ARCHITECTURE OF

ALCOHOL ADDICTION
RECOVERY CENTRES

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University of Nairobi

College of Architecture and Engineering

School of the Built Environment

Department of Architecture and Building Sciences

Author: Owino Grace Oyugi

Registration: B02/0830/2011

Subject: BAR 613 – Written Thesis

Tutor: Arch. Kigara Kamweru

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 DECLARATION

This written thesis is my original work and has not been presented in any other University or Institution for the purpose of awarding a Bachelor’s
degree, to the best of my knowledge.

This thesis is presented in partial fulfillment of the examination requirements of the University of Nairobi, Department of Architecture and Building
Science, for the award of a Bachelor of Architecture degree.

Author ………………………………………………………….................. Date ………………………………….

Owino Grace Oyugi

Supervisor ………………………………………………………………… Date ………………………….............

Arch. Kigara Kamweru

Year Master ……………………………………………………………….. Date ………………………….............

Arch. Erastus Abonyo

Chairman …………………………………………………………………... Date ………………………….............

Arch. Musau Kimeu

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 Uncle Ochi Best

In the hope that you will find true healing…and your way back home

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DEDICATION

This thesis is dedicated to my family; my father A.H. Oluoch for being my voice of reason, my role model and biggest

supporter, my mother Priscilla Oluoch for loving me unconditionally and encouraging me through my studies, my sister

Phoebe for reminding me to value every moment of life and my grandparents, Dr. David Onyango and Mrs. Esther

Onyango, for being the very rock of our family. I am grateful to you all for your immeasurable support and unconditional

love. Dad, thank you for pushing me to see this through and give it my all.

I also dedicate this thesis to all those who are strong enough to seek help in fighting their addictions. I praise your courage

and hope to honour your efforts in this way.

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ACKNOWLEDGEMENT

My deepest gratitude to God almighty for thus far He has brought me in life. He made sure I did not lack in any way and
strengthened me through my most trying and difficult times.

My utmost regard goes to my parents, who have been my encouragement through this whole journey. I am forever grateful
for the sacrifices they have made to ensure my wellbeing and focus through all this. I am, because they were.

I am deeply thankful to my tutor Arch. Kigara Kamweru for his guidance, insight, endless encouragement and constructive
criticism, which have enabled the fruition of this exercise.

I would like to sincerely thank Arch. Erastus Abonyo for his prompting, timely suggestions, wise counsel, guidance, and
for pushing me to exert myself and appreciate this journey.

I extend my gratitude to the chairman of department, Arch. Musau Kimeu, together with all lecturers, for the gift of their
time and guidance through my time in school.

To Mr. Anthony Kang’ethe, the director of Asumbi Treatment Centre, and all the staff who took time to answer my
questions and guide me through my study, I am truly grateful. To Peninah, Esther, Geoffrey, Susan, Elkanah and the rest
of the team at A.T.C, thank you for making all this possible.

I am forever indebted to my friends and classmates whose encouragement, constructive criticism and understanding have
been a beacon through many moments of crisis. To Grace, Dolphine, Dani, Ed, Mari, Balozi, Nyanquir, Edger, Joan, Chiry
and Justus, your friendship means the world to me. Siegmund, thank you for your support and encouragement. I am a
better person for it.

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TABLE OF CONTENTS
1.0 INTRODUCTION ..................................................................................................................................................... 1
1.1 Preamble ................................................................................................................................................................... 2
1.2 Background of the Study........................................................................................................................................... 3
1.3 Problem Statement ................................................................................................................................................... 4
1.4 Aims and Objectives.................................................................................................................................................. 5
1.5 Research Questions .................................................................................................................................................. 5
1.6 Justification ............................................................................................................................................................... 6
1.7 Scope and Limitations ............................................................................................................................................... 7
1.8 Significance of Study ................................................................................................................................................. 8
1.9 Organization of Study ............................................................................................................................................... 8
2.0 LITERATURE REVIEW ............................................................................................................................................ 10
2.1 Introduction ............................................................................................................................................................ 11
2.1.1 History of Rehabilitation Centres ........................................................................................................... 11
2.1.2 Doctor Benjamin Rush ............................................................................................................................ 14
2.1.3 Sober Houses and Halfway Houses ........................................................................................................ 15
2.1.4 Treatment of Alcoholics .......................................................................................................................... 16
2.1.5 The Keeley Cure ...................................................................................................................................... 17
2.1.6 Cocaine Use to Treat Alcoholism ............................................................................................................ 17
2.1.7 Establishment of Alcoholics Anonymous................................................................................................ 18
2.2 Spaces of Treatment for Addiction ......................................................................................................................... 20
2.2.1 Hospitals (hospitalization) ...................................................................................................................... 20
2.2.2 Group Homes (residential treatment) .................................................................................................... 21
2.2.3 Clinics (in-patient care) ........................................................................................................................... 25

