restricted to Yale network users only. It will be made publicly available on 05/27/2021