instability demonstrate the importance of understanding how treatment environments can either strengthen or

undermine recovery. Individuals receiving treatment often struggle with disrupted routines, psychological

distress, and limited support networks, making them highly sensitive to the surrounding environment. Drawing

from psychological theories of behavior change, environmental design principles, and clinical rehabilitation

literature, this paper proposes a multidimensional framework to explain how therapeutic spaces promote or

inhibit recovery. The physical dimension includes comfort, safety, spatial arrangement, sensory stimulation,

lighting, and privacy—elements known to influence stress regulation, readiness to engage in therapy, and overall

psychological stability. The emotional climate encompasses feelings of empathy, trust, non-judgment,

acceptance, and psychological safety, which are crucial for individuals who may carry experiences of trauma,

shame, or social marginalization; a warm emotional environment encourages openness and fosters internal

behavioral transformation. This framework provides theoretical direction for future empirical studies and offers

practical implications for designing recovery programs that prioritize person-centered, supportive, and

transformative environments. These insights underscore the urgency of improving recovery settings nationwide

Substance use disorder (SUD) represents a significant global health challenge characterized by uncontrolled use

of substances despite harmful consequences (McLellan et al., 2022). According to the American Psychiatric

Association (2024), SUD is a complex condition where individuals develop an intense focus on using certain

conducted at Icyizere Psychotherapeutic Centre found a 59.9% prevalence of relapse among patients with SUDs

The normalization of relapse as an almost inevitable part of recovery can reduce the urgency for providing

effective interventions to prevent it (Guenzel & McChargue, 2023). However, the consequences of relapse are

severe, with many individuals losing employment, families, freedom, and even their lives. In 2020, the United

States reported that drug overdose deaths increased by approximately 30% between 2019 and 2020, highlighting

Traditionally, management of SUD has relied on medical and behavioral approaches in the form of medication

and counseling (Theodorakis et al., 2024). Pharmacological means center on how to alter brain chemistry to

address specific SUDs, reduce urges, and control withdrawal signs (Volkow & Blanco, 2023). Specifically,

positive behaviors are reinforced; and motivational interviewing, which enhances the willingness to change

(National Institute on Drug Abuse, 2020). These interventions deal with the thoughts and actions of a single

The traditional policies in Malaysia, as well as in other Southeast Asian nations regarding drug treatment and its

enforcement, have been rigorous and rather punitive (Hassan & Zin, 2025). Such approaches included

compulsory treatment in Narcotic Addiction Rehabilitation Centers (PUSPEN) or community parole (Mustapha

et al., 2023). However, there were arguments on their effectiveness as the relapse rates were high (ranging from

70-90%), no medical attention was provided, and children were reported to be physically assaulted through

corporal punishment in some programs, which prompted a change from the health-enhancing approaches

Moreover, West Coast Recovery Centers (2024) states that any environment can influence recovery in physical

spaces and interpersonal relationships. These therapeutic landscapes, particularly those involving natural

environments, especially marine environments, have been engaged in managing clients' stress and making them

comfortable engaging in therapy (Horn, 2021). According to Mao et al. (2024), the above natural environments

Despite growing recognition of environmental factors in recovery, there remains a significant research gap

regarding integrated conceptual understanding of therapeutic environments in addiction treatment. Most studies

have focused narrowly on clinical protocols and specific interventions rather than taking a holistic view of the

This paper aims to address this gap by developing a comprehensive conceptual framework that highlights the

environments. The third section presents the proposed conceptual framework, detailing its core components and

underlying propositions. The fourth section discusses theoretical and practical implications, potential integration

with existing approaches, and acknowledged limitations. Finally, the conclusion summarizes key insights and

The understanding of addiction and recovery has evolved significantly over time, with current approaches

recognizing the complex, multifaceted nature of substance use disorders (Bahji, 2024). The biopsychosocial

model represents one of the most comprehensive frameworks, acknowledging biological, psychological, and

social factors that contribute to addiction and influence recovery (Roberts, 2023). This model recognizes that

effective treatment must address neurobiological changes caused by substances, psychological factors such as

coping skills and mental health, and social factors including family relationships and peer influences (Cleveland