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 2.3 The Therapeutic Process in Rehabilitation Centres ................................................................................................ 26
2.3.1 Psychotherapy ........................................................................................................................................ 26
2.3.2 Nutritional therapy ................................................................................................................................. 28
2.3.3 Pharmacotherapy ................................................................................................................................... 29
2.3.4 Recreational therapy .............................................................................................................................. 29
2.4 The Needs of the User ............................................................................................................................................ 30
2.4.1 Introduction ............................................................................................................................................ 30
2.4.2 Maslow’s Hierarchy of Needs ................................................................................................................. 31
2.5 Therapeutic Architecture ........................................................................................................................................ 33
2.5.1 The Role of Architecture in Therapy and Rehabilitation ........................................................................ 34
2.5.2 Design of Rehabilitation Centres ............................................................................................................ 36
2.5.3 Therapeutic Gardens and Landscaping................................................................................................... 47
2.6 The Dimensions of Wellness ................................................................................................................................... 49
2.5.1 Emotional Wellness ................................................................................................................................ 50
2.5.2 Physical Wellness .................................................................................................................................... 51
2.5.3 Social Wellness ....................................................................................................................................... 51
2.5.4 Environmental Wellness ......................................................................................................................... 51
2.5.5 Occupational Wellness ........................................................................................................................... 51
2.5.6 Spiritual Wellness ................................................................................................................................... 52
2.5.7 Intellectual Wellness............................................................................................................................... 52
3.0 RESEARCH METHODOLOGY.................................................................................................................................. 53
3.1 Introduction ............................................................................................................................................................ 54
3.2 Research Purpose ................................................................................................................................................... 54
3.3 Research Strategy ................................................................................................................................................... 55

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 3.4 Data Collection........................................................................................................................................................ 56
4.0 DATA ANALYSIS & PRESENTATION ....................................................................................................................... 59
4.1 Introduction ............................................................................................................................................................ 60
4.2 Case Study Selection ............................................................................................................................................... 61
4.2.1 Naufar Rehabilitation Centre, Doha - Introduction ................................................................................ 61
4.2.2 Asumbi Treatment Centre, Homa Bay - Introduction............................................................................. 64
4.3 Building Scale .......................................................................................................................................................... 66
4.4 Humanizing Materials and Colours ......................................................................................................................... 66
4.5 Staff – focused amenities........................................................................................................................................ 67
4.6 Security and Safety ................................................................................................................................................. 68
4.7 Therapeutic Design Considerations ........................................................................................................................ 68
4.8 International Case - Naufar Rehabilitation Centre ................................................................................................. 69
4.8.1 Location & Neighbourhood .................................................................................................................... 69
4.8.2 Entrance & Access................................................................................................................................... 70
4.8.3 Building Scale .......................................................................................................................................... 72
4.8.4 Humanizing Materials and Colours ......................................................................................................... 73
4.5.5 Therapeutic Design Considerations ........................................................................................................ 73
4.9 Local Case – Asumbi Treatment Centre .................................................................................................................. 75
4.9.1 Location & Neighbourhood .................................................................................................................... 75
4.9.2 Entrance & Access................................................................................................................................... 76
4.9.3 Building Scale .......................................................................................................................................... 77
4.9.4 Humanizing Materials & Colours ............................................................................................................ 78
4.9.5 Security & Safety..................................................................................................................................... 78
4.9.6 Staff – focused Amenities ....................................................................................................................... 79

