Journal of Therapeutic Horticulture 8 - 1996


Design Considerations for the Development of Therapeutic Gardens
David Kamp, ASLA

Nature is an agent of healing. It helps re­store a sense of well-being, reduces stress, fosters dignity, and offers a sense of hope and promise by virtue of its power to produce memorable experiences, powerful and positive feelings, and a sense of connectedness to the world around us. Healing is a personal process, a process of discovery as one copes with illness. Gardens encourage such discovery by helping to restore a sense of self, reconnecting with life and life's processes through-the thread of care that brings about growth. 

Designing for Emotional Restoration: Understanding Environmental Cues
Marni Barnes, MLA, LCSW

The sights, sounds, and smells that sur­round us have a tremendous impact on our emotions. The appearance of a rainbow gives rise to a smile on the lips, memories are triggered by fragrances, cleansing and releas­ing is assisted by a stiff breeze or a plunge into a cool lake. Horticultural therapists and designers of healing outdoor spaces can dramatically in­crease the degree of therapeutic benefit derived from our environment by attending to this "pas­sive" impact of our surroundings. To do this ef­fectively, the process of emotional restoration and the relationship between our environment and our feelings need to be understood. This re­search elucidates the connection between emo­tional restoration and the envirornnental settings specifically chosen by individuals to assist their healing process. The resulting conclusions have significant implications for the design of thera­peutic outdoor spaces. 

The Garden as a Restorative Environment: A Theoretical Perspective
Gowri Betrabet

An emerging area of interest in human­nature rela tionsl1ips is the concept of natural settings as restorative environments. This is a latent concept in some fields, such as healthcare and tourism that sell restora­tion or landscape architecture, which explores the link between aesthetics and restorative experiences. Other fields, such as horticultural therapy and environmental psychology, have been more visible in directly targeting the explo­ration of the process of restoration and how and where it may be achieved. These fields continue to pursue the investigation of what people need to be restored from and why restorative experi­ences are important. There is an abundance of an­ecdotal accounts in various forms of contemporary literature that converge on some research findings on restorative experiences. People tend to overwhelmingly prefer experi­ences of varying degrees in natural environments of varying scales. From accounts of gardening experiences to hiking in the wilderness, several personal stories testify to the magical healing power of being in nature.

Guidelines for Designing Healing Gardens
Mara Eckerling, JD

For this paper, a healing garden is defined as a garden in a healing setting designed to make people feel better. The ideas for what should be in the garden are taken from his­toric precedent, clinical studies, literature, inter­views with designers, and existing guidelines, as well as personal experience. The prime consider­ation for designing the space is the emotional state, or how a person would feel while in the space. For a healing garden to be successful, the person in the garden should feel less stressed, more comfortable, safe, and even invigorated. This is the goal of these guidelines. 

The Primary Colors of Nature: The Essentials of Therapeutic Landscapes
Elizabeth R. Messer, MLA

Therapeutic landscapes exist as places to stimulate the senses, the body, and the mind and to encourage imagination and exploration. This experience can be much more significant when we consider the various forms of the landscape and the natural phenomena that affect it, such as light, temperature, air move­ment, and sound. While there is a lot of good de­sign work being done in terms of accessible spaces and opportunities to get people outdoors, many designs and designers are overlooking the most fundamental elements of the landscape and nature, which when used effectively are the most therapeutic qualities of any landscape. Every landscape offers cues for one's behavior and abil­ity to function within the space, and our ability to offer therapeutic experiences is directly related to those cues and the properties of nature that make them up. In understanding the relationship be­tween nature and human functioning, therapeu­tic landscape design can go beyond accessible gardening to incorporate and magnify qualities of the surrounding environment which evoke positive responses. Historically, horticultural therapy has dealt with the hands-on, tangible ele­ments of nature and ways to make these elements accessible. These aspects of horticultural therapy are very important and very effective, but we also need to incorporate the intangible elements of the site, such as light, wind, sound and temperature, in both design and programming to provide a more effective and holistic approach to therapeu­tic experience. 

Stress Management through Garden Design
Virginia McGrath Salamy, RN, MLA

Research on stress indicates that stressful  stimuli is detrimental to one's health.  Several theories have determined that reduced stress can lead to enhanced immunity and health (Ader, Felton and Cohen, 1991, Benson, 1992, Kiecolt-Glaser and Glaser, 1993, Lazarus, 1966, Selye, 1976). A garden, if designed properly, is ca­pable of reducing stress. Such a garden becomes: 1)an aphrodisiac that provides sensual pleasure through stimulation, diversity, and interest, 2) a ha­ven that creates a bond with nature conducive to a personal and spiritual introspection, and 3) an environment that requires an active as well as passive interaction between the senses and natu­ral stimuli. The garden is, therefore, recom­mended as one means of stress reduction.

Growing Citizens: The Role of Gardens in a Women’s Prison
Weeks Ringle, ASLA

Growing Citizens investigates the garden's potential as a linear space of movement as well as a boundary. This linear space functions as a nursery and test gardens for voca­tional training some inmates receive in horticul­ture. The nursery is a metaphor for a prison as a place of disparate and temporary as­sociations and one of sheltered growth prior transplanting. The design of this linear space ex­plores the role of nature in marking time and of self-development in a world where time is what separates a woman from her family and home.