Recovery is increasingly viewed as a process rather than an event, with distinct stages that individuals progress

through over time (Branje et al., 2021). Guenzel and McChargue (2023) describe three stages of recovery: the

abstinence stage (first 1-2 years), the repair stage (years 2-3), and the growth stage (years 3-5 and beyond). Each

stage involves different challenges and requires different forms of support, highlighting the need for treatment

Environmental psychology offers valuable insights into how physical spaces impact psychological well-being

and behavior (Jeong et al., 2022). Research by Li et al. (2021), demonstrated that the design and characteristics

of environments can significantly influence mood, stress levels, cognitive functioning, and social interactions.

natural landscapes to assist in the recovery from physiological stress and mental exhaustion" (Youssef, 2022).

The 'enabling places' concept has been developed to define how contexts support recovery. These places embrace

drug-free lifestyles and encourage people to participate in productive behavior models (Bank & Roessler, 2022).

Post-structuralist frameworks radically differ from the geometric view of space as they believe space is

"constructed through the assembled synthesis of a composition of processes, matter, and discourse which

Studies have outlined several factors that have been known to enhance therapeutic conditions for individuals

undergoing substance rehabilitation. Stability, protection, assistance, and involvement are necessary for healing

and sustainable development (Hariram et al., 2023). The structure also has characteristics of predictability and

between therapeutic environments and recovery outcomes. First, supportive therapeutic environments enhance

client motivation and reduce relapse risk. Through physical comfort, emotional safety, and a supportive social

environment within the treatment setting, one will likely remain sober and active in completing recovery

processes. This proposition is in agreement with the following research by stating that being in a place that

reminds them of their trigger can compel them to use it again, and being in a place that is unsafe or uncertain

process. The framework rejects the notion that therapeutic interventions can be meaningfully isolated from the

recovery. Regarding addiction treatment, this idea identifies the importance of the environment and the fact that

getting better happens in context, even when individual therapeutic techniques seem logical and scientific. The

It also collapses the separation between treatment and setting, claiming that the setting is a treatment entity. This

aligns with Galaj et al. (2020) on environmental enrichment (EE), with the researchers finding that when

"exposure to EE (running wheel) is offered simultaneously with the option to self administer the drug, great

alteration occurs in drug related behaviors." This evidence suggests that environmental modifications can

produce therapeutic effects that work through physical and neurological pathways rather than requiring explicit

cognitive awareness. The implications challenge the assumption that recovery necessarily requires conscious

deliberation or intentional behavior change. Environments may directly influence substance use patterns through

The framework also questions whether standardized treatment protocols can adequately address recovery needs.

If recovery emerges from person environment interactions, then what works in one setting for one person may

fail in another setting for another person. This demands context sensitive application of treatment principles

The conceptual framework has profound implications for the recovery centers' layout and functionality. The

framework demands that treatment facilities be designed as flexible spaces that can accommodate diverse and

changing recovery needs. The environment of care settings should be optimized and purposefully built

improvements alone prove insufficient. The framework requires that individuals in recovery have genuine

agency in shaping their environments rather than merely occupying prefabricated therapeutic spaces. Without

such participation, even well-designed environments risk reproducing the disempowerment that characterizes

In particular, treatment centers near nature, especially the sea, have proven that nature's effects help improve

patient outcomes. Yet the therapeutic value of nature cannot be reduced to simple exposure. Natural

environments may facilitate recovery through multiple pathways including sensory restoration, symbolic

associations with renewal, and opportunities for meaningful activity. Understanding which mechanisms operate

Another important practical implication is staff training. Kyambade et al. (2024) also note that staff must be

foster human development and meaningful ways of existing." Staff must learn to recognize when environments

produce therapeutic effects and when they generate harmful consequences such as stigmatization, infantilization,