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 4.9.7 Therapeutic Design Considerations ........................................................................................................ 80
5.0 CONCLUSIONS & RECOMMENDATIONS ................................................................................................................ 83
5.1 Introduction ............................................................................................................................................................ 84
5.2 Summary of Findings .............................................................................................................................................. 85
5.3 Recommendations .................................................................................................................................................. 88
REFERENCES .............................................................................................................................................................. 93
APPENDICES .............................................................................................................................................................. 94

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LIST OF FIGURES

Figure 0.1.1 INFOGRAPHIC SHOWING THE CYCLE LEADING TO ALCOHOL ADDICTION.............................................................................................................2

Figure 1.2 IMAGE SHOWING THE LINK BETWEEN CYCLES OF ADDICTION AND RECOVERY ......................................................................................................3
Figure 0.2 IMAGE SHOWING THE LINK BETWEEN CYCLES OF ADDICTION AND RECOVERY ......................................................................................................3
(Source: Google Images) ............................................................................................................................................................................................................3
Figure 1.2 & 1.3 IMAGES SHOWING THE IMPORTANCE OF THERAPEUTIC TREATMENT FOR ALCOHOLICS .............................................................................3
Figure 1.0.3 INFOGRAPHIC SHOWING A REPRESENTATION OF THE POPULATION OF ALCOHOLICS IN NYANZA PROVINCE ....................................................4
Figure 1.0.4 INFOGRAPHIC HIGHLIGHTING THE STUDY AIMS & OBJECTIVES............................................................................................................................5
Figure 1.0.5 IMAGE SHOWING THE MAIN POINTS OF INTEREST IN THE STUDY .......................................................................................................................6
Figure 1.0.6 INFOGRAPHIC SHOWING THE PROJECTED SCOPE OF LIMITATIONS TO THE STUDY .............................................................................................7
Figure 1.0.7 INFOGRAPHIC SHOWING A SUMMARY BY CHAPTER, OF THE STUDY ORGANIZATION .........................................................................................9
Figure 1.6 IMAGE SHOWING A SUMMARY OF THE STUDY ORGANISATION .............................................................................................................................9
Figure 2.1 IMAGE SHOWING EARLY SETTLERS TRADING ALCOHOL FOR ANIMAL SKINS WITH INDIGENOUS COMMUNITIES ...............................................12
Figure 2.2 IMAGE GIVING A SUMMARY OF THE EARLY FACTORS CONTRIBUTING TO ALCOHOL ABUSE ................................................................................12
Figure 2.3 IMAGE SHOWING A CIVIL WAR VETERAN USING OPIATES.....................................................................................................................................13
Figure 2.4 UNDATED IMAGE OF DR. BENJAMIN RUSH - THE FATHER OF AMERICAN PSYCHIATRY ........................................................................................14
Figure 2.5 ARTISTIC IMPRESSION OF THE NEW YORK STATE INEBRIATE ASYLUM ..................................................................................................................15
Figure 2.6 IMAGE SHOWING PEOPLE PROTESTING THE ESTABLISHMENT OF THE PROHIBITION ACT ...................................................................................15
Figure 2.7 IMAGE SHOWING THE FRONT FACADE OF AN EARLY HALFWAY HOUSE FOR ALCOHOLICS AND PRISONERS .......................................................16
Figure 2.8 IMAGE CAPTURING THE INTERIOR LAYOUT OF THE HALFWAY HOUSE..................................................................................................................16
Figure 2.9 UNDATED IMAGE OF DR. LESLIE KEELEY .................................................................................................................................................................17
Figure 2.10 IMAGE SHOWING TREATMENT & HEALTH CHECKUP IN A HOSPITAL...................................................................................................................20
Figure 2.11 IMAGE DEPICTING HOSPITALIZATION AS AN OPTION FOR TREATING ALCOHOL POISONING .............................................................................20
Figure 2.12 IMAGE SHOWING THE FAÇADE OF A GROUP HOME OFFERING TREATMENT FOR ALCOHOLISM .......................................................................21
Figure 2.13 IMAGE SHOWING THE RESIDENTIAL CHARACTER SYNONYMOUS WITH GROUP HOMES....................................................................................21
Figure 2.14 IMAGE SHOWING SUMMARY OF THE MINNESOTA MODEL OF GROUP HOME TREATMENT ..............................................................................23
Figure 2.15 IMAGE SHOWING THE FOCUS OF ADDICTION TREATMENT IN HEALTH CLINICS .................................................................................................25
Figure 2.4 IMAGE SHOWING THE FOCUS OF ADDICTION TREATMENT IN CLINICS .................................................................................................................25
Table 1 TABLE SHOWING DIAGNOSIS CRITERIA USED IN CLINICS TO GAUGE LEVEL OF ALCOHOLISM IN PATIENTS..............................................................26
Table 2 TABLE HIGHLIGHTING THE VARIOUS FORMS OF PSYCHOTHERAPY APPLIED TO ALCOHOLICS IN REHABILITATION CENTRES ..................................27
Figure 2.16 IMAGE SHOWING THE FOOD PYRAMID AS APPLIED TO NUTRITIONAL THERAPY ................................................................................................28

