Exploring therapeutic architectural strategies as recovery- supportive design interventions in selected international sanatorium and therapeutic wellness facilities

BackgroundSanatoriums, initially developed for the treatment of tuberculosis, emphasise therapeutic architecture strategies that integrate design elements that enhance patient well-being and recovery. However, modern healthcare facilities often overlook these strategies, resulting in environments that prioritise illness over holistic care. The application of therapeutic architectural strategies (TASs), such as biophilic design, lighting design, and the integration of outdoor spaces, can create restorative therapeutic settings. Despite their benefits, challenges such as inadequate implementation, environmental exposure, climate sensitivity, and accessibility limit their effectiveness.PurposeThis study explores the presence, quality, and recovery-supportive associations of TASs within selected international sanatorium and wellness facilities, using structured observational methods and literature-derived proxy recovery indicators to identify key therapeutic architectural elements (TAEs) that contribute to patient well-being.MethodsA mixed-methods approach was adopted, employing structured observational checklists applied to publicly available architectural documentation, professional photography, and academic literature across three internationally recognised facilities. Spearman’s rank correlation was used to examine the association between TAS implementation scores and proxy recovery indicator scores.ResultsThe findings indicate that TASs such as privacy and personalisation, colour psychology, and material selection are strongly associated with recovery-supportive design conditions, consistent with outcomes documented in the therapeutic architecture literature. A strong positive association (ρ = 0.83) was observed between TAS implementation scores and proxy recovery indicator scores; however, inadequate implementation and climate sensitivity pose contextual challenges.ConclusionThe study highlights the need for evidence-based design (EBD) principles in therapeutic architecture and presents an observational assessment framework for integrating TASs into sanatorium and wellness facility design. The findings offer associative evidence supporting recovery-supportive design practice, with particular relevance to under-resourced healthcare contexts such as Nigeria.