Such work also entails consideration of the social organization of care environments in which treatments are

provided. It should enable positive interactions with peers and provide possibilities for building friendly relations

social environments during and post treatment. This finding reveals that therapeutic environments must extend

beyond treatment facilities into homes, neighborhoods, and communities. Recovery cannot be sustained if

individuals return to environments that actively undermine their efforts. Therefore, recovery centers should

include family, peer, and community factors (Stanojlović & Davidson, 2021). This demands expanding the scope

The provisioned framework is not intended to replace other models of addiction treatment, such as a trauma

informed or person-centered approach, but builds upon these frameworks. Rather than simply adding

environmental considerations to existing models, the framework reinterprets them through an environmental

inadvertently replicate traumatic conditions. Trauma informed environmental design therefore requires

eliminating architectural and organizational features that trigger fear, shame, or helplessness (Owen & Crane,

Person centered theories advocate for protecting the rights and their dignity and recognizing individual

differences (Cárdenas et al., 2022). However, person centered care risks becoming empty rhetoric if it ignores

the material and social conditions that enable or constrain personhood. This is consistent with the framework

suggesting that the therapeutic environment should not be standardized but should feel normal and incorporate

each person's interests. In their study, Mustapha et al. (2023) explained that "the types of therapeutic programs

provided in the centers of a drug addict are associated with the characteristics of the addicts such as frequency

of the use of the drugs, the kind of drugs taken as well as their history of the use of drugs", this clearly shows

framework questions the strict linearity implied by stage models. Recovery trajectories often involve recursive

movements with individuals cycling between stages rather than progressing steadily forward. During different

stages of change, from pre contemplation to action and into maintenance, other environmental contexts may be

more conducive to change. This further shows how therapeutic environments develop and are unfixed as people

continue recuperation. The framework therefore calls for developmentally responsive environments that provide

appropriate supports and challenges as individuals' needs evolve. What constitutes a therapeutic environment

during early abstinence may differ substantially from what supports long term recovery. Environments must

However, several limitations are also associated with the framework provided in this research. The framework's

comprehensiveness creates significant methodological challenges. First, the key components of the

factors and allows for context specific variations, specifying what evidence would count against it becomes

However, when applied in real life contexts, it can experience particular difficulties associated with resources,

framework, and organizational culture. Implementation faces obstacles beyond resource scarcity. Creating good

therapeutic milieux may involve spending money, changing the physical space, and challenging people's beliefs

and working methods. Treatment facilities operate within regulatory regimes, funding structures, and

professional hierarchies that resist the flexibility the framework demands (Poljašević et al., 2025). Organizations

may endorse the framework verbally while maintaining institutional practices that contradict its principles.

However, as with many student and collegiate affairs best practices, scarce resources often prevent the

implementation of the entire framework, which inevitably leads to deliberative choices about what can and

should be accomplished. The framework also raises difficult questions about equity and access. If therapeutic

This paper has proposed a conceptual framework highlighting the critical role of therapeutic environments in

supporting drug recovery. The framework identifies three core components such as physical environment,

emotional climate, and social structure, that collectively shape recovery experiences and outcomes. Beyond

cataloging environmental factors, the framework advances a relational understanding of recovery. It argues that

recovery emerges neither from individuals alone nor from environments alone but from their ongoing interaction.

By emphasizing the importance of creating environments that promote physical comfort, emotional safety, and

supportive social interactions, the framework offers a holistic perspective on addiction treatment that extends

of therapeutic milieu in substance use disorders treatment by providing a foundation from which future research

and implementations can begin. The framework’s main contribution is challenging three addiction research

assumptions. First, it challenges the idea that environments are passive treatment containers. Second, it

challenges the idea that individual treatments cause therapeutic benefits rather than systemic configurations.

Third, it undermines the idea that recovery is context-independent. While recognizing that recovery is shaped by

relationships, contexts, and moods that can be enacted in physical space, the framework offers a better way of

conceptualizing what makes recovery happen than approaches that focus on individual or clinical factors alone.

By foregrounding environment, the framework shifts fundamental research questions. Rather than asking only

what works, researchers must ask what works for whom, in which contexts, through which mechanisms, and