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Figure 2.17 IMAGE SHOWING OUTDOOR GAMES THAT CAN BE MADE AVAILABLE TO PATIENTS AS A MEANS OF EXERCISING AND REDUCING STRESS ...30
Figure 2.18 IMAGE SHOWING RECREATION THROUGH LESS STRENUOUS PHYSICAL EXERTION ............................................................................................30
Figure 2.19 IMAGE SHOWING A SIMPLE ILLUSTRATION OF MASLOW'S PYRAMID .................................................................................................................31
Figure 2.20 IMAGE SHOWING DETAIL OF MASLOW'S HIERARCHY OF NEEDS.........................................................................................................................33
Figure 2.21 INFOGRAPHIC SHOWING THE GLOBAL ARCHITECTURAL PRINCIPLES OF GOOD DESIGN IN RELATION TO CONSIDERATIONS FOR
REHABILITATION CENRES .........................................................................................................................................................................................................35
Figure 2.22 IMAGE SHOWING THE INCORPORATION OF GREENERY INTO THE WAITING AREA OF A TREATMETNT CENTRE ...............................................41
Figure 2.23 IMAGE SHOWING DESIGN ARTICULATION TO ALLOW USER ACCESS TO NATURE THROUGH A PLAY OF SOLIDS AND VOIDS ............................41
Figure 2.6 IMAGE SHOWING DESIGN OF INTERIOR & EXTERIOR SPACES TO ENABLE USER ACCESS TO NATURE ..................................................................41
Figure 2.24 IMAGE SHOWING THE USE OF WALL MURALS AND PAINT FINISH TO CREATE POSITIVE DISTRACTIONS ...........................................................42
Figure 2.25 IMAGE SHOWING THE USE OF ARTWORK TO CONTRAST WALL FINISHES AND OFFER POSITIVE DISTRACTION TO USERS OF SPACE ...............42
Figure 2.26 IMAGE SHOWING A WAITING LOUNGE THAT OFFER USERS SOME DEGREE OF PRIVACY ...................................................................................43
Figure 2.27 IMAGE SHOWING THE INTERIOR OF A PRAYER HALL WITHIN A TREATMENT CENTRE ........................................................................................43
Figure 2.28 IMAGE SHOWING DAYTIME 3-D SHOT OF THE REHABILITATION CENTRE ...........................................................................................................44
Figure 2.29 IMAGE SHOWING DAYTIME SHOT OF THE FRONT FACADE AND MAIN ENTRANCE INTO THE CENTRE ...............................................................44
Figure 2.30 IMAGE SHOWING A LONGITUDINAL SECTION OF THE BUIDING S1 .....................................................................................................................44
Figure 2.31 IMAGE SHOWING 3-D SKETCH OF THE CENTRE, WITH SECTION S1 .....................................................................................................................45
Figure 2.33 IMAGE SHOWING A 3-D SKETCH OF THE CENTRE, WITH SECTION S2 ..................................................................................................................45
Figure 4.1 IMAGE SHOWING DAYTIME SHOTS OF THE MAIN ENTRANCE TO THE REHABILITATION CENTRE.........................................................................45
Figure 2.32 IMAGE SHOWING A CROSS SECTION THROUGH THE WIDTH OF THE BUILDING S2.............................................................................................45
Figure 2.34 IMAGE SHOWING THE EXTENSIVE USE OF GLASS ON THE BUILDING FACADE AND ENCLOSED PRIVATE GARDEN.............................................46
Figure 2.35 IMAGE SHOWING THE BRIGHT INTERIORS ADN VIEWS TO NATURE....................................................................................................................46
Figure 2.36 IMAGE SHOWING INCORPORATION OF A WATER POOL INTO A GARDEN ...........................................................................................................48
Figure 2.37 1 IMAGE SHOWING INCORPORATION OF NATURAL STONE AND ROCK OUTCROPS INTO A GREEN GARDEN ....................................................48
Figure 2.38 INFOGRAPHIC SHOWING THE SEVEN DIMENSIONS OF WELLNESS COMBINING TO FORM A WHOLE ................................................................50
Figure 3.1 IMAGE SHOWING THE ADMINISTRATION BLOCK AT ASUMBI TREATMENT CENTRE .............................................................................................55
Figure 3.2 IMAGE OF THE MAIN THERAPY BLOCK AT NAUFAR REHABILITATION CENTRE ......................................................................................................55
Figure 3. INFOGRAPHIC SHOWING A SUMMARY OF THE DATA COLLECTION TOOLS .............................................................................................................56
Figure 4.1 INFOGRAPHIC SHOWING A SUMMARY OF THE PARAMETERS GUIDING THE STUDY.............................................................................................60
Figure 4.2 IMAGE SHOWING AND EVENING SHOT OF THE ACCESS AND ENTRANCE TO THE MAIN THERAPY BLOCK ...........................................................62
Figure 4.3 IMAGE SHOWING A DAYTIME 3-D SHOT OF THE THERAPY BUILDING ...................................................................................................................62
Figure 4.4 IMAGE SHOWING THE SERIES OF CONNECTED VILLAS THAT PROVIDE PATIENT ACCOMMODATION (Source: www.naufar.com) ......................62

