Therapeutic garden

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Gardening as therapy Gardening.jpg
Gardening as therapy

A therapeutic garden is an outdoor garden space that has been specifically designed to meet the physical, psychological, social and spiritual needs of the people using the garden as well as their caregivers, family members and friends. [1]

Contents

Therapeutic gardens can be found in a variety of settings, including hospitals, skilled nursing homes, assisted living residences, continuing care retirement communities, out-patient cancer centers, hospice residences, and other related healthcare and residential environments. The focus of the gardens is primarily on incorporating plants and friendly wildlife into the space. The settings can be designed to include active uses such as raised planters for horticultural therapy activities or programmed for passive uses such as quiet private sitting areas next to a small pond with a trickling waterfall.

Design

Nature is referred to as a ‘positive distraction’ by Roger Ulrich, Ph.D. at Texas A&M University. [2]

History

The American Horticultural Therapy Association (AHTA) Definitions and Positions Paper draws a distinction between a therapeutic garden and a healing garden. [3] The AHTA defines a healing garden as "plant dominated environments including green plants, flowers, water, and other aspects of nature. They are generally associated with hospitals and other healthcare settings, designated as healing gardens by the facility, accessible to all, and designed to have beneficial effects on most users." On the other hand, a therapeutic garden is "designed for use as a component of a treatment program such as occupational therapy, physical therapy, or horticultural therapy programs and can be considered as a subcategory of a healing garden." A therapeutic garden can be described as being therapeutic in nature when it has been designed to meet the needs of an individual or group. Individuals or groups strive to improve their well-being through active engagement by using plants and engaging in activities ranging from planting, growing and maintaining plants.

Horticulture has been soothing man's senses as early as 2000 BC in Mesopotamia. Lush agricultural plots lay in the fertile river valleys between the Tigris and Euphrates providing agriculture and inspiration for the first designed gardens in this typical arid landscape. [4] In the 5th century AD, gardens were generally perceived to contribute to the improvement of health and have been used as a place of respite from travels, to serve as a place to recover or recuperate from an illness, or to simply isolate the sick or infirm from the healthy individuals. Gardens located within Christian hospices in the Middle Ages emphasized charity and hospitality. Monasteries ministering to the sick and the insane incorporated an arcaded courtyard where they could find the some shelter, sun, or shade in a human-scale, enclosed setting. [5]

In the 18th to the 19th century, the increased need for hygiene during treatment led to the acceptable uses of "sanitary reforms" [6] such as cross-ventilation, access to sunlight and gardens. The 20th century ushered in the discovery of germ theory, advances in medical science theories, the biomedical model, and improved technology in the medical sciences.

The biomedical model, derived from Louis Pasteur's germ theory of disease, became the predominant conceptual model used by physicians in diagnosing disease. According to the biomedical model, health constitutes the freedom from disease, pain, or defect, thus making the normal human condition "healthy". [7] The biomedical model of health focuses solely on biological factors, and excludes psychological, environmental, and social influences. This narrow focus rationalized and streamlined not only medical diagnosis but also medical processes. Infection reduction, cost effectiveness and operational efficiency became the norm in the design of medical facilities. "Pressure from insurance companies to minimize hospital stays have largely worked against the provision of actual usable gardens in new or refurbished medical complexes.". [8] At this time, gardens were no longer perceived as settings that could contribute to the restoration of the patient's health. Nature and gardens were relegated to the beautification of entrances; small "pocket" areas were used as focal points; sidewalks and even parking areas.

In response to the reductionistic scope of the biomedical model, several medical researchers and scientists such as George Engel strongly believed that "…a medical model must also take into account the patient, the social context in which he lives, and the complementary system devised by society to deal with the disruptive effects of illness, that is, the physical role and the health care system. This requires a biopsychosocial model." [9] Since then, the impact of the physical environment on the well-being and health of the patient has received extensive academic research and attention. In 1984, Roger Ulrich conducted a ground-breaking study comparing the positive effect of views of natural scenery, i.e., trees, on the recovery of patients from surgery to patients in similar conditions who were exposed to a view of a brick wall. He was the first to use the standards of modern medical research—strict experimental controls and quantified health outcomes—to demonstrate that gazing at a garden can sometimes speed healing from surgery, infections and other ailments. Ulrich showed that in comparison with the wall-view group, the patients with the tree-view had the following results: shorter post-operative hospital stays; fewer negative evaluative comments from nurses; took less medication, and slightly lower scores for minor post-surgical complications. [10] In 1992, Dr. Stokols proposed a concept of health promotive environments [11] that involves the physical and social features of the physical environment and how they affect the overall well-being of individuals and groups.