The Paradise Garden: A Model for Designing for those with Dementia and Alzheimer's Disease
Margarette E. Beckwith, ASLA, and Susan D. Gilster, RN, BGS, NHA

Guidelines to confirming the effectiveness of a proposed exterior space and associated elements are revealed in two ways: first, through current and recent research into the response to the natural setting, and second, through historic precedents that have seeped into our psyches through cul­ture and tradition. The repetition of garden ele­ments over time confirms the preference for them. Based on the review of these bodies of in­formation, an application of the concepts is pre­sented in the form of three gardens designed for a specialized Alzheimer's facility in the suburb of a midwestern city. First, let us review some of the characteristics of the disease. 

The Walter and Alice Borgeest Garden at Friends Hospital
Ronald A. Durham, BS, HTR, and Nadine G. Kenline, HTR

A hospital committee was formed and the committee identified key areas that needed to be addressed in the garden. They included a safe area in which to wander freely with minimal su­pervision, plant material for sensory stimulation, and construction elements to provide safety. Af­ter three years of planning, meeting, researching, fundraising, and developing three major archi­tectural blueprints (with and without the help of architects and engineers), the Walter and Alice Borgeest Garden began construction in the fall of 1993 and was completed and dedicated in Octo­ber 1994. It was not an especially smooth process as the construction began with a lean-to green­house to be used as an entrance. After the green­house was installed, we had to abandon the site as the patient population it was to serve was moved to another building. A new site had to be chosen and two more garden plans designed. 

The Evolutive Prosthetic Garden: A New Concept for Elderly Living in Nursing Facilities
Carole Labrecque, BS, CSLA, and Lucie Tremblay, RN, BS, MS

The Evolutive Garden goes far beyond the simple garden. It tends to be a global concept that has many ramifications in the day-to-day life of the resident. It extends from therapy to daily ac­tivities, from outdoor to indoor spaces. There are many benefits derived from such an approach that can be achieved within a very reasonable budget. 

The Therapeutic Qualities of Plants
Karen L. Haas, HTR, and Rob McCartney, MS

A fundamental question in the discussion of therapeutic landscapes is "what is it that makes them therapeutic?" Is it the accessible structure, the location or setting of the garden, the techniques of gardening in them, or the abundance of plants? This paper will explore the interactive qualities that plants add to thera­peutic spaces and their role in "therapeutic land­scapes," rather than structures, techniques, or actual gardens. Plants intrigue our minds, stimu­late our senses, awaken our curosities, and moti­vate our spirits. Plants invite-· human participation in the garden. For, without plants, therapeutic landscapes are merely accessible lo­cations. 

Design of Outdoor Environments for Wellness and the Role of Landscape Architecture
Scott C. Scarfone, ASLA

At present, many architectural design guidelines for the design for wellness of health care facilities have been researched and documented. However, at present, landscape architectural supportive design for wellness for the ill and elderly have not been fully addressed. This paper is intended to pro­vide an overview of the theory and the consider­ations for the design of outdoor environments for wellness and to illustrate the progress made by researchers and landscape architects. 

Compact Nature: The Role of Playing and Learning Gardens on Children's Lives
Robin C. Moore, MLA

Each child is born both from and into our  biospherical garden on which all humans depend. Healthy humans cannot exist without a healthy biosphere. It is our home. We are part of it. Indeed, health in the broadest sense can be defined as a quality of interrelation­ship between people and planet. 

Classroom? Playground? Garden? Or Clinic?
Nancy K. Chambers, HTR, Sonja Johansson, ASLA, and Donna M. Walcavage, ASLA

The goal of treatment at Rusk Institute is to help patients achieve their highest level of independence-physically, socially, emotionally, and vocationally. This is achieved through an integrated team approach, with the patient and family sharing the work with physi­cians, nurses, teachers, therapists, and other team members. 

What's a Nice Guy like Me Doing in a Place Like This? A Landscape Architect and Recovering Alcoholic's Thoughts on Designing Therapeutic Landscapes
Robert Benson, MLA

Addiction treatment facilities are clois­tered environments that preserve ano­nymity and confidentiality where patients take the first steps in their return to normalcy. Emphasis is placed, not on regaining control of out-of-control lives, but on uncovering and ex­ploring the roots of present predicaments, taking "ownership" of one's life and actions, and accept­ing responsibility for their results. An integral part of this process is focused, often excruciating attention on patients' physical, mental, and emo­tional condition in sequestered, nonjudgemental settings where they can examine their motives and zero in on the real causes of their addiction problems. Patients are of all ages and from all walks of life. 

The Healing Gardens of Makahikulia: The Landscape as a Healer
Calley O'Neill

The Gardens of Makahikilua will be the first landscape of its kind to be realized. As such, it has the opportunity, within an institutional framework, to become a significant prototype of a comprehensive, ecological land­scape, incorporating the essential elements of food production, solar energy, rare aesthetics and deep healing environments: that is, the landscape as healer. In Hawaiian culture this might well be Lokahi-that exquisite triadic union of humanity, nature, and the divine in harmony-which will unfold the abundant and infinite healing poten­tial of the forces of the earth, the inner being, and the cosmos. In that, "The Healing Gardens" rep­resent the necessary integration of earth healers and healers of humanity, in a landscape form, which is at once cultural and historical, sociologi­cal, ecological and sustainable, economical and productive, beautiful, deeply healing, and highly spirited. As "The Healing Gardens" are based on community values and participation, they may have their most profound impact as a direct edu­cational center for all those, young and old who visit and come to know and use them. Gardens are teachers of ancient, timeless wisdom. It is the hope of the designers that these gardens may provide a safe haven filled with people each day practicing hula, tai chi, yoga, walking, garden­ing, and exercise.