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Figure 4.5 MAP SHOWING THE LOCATION OF DOHA, QATAR (Source: Google Maps, modified by author) ..........................................................................63
Figure 4.6 IMAGE SHOWING THE MAIN ENTRANCE INTO ASUMBI TREATMENT CENTRE ......................................................................................................64
Figure 4.7 MAP SHOWING LOCATION OF HOMABAY COUNTY (Source: Google Maps, modified by author) ........................................................................65
Figure 4.8 IMAGE SHOWING THE LOCATION OF ASUMBI TREATMENT CENTRE (Source: Google Earth, modified by author) ..............................................65
Figure 4.9 MAP SHOWING THE LOCATION ANAD CONTEXT OF NAUFAR REHABILITATION CENTRE ......................................................................................70
Figure 4.10 IMAGE SHOWING THE MAIN ACCESS POINT AND ROUTES OF VEHICULAR MOVEMENT INTO THE CENTRE ......................................................71
Figure 4.11 DAYTIME IMAGE OF THE MAIN REHABILITATION BLOCK UNDER CONSTRUCTION .............................................................................................72
Figure 4.12 DAYTIME SHOT OF THE CLINIC BLOCK UNDER CONSTRUCTION ..........................................................................................................................72
Figure 4.13 COMPUTER GENERATED 3-D IMAGE OF TEH REHABILITATION CENTRE (Source: www.naufar.com) .................................................................72
Figure 4.14 IMAGE SHOWING USE OF NATURAL STONE AND SAND TO CREATE INTEREST WITHIN THE SURROUNDING LANDSCAPE .................................73
Figure 4.15 IMAGE SHOWING THE USE OF PATTERNED ALUMINIUM SCREENS AND CONCRETE FINISH ON THE RESIDENTIAL VILLAS ................................73
Figure 4.16 IMAGE SHOWING THE TREATMENT CENTRE LOCATION WITHIN ASUMBI ..........................................................................................................75
Figure 4.17 IMAGE SHOWING TEH LAYOUT OF ASUMBI TREATMENT CENTRE AND THE FACILITIES PROVIDED (Source: Author) ........................................76
Figure 4.18 IMAGES OF THE PATIENT ACCOMMODATION BLOCKS ........................................................................................................................................77
Figure 4.19 IMAGE OF THE TREATMENT CENTRE COURTYARD ...............................................................................................................................................78
Figure 4.20 IMAGE OF THE ADMINISTRATION BLOCK .............................................................................................................................................................78
Figure 4.21 BRIGHT PAINT FINISH AND ARTWORK ON THE WALLS GIVES A STRONGER SENSE OF IDENTITY ........................................................................79
Figure 4.22 BUILDING WINDOWS FACING INTO THE COURTYARD FOR NATURAL SURVEILLANCE ........................................................................................79
Figure 4.23 THE CENTRE PROVIDES SHARED STAFF HOUSING, WHICH IS INADEQUATE ........................................................................................................80
Figure 4.24 DESIGN PROVIDES ACCESS TO NATURE WITHIN THE NATURAL LANDSCAPE.......................................................................................................80
Figure 4.25 SPACES OF SOCIAL INTERACTION WITH FAMILY AND VISITORS ARE INADEQUATELY PROVIDED .......................................................................81
Figure 4.26 THE WAITING ROOM DOES NOT MEET THE NEEDS OF THE USER AND DAMPENS USER EXPERIENCE ................................................................81
Figure 4.27 IMAGE SHOWING THE TYPICAL LAYOUT OF A PATIENT ACCOMMODATION UNIT AT THE TREATMENT CENTRE ...............................................82
Figure 4.28 IMAGE SHOWING TYPICAL LAYOUT OF STAFF HOUSING UNIT WITHIN THE COMPOUND ..................................................................................82