Examples

Enid Haupt Glass Garden: Combining horticultural therapy with medical therapy – Built in 1959, the garden is part of the Rusk Institute of Rehabilitation Medicine at New York University. The Rusk Institute is one of the world's leading centers for rehabilitation medicine. Dr. Howard Rusk, a pioneer in rehabilitation of physical disabilities convinced Enid Haupt to donate a greenhouse amidst the increase of returning World War II soldiers and polio patients. The garden started simply as a peaceful retreat from hospital treatment or rehabilitation; but has grown to incorporate a program of horticultural therapy in the 1970s. Trained horticultural therapists work with patients in the therapeutic garden to identify, nurture and learn from plants. Ultimately, the goal is to make therapy seem like a respite. [12]

Joel Schnaper Memorial Garden: Garden of Hope – Recipient of the 1995 Therapeutic Garden Design Award by the AHTA [13] and the 1995 Merit Award for Design from the ASLA. [14] The therapeutic garden is part of the Terence Cardinal Cooke Medical Center in New York City. In 1989, the center became the first long-term care skilled nursing facility to designate a unit to care for HIV / AIDS patients. [15] The garden "provides opportunity for everyone to connect with nature on their own terms, in their own way and at their own pace, regardless of their capabilities." [16] Built in 1995 and rebuilt in 2004, the Schnaper Garden is a restorative garden, advancing the concept that "properly planned and operated gardens can reduce stress and encourage a sense of well being for long-term health care patients." [17] Designed with an appreciation of changing medical protocols and individual preferences, a series of garden rooms vary in size and character to provide opportunities for structured activities, casual socializing, contemplation, and quiet solitude. A choice of protective settings is offered for individual comfort, ranging from complete shade to full sun. Ease of maneuverability is emphasized to conserve stamina and encourage residents to experience the garden without assistance. The Joel Schnaper Memorial Garden is designed by Dirtworks Landscape Architecture, PC New York, NY.

Mother / Child Garden at Bedford Hills Correctional Facility: Garden of Connection and Compassion –Gardens have been used in U.S. prisons since at least the 19th century for vocational training and therapy. [18] The Mother / Child Garden at Bedford Hills Correctional Facility located in Bedford, New York is part of an innovative program created in 2005 that recognizes family and motherhood as a transformative process for female inmates. [19] The garden acts as a meeting place for mothers and their visiting children to reconnect. It is natural setting that relieves the stresses of incarceration and separation, renewing bonds of nurturing and compassion amidst mature and shady linden trees, newly planted trees, perennial beds, play equipment, arbors and picnic tables. Within this enclosed and safe setting, families enjoy togetherness, free of judgment and the harsh realities imposed on their lives. The Mother / Child Garden is designed by Daniel Winterbottom, RLA, FASLA.

Elizabeth & Nona Evans Restorative Garden: Combining landscape design and modern medical technology in a public setting – Recipient of the 2005 Therapeutic Garden Design Award by the AHTA [13] and the 2006 Honor Award in Design from the ASLA. [20] As part of the Cleveland Botanical Garden, the therapeutic garden reflects the mission of the Botanical Garden to "blend education, social responsibility, cultural and environmental stewardship.". [21] This restorative garden uses a "best practices" approach to therapeutic gardens. It combines design and medical technology advances learned in a hospital setting and applied in a publicly accessible space. The result is a deep understanding of the dynamic between public and private spaces. A balance is effectively struck between the public botanical garden where all visitors are welcome to stroll and the privacy and security that some visitors to the therapeutic garden would want and need. The garden is composed of three unique settings, each with a distinct character and level of activity: one for quiet contemplation; one for both individual exploration and teaching large groups; and one for horticultural therapy. The desire to create a sense of welcome and accommodation for all, regardless of ability, was a significant consideration in details and the selection of materials. The Elizabeth & Nona Evans Restorative Garden is designed by Dirtworks Landscape Architecture, PC, New York, NY.

Warrior and Family Center Support Center Healing Garden: A Garden for Soldiers – Recipient of the 2015 Therapeutic Garden Design Award by the AHTA. [13] The garden, located in San Antonio, Texas, at the Brooke Army Medical Center, is dedicated to soldiers and their families to assist and comfort them through their physical and emotional recovery. [22] The goal of the Warrior and Family Center is to create an empathetic environment as they make their way to rejoin society and lead civilian lives. The garden provides a place to exercise with fitness trails and exercise stations, experience nature, relax, and spend time alone with friends and family. Thoughtful consideration was given from the surfaces used by soldiers with prosthesis, lush and colorful plants, edible flowers and fruits, to shaded porches and walkways for protection from the Texas sun. Warriors are also able to use the Gardens for social events. The Warrior and Family Center Support Center Healing Garden is designed by Quatrefoil Inc., Portland, OR.

