Normal Spaces in Abnormal Places: The Significance of Environment in Occupational Therapy with Hospitalised Teenagers

The increasing orientation of adolescents toward social contacts outside their families makes them organise in peer groups and subcultures which provide the space to act out generational concerns collectively. For some young people, the hospital setting is an environment in which they find themselves repeatedly. People usually decide to enter environments that are relevant to them. However in hospital, there are usually few familiar artifacts and the patient has little choice about being there. For young people to attain independence, they must experience competence and autonomy. In an attempt to capture some of the features of ordinary life, the sort of inanimate, social and temporal features within the hospital environment that facilitate independent behaviour must be available to youth: features like personal space and access to the peer group. When environmental requirements such as these are available, then occupational therapy can enable young people who are hospitalised to get back in touch with their abilities. During adolescence, the struggle for autonomy is at its peak. The hospital system demands of young people a passive and vulnerable role in which feelings of helplessness are exacerbated. In order to continue development in hospital, young people need appropriate spaces. At The Children's Hospital in Sydney, a Youth Ward is soon to be established. The establishment of such a ward is tangible acknowledgement that teenage patients support each other and receive better and more comprehensive care when they are grouped together. The occupational therapy approach discussed here recognises how important environment is in the healthy development of young people.