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ABSTRACT

This study is concerned with the planning and design considerations of treatment centres dedicated to the rehabilitation

of alcoholics. An existing concern is the clear disconnect between availability of treatment centres and the culture of seeking

medical or social interventions to address alcoholism.

Treatment was traditionally provided in community (home) settings with little knowledge of the specialized care necessary

for successful treatment. With advancements in medicine after World War I, developed hospitals and clinics were later

tasked with treatment of illnesses caused by alcohol abuse. Resulting from specialization in medicine, which broke down

the structure of care provided to patients, and client courage to openly seek treatment, hospital intervention is now

supplemented with therapy provided in dedicated facilities. These facilities focus on instilling accountability to self and

others as a means of achieving rehabilitation and maintaining abstinence, while hospitals focus on treating the resultant

physical side effects of long-term abuse.

Rehabilitation facilities have gradually changed from hospital – like institution designs to a more friendly and residential

approach in a bid to reduce the stigma associated with alcoholism and the need for therapeutic interventions. This

approach has however suffered too literal an interpretation, with common practice being the retrofitting of residences to

accommodate clients. This limits the flexibility of treatment processes, as they should ideally be tailored to individual client

needs, based on the severity of alcohol abuse. Planning and design guidelines are therefore not clearly defined, since the

initial designs of residential buildings are as varied as the architects involved, the needs of the owners and building

materials.

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This study aims to investigate the design considerations set as guiding standards for the development of treatment facilities

from first principles, with a view to gauge the level of successful implementation within the Kenyan context. This is done

in comparison to other rehabilitation facilities identified as world leaders in both design language and treatment practices.

All this is in the hope of establishing recommendations that will guide future design and planning that is geared towards

the successful rehabilitation of alcoholics.

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INTRODUCTION

1
 1.1 Preamble

Substance abuse is a common and silent problem in our society. We live in times when legal drugs

like alcohol and cigarettes are considered suitable offerings at social events; their ready

availability and ease of access make them a staple at many social gatherings. It should be of great
EXPOSURE and urgent concern that such addictive drugs are marketed and advertised through all platforms

of mass media, exposing children and non-users to the drug use culture. Successive generations

REGULAR
are inducted into the consumption of alcohol as a means of relieving stress and socializing, while
USE
the effects of alcoholism are downplayed and made to seem rare and exaggerated.