The Crown Sky Garden: Ann & Robert H. Lurie Children's Hospital of Chicago - Recipient of the 2013 ASLA Professional Awards, [23] located in Chicago, Illinois. Designed by Mikyoung Kim, the garden was "built upon a growing body of scientific research which links access to natural light and contemplative spaces to reduced patient recovery time." [24] The 5,000 square foot garden provides scenic views to the city, natural bamboo plantings, peaceful resting areas, and active areas for children. The space was designed with colorful walls and natural materials to provide a space that would be inviting to patients of all ages.

Olson Family Garden at St. Louis Children’s Hospital - This garden was built in 2000 and is located in St. Louis, Missouri, on top of the St. Louis Children's Hospital. [25] The Olson Family Garden was built as a sanctuary for patients and their families to find respite from their sickness and trials. The garden is built on the 7th floor of the building and overlooks St. Louis’s largest park, Forest Park. The roof is an intensive green roof with 3 feet of soil to maintain its 7000 plants, flowers, and trees. [26] Over its 16 years, the garden has grown well and been very successful. It is a place that families often come back to years after to remember the experiences they have with their family members while there.

A unique an interesting therapeutic garden located in White Plains, New York has been designed specifically for dementia patients. This garden is unique because it is on a fifth floor balcony and has an elongated shape that is uncommon for a therapeutic dementia garden. Typically therapeutic dementia gardens are square or round and create easy walking paths that follow these shapes. This elongated garden is split up into three distinct areas with two entrances, one from the dining room / kitchen and the other from the activity room. [27] Entrances are a very important part of dementia gardens. Because way finding abilities can be damaged by the disease clear way finding strategies must be put into place. Entrances have to be thoroughly considered when designing a therapeutic dementia garden. Having the entrances be extremely obvious is one of the ways this is executed. Entrances should be visible from all places in the garden and should be very obvious that they are an entrance or exit. Another strategy that this particular garden uses is the use of colour, with a path painted onto the ground. Each distinct area of the garden is a different colour and is connected with a very obvious walking path for the patients to follow. The three areas of the garden include: “a covered front porch outside the kitchen; a park with circular benches between the two other areas and with no direct doorway inside; and a back yard with seating and a barbecue outside the second doorway.” [27] Therapeutic dementia gardens are used to reduce the symptoms of the disorder without the use of drugs.

In literature

See also

Related Research Articles

Landscape design

Landscape design is an independent profession and a design and art tradition, practiced by landscape designers, combining nature and culture. In contemporary practice, landscape design bridges the space between landscape architecture and garden design.

Dance/movement therapy (DMT) in USA/ Australia or dance movement psychotherapy (DMP) in the UK is the psychotherapeutic use of movement and dance to support intellectual, emotional, and motor functions of the body. As a modality of the creative arts therapies, DMT looks at the correlation between movement and emotion.

Sensory garden

A sensory garden is a self-contained garden area that allows visitors to enjoy a wide variety of sensory experiences. Sensory gardens are designed to provide opportunities to stimulate the senses, both individually and in combination, in ways that users may not usually encounter.

Healing environment, for healthcare buildings describes a physical setting and organizational culture that supports patients and families through the stresses imposed by illness, hospitalization, medical visits, the process of healing, and sometimes, bereavement. The concept implies that the physical healthcare environment can make a difference in how quickly the patient recovers from or adapts to specific acute and chronic conditions.

Evidence-based design (EBD) is the process of constructing a building or physical environment based on scientific research to achieve the best possible outcomes. Evidence-based design is especially important in evidence-based medicine, where research has shown that environment design can affect patient outcomes. It is also used in architecture, interior design, landscape architecture, facilities management, education, and urban planning. Evidence-based design is part of the larger movement towards evidence-based practices.

Snoezelen

Snoezelen or controlled multisensory environment (MSE) is a therapy for people with autism and other developmental disabilities, dementia or brain injury. It consists of placing the person in a soothing and stimulating environment, called the "Snoezelen room". These rooms are specially designed to deliver stimuli to various senses, using lighting effects, color, sounds, music, scents, etc. The combination of different materials on a wall may be explored using tactile senses, and the floor may be adjusted to stimulate the sense of balance. The person is usually accompanied by an aide or therapist.

Horticultural therapy Kind of therapy

Horticultural therapy is defined by the American Horticultural Therapy Association (AHTA) as the engagement of a person in gardening and plant-based activities, facilitated by a trained therapist, to achieve specific therapeutic treatment goals. Direct contact with plants is believed to guide a person's focus away from stress enhancing their overall quality of life. The AHTA believes that horticultural therapy is an active process which occurs in the context of an established treatment plan. Horticultural therapists are specially educated and trained members of rehabilitation teams who involve the client in all phases of gardening, from propagation to selling products, as a means of bringing about improvement in their life.

