Medical anthropology has a long-standing concern with the health and well-being of individuals as understood within their cultural contexts. As early as the 1950s, medical anthropological research identified the problems inherent in treating people in hospitals, other medical institutions where patients are separated from their homes, families, and culturally meaningful surroundings. One of the principal theories in environmental psychology that focuses on the therapeutic landscape was developed by Stephen and Rachel Kaplan after discovering that an Outward Bound-style program provided participants with ' sense of well-being, of being renewed, of being restored. The Northern Michigan Asylum, founded on the principles of Thomas Story Kirkbride, was an institution built based on his belief that the physical environment and the interactions one has with the environment have the power to alter person's mental, or moral, self. As survival mechanism, directed attention is used to decrease confusion brought about by stressful situations and allow an individual to focus on stimuli without losing concentration.