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Waiting Areas, Intake, and Individual Counseling

Welcoming and supportive environments not only reduce barriers, but they also actively promote the reduction of stress. The ambient conditions of facilitative environments are consciously designed to give the person a sense of peace and calm. This is particularly important in waiting areas, intake rooms, and individual counseling areas.

Minimizing Distractions

A survivor who is stressed needs distractions to be minimized.

Important discussions with survivors should be in quiet rooms without loud background noise, or visual distractions like traffic outside windows or people walking by.
Room temperature should be managed. If an independent room control thermostat is available, give the survivor the opportunity to adjust it to help give her a sense of control over the environment.
Consider adjustable lighting that the survivor is encouraged to set to a level that is bearable for her.
Reduce clutter in the room.
Minimize patterns on walls, floors, and furniture. Minimize patterns in your own clothing.

Seating

The universal design solution to seating is to have multiple styles, so that people can choose what works best.

People with limited agility will not want to sink too deeply.
People with strength or mobility limitations may need chairs with arms to rise from sitting.
Many people need places to sit more frequently. Long corridors can be broken up with occasional chairs. If people often linger outdoors for rides or to get some air, provide a place to sit.

Noise

Providing inexpensive foam earplugs to anyone who wants them is a simple but effective strategy for dealing with noise in waiting rooms. Especially when children and adults are mixed, certain survivors may need a sense of tranquility or privacy.

Everyone benefits from low background noise and short reverberation times. Noise causes stress. Background noise and excessive reverberation are especially difficult for the person with poor concentration or distractibility (like a survivor with a concussion or traumatic brain injury). Reducing risks for people with cognitive limitations also reduces the level of stress that everyone is exposed to in any environment.

Do a review of your facilities at different times of day and during the different seasons. Identify the sources and paths of noise in your buildings.
Consider acoustical ceiling tile, or dropped ceilings in places that have excessive reverberation. Playrooms and other group activity rooms are high priority areas to reduce reverberation.
Consider adding self-adhesive pads to the bottom of chairs that are loud when sliding on floors in group activity rooms. Low-pile carpeting adhered with low-VOC adhesives is another option.,
Consider sound-absorbing panels high on walls and in corners of group activity rooms for additional noise control.
Add storm windows to old windows that are poor at blocking out street noise. Makes sure areas around window frames are sealed well. If replacing windows, consider what level of sound protection makes sense given the kinds of outdoor noises that exist.
Avoid having seating next to heating and cooling systems with loud fans and compressors.
Consider options for reducing the noise of ventilation and cooling systems.

Color

Healing environments should avoid institutional associations like the pale green so prevalent in institutional settings. The role of color and mood, however, has been understudied. “While several studies show that a color-mood association exists, it appears that different colors awaken different moods for various people.”¹ Some studies have associated red colors with anxiety but later studies do not confirm this. Colors associated with a sense of personal safety may be deeply personal. Because of the diversity of personal factors associated with the intensity of colors, lighter pastel hues are recommended as more likely to be comfortable for a majority of people. Other factors, such as lighting and objects in the room relative to the background, should be considered in creating soothing spaces.

Lighting

People are realizing that daylight is an important quality of life issue and studies are validating the importance of natural light. Some programs and services block out window light in an attempt to create security from batterers. However, natural lighting can be a valuable asset for people struggling with stress. There is wide variation in the perception of light and how it affects the nervous system. The need for greater light intensity increases with age as less light reaches the retina. A forty year old needs twice as much light for the same task as a twenty year old. People with traumatic brain injury, fatigue, and people with Asperger’s syndrome can be hypersensitive to lighting. Flexible options are best.

Reduce glare from windows during meetings, and use multiple sources of light to create an even illumination.
Giving survivors individual control over how the lighting is set in a counseling room increases the survivor’s perception of care, comfort, and personal control over the environment. Consider dimmer switches and methods for increasing outdoor light in rooms as discussed in Lighting.

Temperature

A variety of health conditions and limitations reduce the ability of people to control their body temperature, including menopause, medication side effects, nervous system conditions, multiple sclerosis, brain injury, and spinal injuries. Giving survivors individual control over how temperature is set in a counseling room increases the survivor’s perception of care, comfort, and personal control over the environment. Consider individual room thermostats, fans, room heaters, and air conditioning.

Suggested Barrier Removal and Other Details of Welcome

A checkbox next to a statement means that it corresponds with an item in the Checklist for Existing Facilities, Version 2.1.

Create a wheelchair seating space as part of the waiting area setup by removing existing seats. Also plan for how another spot can be created easily when needed.
Rearrange furnishings to widen aisles, or, as an alternative to barrier removal, provide assistance when requested.
Lower controls, levers, and switches to be within accessible reach ranges (48 inches for a forward approach and 54 inches for a side approach).
Post brochures to be within accessible reach ranges (no higher than 48 inches for a direct approach and 54 inches for a side approach) and post notices on walls no higher than are easy to read for a seated person.
Post notices on walls within 'a comfortable viewing zone'.¹

A Comfortable Viewing Zone (courtesy of Adaptive Environments)
Sighted people can read 5/8" height text with good color contrast from 6 feet away centered at 54" height. If there are multiple pages and memos, then consider that from a 19" viewing distance, a viewing range of 48" to 67" above the floor can work for most people. See the diagram "A Comfortable Viewing Zone".
Provide controls and other hardware that are operable with a closed fist.
For changes in level between ¼ inch and ½ inch, install a beveled transition in wood or rubber.
If no 5-foot turning radius exists, rearrange furnishings and fixtures.
Replace high-pile and loose-weave carpeting. Carpet pile should be no more than ½ inch high and should be level cut or level loop pile with firm, thin padding or no padding.
Secure carpeting along the edges.
Where obstacles are not cane-detectable, relocate them or install furnishings, planter, or other barriers underneath them. It is not necessary to remove objects that protrude 4 inches or less.
Replace complex and hard-to-read signage.
Provide large print, Braille or digital version of standard information upon request.
Regularly check and maintain access features such as clear aisles, goods at accessible heights, and smooth, secure carpeting.
Rearrange tables to provide 36-inch aisles.
Assess tables for ease of use by a wheelchair user. Tables with legs at the outer corners can be very restrictive.
Where dispenser controls for soap or paper towels are too high for easy reach for someone with limited reach range, replace dispensers or add lower dispensers.