Toby Israel Ph.D.

Design on My Mind

Think Tangerine Trees (Not Pink) for Breast Cancer Centers

Patients, themselves, can design and CREATE healing healthcare spaces and home

Posted Apr 17, 2013

YWCA Princeton Breast Cancer Resource Center

Picture yourself in a boat on a river with tangerine trees and marmalade skies. (1) Far be it for me to analyze the meaning of a Beatle’s lyric but, close your eyes and keep floating down that peaceful river. Imagine arriving at a beautiful oasis—perhaps a favorite, nurturing place from your past where you went to relax and renew yourself. Through such Design Psychology ‘guided fantasy’ techniques you can envision and create nurturing places for yourself or your community. Place visualization as part of user participation in design is not new. What is revolutionary is the use of such Design Psychology tools as a type of “Design Art Therapy” that can have a beneficial impact on patients.

For more than a decade, groups such as Planetree (2) have encouraged healthcare providers to create ‘patient-centered’ spaces. In the Fall of 2013, I helped patients and survivors at YWCA Princeton Breast Cancer Resource Center create their own spaces by and for themselves during a “Creating a Healing Oasis Workshop.” (3)

The YWCA Princeton Breast Cancer Resource Center (BCRC) “helps women live with, through and beyond breast cancer” by offering many free programs and services that reach thousands every year. (4) After forty-one years operating support groups, wellness programs, and a prosthesis & wig bank out of a cramped warren of meeting, counseling, and office rooms, the YWCA sought to transform its facility. Given the Y’s mission of “empowering women ,” the goal of the four-session workshop was to both renovate BCRC’s space and involve patients and staff in the process, thereby helping them to feel empowered.

Uniquely, the Oasis workshop involved a) both users and professionals- - breast cancer patients, survivors, BCRC staff, as well as psychologists and designers (5), b) exploratory Design Psychology exercises that took participants back to their primal past-place experience of oases, c) a simultaneous process of imagining public and private space healing space

Including both professionals and non-professionals in the workshop helped debunk myth that only designers have a treasure chest of space-shifting ideas. Instead, in going through a series of eight exercises exploring their “environmental autobiographies,” workshop participants opened their treasure chests of favorite past oases to recall design elements – colors, textures, furniture and special objects - - that had positive, nurturing associations for them. (6) Sharing of such associations led to a collective vision for BCRC’s public space:

"Our ideal BCRC space is a warm and welcoming oasis providing balance, calm and empowerment. It is a personal, nurturing, homey place where we bring strength to each other and allow women to reach their full potential. The use of water, plants, sunshine and other natural materials in the space reflects BCRC’s place as a touchstone for hope, healing and community where women can feel unstoppable."

Thankfully, recommendations for tangerine trees and marmalade skies weren’t part of the more specific ‘Design Psychology Blueprint’ the group went on to develop for BCRC. Instead the Blueprint emphasized ways to create Center spaces that could be both emotionally and socially satisfying as well as more functional and aesthetic.

Although the primary emphasis here was on the Center’s physical renovation, BCRC’s transformation was meant to act as a metaphor, a catalyst to help participants clarify, express, and realize their vision of “whole” self. As such, each group member likewise envisioned a home retreat that mirrored the sense of relaxation, renewal and fulfillment they wished to achieve. In order to do this (as with art therapy) they needed to think through ways to “resolve conflicts and reduce negative stress,” (7) albeit via personal space. Creating a “Place Sociogram,” for example, helped participants gain insight about their family dynamic and ways to establish boundaries that allowed for privacy and peace.

Did the workshop lead to final oases designs? Typically, visioning exercises result in recommendations that designers translate into final design. Faster than I could say “Frank Lloyd Wright,” however, BCRC staff measured their space, created a floor plan, selected furniture, flooring, and paint colors and, with the assistance of the Y’s onsite crew, they completed the space renovation. Imagine yourself entering BCRC via an accessible entry ramp (at last!) walking through a reception room filled with light falling on natural wooden floors. Soft music plays as you enter a room with soothing (not pink) colors and wait with a warm cup of coffee.

Overall as with any creative arts therapy, the point was not to create “Professional” artists or “Professionally” designed space with capital “Ps” nor to ignore the important role played by design professionals. At key points as BCRC’s design evolved, I spoke up to offer gentle and sometimes not so gentle guidance. (“Don’t build that closet in the middle of the room!) Yet in the end, the staff member spearheading the renovation stepped back and declared with justified satisfaction, “I want to be an interior designer!” Shortly thereafter BCRC’s director relocated to the West Coast but commented, “I see the space transformation as part of my legacy.”

I encouraged individual participants similarly to develop and complete their home oasis designs. As part of a follow-up P.O.E. (8), I hope to determine how many of them went on to transform their own personal spaces. Survivors/patients expressed pleasure in taking the workshop. We know that for patients in particular, gaining a sense of control of their environment has special significance when life, due to illness, seems out-of-control. (9) Still the use of Design Psychology as a therapeutic process remains exploratory. Does such a participatory design process result in personal as well as physical transformation? Is there an appropriate way to use the process with in-patients as well as those recovering in the community? Does Design Psychology “provide the life-affirming pleasure of making art” (10) and . . . enable us to imagine soothing oases to which we all can retreat?


1. John Lennon and Paul McCartney, “Lucy in the Sky with Diamonds”


3. For upcoming Design Psychology workshops see and

4. Established in 1971, the Princeton YWCA Breast Cancer Resource Center became a model for similar YWCA breast cancer support programs that were established nationwide under the name “Encore.”

5. Participants attended the sessions in person at Princeton BCRC or via webinar. Designers and psychologists were motivated to attend the sessions to learn how to use the Design Psychology process, especially in healthcare settings.

6. For further description of this process see “Some Place Like Home: Using Design Psychology to Create Ideal Places” by Toby Israel.


8. Post-occupancy evaluation

9. Toby Israel, The Nurture Report, “Oasis by Design Psychology,” 2009.


Copyright Toby Israel 2013

About the Author

Toby Israel is an environmental psychologist who studies design psychology.

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