Therapeutic Architecture and Temporality: Evidence-Based Design for Long-Stay Facilities for Individuals with Severe Intellectual Disabilities and Challenging Behaviour

Abstract

Since individuals with severe and profound Intellectual Disabilities (IDs) have no concept of time, it is difficult for them to autonomously maintain daily structures. Those affected are dependent throughout their lives on external care structures. Even though research suggests that individuals with IDs should live in smaller facilities, individuals with higher support needs are more likely to be placed in large institutions and clustered group homes. The aim of this study was to define design criteria and test their applicability to a residential building design whose architecture enables individuals with IDs to develop autonomy through spatially experienced temporality. Qualitative data was collected in a mixed method evidence-based design approach: systematic behavioural observations, structured interviews, focus groups, and the UV-index method. Four design criteria could be described that contribute to an autonomy-promoting temporality: (a) spatial sequencing and repetition, (b) privacy-related variation of spatial dimensions, (c) spatial orchestration of daylight, and (d) constant emotional proximity to the caregiver. The hypothesis of using architecture to promote temporality in clients with IDs and Challenging Behaviour (CB) has proven to be potentially effective in designing a therapeutic environment. Our findings provide valuable data on how long-stay facilities should be designed in the future.