The use of alcoholic drinks, for example, is subliminally encouraged, yet seeking treatment
ADDICTION
against the same is frowned upon. In our current society, one is considered weak for not

“handling their liquor”. Alcoholics face constant stigma of shaming ridicule and are deemed

immoral and irresponsible, while being treated as societal outcasts. They are shunned for being

Figure 0.1.1 INFOGRAPHIC SHOWING THE CYCLE unable to play their culture – assigned roles as constant caregivers, providers and protectors.
LEADING TO ALCOHOL ADDICTION

Source: Author

2
 1.2 Background of the Study

The treatment of alcoholism has experienced evolution over time. Resulting from the courage to

openly seek help, hospital care for alcoholics is now supplemented with therapy provided in

dedicated facilities. These centres of treatment recognize and seek to treat addiction as a disease,

with focus on instilling accountability to self and others.

Rehabilitation facilities have gradually changed from hospital-like designs that focus on

treatment only, to a more personable and friendly approach in a bid to reduce the stigma
Figure 1.1 IMAGE HIGHLIGHTING SIGNAGE OF AN
ALCOHOL REHABILITATION CENTRE associated with alcoholism and seeking help for the same. Architectural design has taken a more

(Source: Author) residential approach, with a focus on patient experience for a more wholesome experience that

reduces chances of relapse. This, however, is hindered greatly by the fact that treatment centres

are not designed from first principles, but existing residences are retrofitted into treatment

facilities – this impairs the treatment processes recommended before an individual is

reintroduced to society, since spaces and environments are restricted in function.

This study is based on the recognition of alcoholism as a current societal problem and disease,

Figure 1.2 IMAGE SHOWING THE LINK BETWEEN

and the importance of spaces in which rehabilitative therapy is carried out, with a focus on the
CYCLES OF ADDICTION AND RECOVERY

(Source: Google Images)

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Figure 1.0.3 INFOGRAPHIC SHOWING A
REPRESENTATION OF THE POPULATION OF
ALCOHOLICS IN NYANZA PROVINCE
About 200, 000 people rely on the services of
Asumbi Treatment Centre, which is inadequately
equipped to serve them all
(Source: NACADA, modified by author)
therapeutic experience and wellbeing of alcoholic patients, their family/visitors and care giving
staff.
1.3 Problem Statement
Alcohol use and abuse has become widespread in Nyanza province. At a national scale, legal
drugs are vigorously marketed and cheaper, locally brewed versions are easily accessible to
teenagers and young adults. It is a common trend that most people condone substance abuse, yet
do not know how to properly deal with addiction.
In recent years, the media has highlighted the widespread problem of alcohol addiction,
especially in Nairobi, Central and Nyanza provinces, where incidents of domestic violence,
unproductivity and poverty have been directly attributed to alcoholism. Addiction is mainly
highlighted as a male problem, forcing women to take on the added responsibility of being the
sole breadwinners and caregivers of their families. This has led to a reversal of family roles, where
women are tasked with leading their households and occasionally react violently to symptoms of
alcohol abuse in their homes.
Nairobi has a monopoly of addiction treatment facilities, but these are still inaccessible to most of
the population. Considering that addiction is a disease that is not unique to Nairobi, the
government is mandated to ensure addiction treatment is available in every county, through the
4
 Ministry of Health. It is unfortunate that concerned parties only offer help in worst-case scenarios

after addicts succumb to the effects of consuming sub-standard drinks that are locally and

illegally brewed, as witnessed in 2015 when treatment for withdrawal symptoms was offered in

makeshift tents set up in playing fields within Central province. Ideal treatment processes should

be identified and suitable environments made available in order to ensure proper rehabilitative

care for alcoholics.

1.4 Aims and Objectives

1. To investigate how architecture may influence the treatment of alcoholics

2. To establish user needs and the planning and design requirements for a rehabilitation centre

3. To explore case studies or best practices of rehabilitation centres

Figure 1.0.4 INFOGRAPHIC HIGHLIGHTING THE
STUDY AIMS & OBJECTIVES 4. To develop planning principles and design guidelines for therapeutic environments that

promote recovery and wellness of alcoholics

(Source: Author)

1.5 Research Questions

1. What is the influence of architecture on the treatment of alcoholics within built

environments?
2. What constitutes user needs and the planning and design requirements for

5
 rehabilitation centres?
3. What cases can establish the best practices for rehabilitation centres?

4. Which planning principles and design guidelines for therapeutic environments promote

recovery and wellness of alcoholics?

1.6 Justification

Alcohol addiction in Nyanza province has been highlighted in recent years as a problem that

has crippled not only economic ventures, but also the basic family unit. The youth are reported

to have turned to alcohol abuse as a means of dealing with realities of unemployment, poverty,

inadequate moral direction and lack of education.

Figure 1.0.5 IMAGE SHOWING THE MAIN POINTS Architecture can respond to this through the design of environments in which alcoholics can
OF INTEREST IN THE STUDY
comfortably seek treatment and find support. The provision of rehabilitation facilities that share
The research objectives and study shall seek to
understand the treatment of alcoholics and the a link with the surrounding communities reduces the stigma associated with substance abuse
design of suitable environments for therapy
and encourages addicts to seek help. Treatment facilities should incorporate vocational training
(Source: Author)

6

Figure 1.0.6 INFOGRAPHIC SHOWING THE
PROJECTED SCOPE OF LIMITATIONS TO THE STUDY
(Source: Author)
in order to further dignify the treatment process and enable patients to become productive
members of society upon re-integration into family life.
This study intends to examine the treatment facilities available to victims of alcoholism, with
special focus on facility design, functionality and how treatment processes are suitably
accommodated within various spaces.
1.7 Scope and Limitations
With sensitivity to the limited time allotted to this research, the study will be limited to the design
and therapeutic considerations of alcohol addiction recovery facilities. It will seek to investigate
how overall design of therapeutic environments influences treatment processes in such facilities,
through analysis of local cases in Nairobi and Homa-bay counties.
Other limitations will be access to sensitive information (individual facility practices) and
inadequate information regarding the various levels of addiction and how they are treated.
Previous studies have also cast a cover of generalization as far as investigating substance abuse,
without giving focus to the most commonly abused substances among the general population, or
the specific needs of users within spaces in which treatment is offered.
7
1.8 Significance of Study

This study will showcase the fundamental spaces required in facilities that cater to treatment of alcoholics. The design and therapeutic

considerations of such facilities have great impact on how they are perceived, especially in environments where stigma from the

community is ingrained as a constant deterrent against seeking treatment. This paper seeks to develop recommendations for

adaptation into future developments, in order to ensure treatment is carried out to global standards and alcoholics are made

accountable and productive upon reintegration into their communities.

1.9 Organization of Study

Chapter 1 – This gives a brief introduction of alcohol addiction in current society and introduces readers to the attitudes associated
with rehabilitation, spaces of rehabilitation and the areas of focus as far as the facilities for treatment are concerned.

Chapter 2 – This focuses on review of literature (published and unpublished) in order to better understand the practices that are
already in use for guidance in construction of treatment facilities for alcoholics. This will also help in the analysis of current trends

used in the development of treatment spaces in Kenya, and how this affects the execution of treatment processes. Fieldwork

investigation, highlighted in chapter 4, will be guided by parameters derived from this chapter.

8
 Chapter 3 – This gives an overview of the research methods and tools that will be employed
during fieldwork research in the collection, documentation, analysis and presentation of data, in

order to better understand the character, design and functionality of treatment centres for

alcoholics.

Chapter 4 – This presents a detailed analysis of the selected case studies, with a focus on the
parameters derived from a review of Chapter 2. The analysis will therefore not fully exhaust all

aspects of the case studies, being restricted within the selected parameters.

Chapter 5 – This details the findings and lessons learnt from case study analysis, with a view to

determine how to improve on or reinforce suitable existing conditions and practices in the future

design of rehabilitation facilities for alcoholics.

Figure 1.0.7 INFOGRAPHIC SHOWING A SUMMARY

BY CHAPTER, OF THE STUDY ORGANIZATION

(Source: Author)