Animal-assisted therapy Alternative or complementary type of therapy

Animal-assisted therapy is an alternative or complementary type of therapy that includes the use of animals in a treatment. It falls under the realm of Animal Assisted Intervention, which encompasses any intervention in the studio that includes an animal in a therapeutic context such as emotional support animals, service animals trained to assist with daily activities, and animal assisted activity. Animal-assisted therapy can be classified by the type of animal, the targeted population, and how the animal is incorporated into the therapeutic plan. The most commonly used types of animal-assisted therapy are canine-assisted therapy and equine-assisted therapy. The goal of animal-assisted therapy is to improve a patient's social, emotional, or cognitive functioning and literature reviews state that animals can be useful for educational and motivational effectiveness for participants. Studies have documented some positive effects of the therapy on subjective self-rating scales and on objective physiological measures such as blood pressure and hormone levels.

Psychoeducation is an evidence-based therapeutic intervention for patients and their loved ones that provides information and support to better understand and cope with illness. Psychoeducation is most often associated with serious mental illness, including dementia, schizophrenia, clinical depression, anxiety disorders, psychotic illnesses, eating disorders, personality disorders and autism, although the term has also been used for programs that address physical illnesses, such as cancer.

The Children's Institute of Pittsburgh is a nonprofit organization dedicated to children with special needs and their families in Western Pennsylvania and Pittsburgh, Pennsylvania, United States.

A playscape is an outdoor environment designed for play. The term is a portmanteau of play and landscape and has been used by designers and community leaders to describe a variety of outdoor spaces for play that are different from a "typical" playground where manufactured playground structures are set on a flat surface. In recent years, the term playscape has frequently been used to describe rugged, nature play environments for children but some of the earliest uses of the word were to describe modernist play areas of the late 1950s and early 1960s that mixed concrete play settings and sculptures with sand areas, carefully molded topography, wading pools, and plantings.

Bagadilico, Basal Ganglia Disorders Linnaeus Consortium, is a research group in Lund, Sweden, and a Linnaeus environment, supported by the Swedish Research Council. The group consists of about 120 researchers at either Lund University or Lund University Hospital.

Magee Rehabilitation Hospital, part of Jefferson Health, founded in 1958, is a 96-bed specialty medical rehabilitation hospital providing physical and cognitive rehabilitation services. Magee's flagship facility is located in Center City Philadelphia. In addition to the main campus that offers comprehensive services for spinal cord injury, brain injury, stroke, orthopaedic replacement, amputation, pain management and work injury, Magee provides an expanding outpatient network serving the surrounding communities. In 1985, Magee's brain injury rehabilitation program became the first in the nation to be accredited by the Commission on the Accreditation of Rehabilitation Facilities. Magee partnered with Jefferson Hospital to create one of the nation's 14 federally designated centers for spinal cord injury rehabilitation. Magee has been rated one of America's leading rehabilitation hospitals by U.S. News & World Report. Magee provides treatment to more than 5,000 individuals annually. Magee is authorized to treat wounded military personnel returning from war. Magee is not an Obligated Group Affiliate.

A sensory room is a special room designed to develop a person's sense, usually through special lighting, music, and objects. It can be used as a therapy for children with limited communication skills.

Gardening Leave (charity)

Gardening Leave is a British registered horticultural therapy charity that focuses on the mental health of British Armed Forces veterans. It supports veterans with a wide range of mental health conditions including depression, anxiety and posttraumatic stress disorder (PTSD).

Serene Oasis

Serene Oasis is a garden adopting horticulture as a new emerging approach of therapy in Hong Kong. Its major goal is to improve the condition of people suffering from mental illnesses such as dementia and depression. Besides, the organization is also committed to promoting horticulture and green life in Hong Kong. It provides professional training programmes of horticulture and courses for planting. The rate of depression among senior citizens in Hong Kong has been increasing, so Serene Oasis aims to build up diversified therapeutic services to cope with the worsening mental health of people.

Clare Cooper Marcus is a prominent educator in landscape architecture and architecture and a pioneer in the field of social issues in housing, open space design, and healing landscapes.

Bloomfield Hospital, Orange

Bloomfield Hospital is a heritage-listed former psychiatric hospital at Forest Road, Orange, City of Orange, New South Wales, Australia. It was designed by Walter Liberty Vernon and George McRae and built from 1923 to 1931. It is also known as Orange Mental Hospital. The property is owned by Orange Ex-services Club. It was added to the New South Wales State Heritage Register on 10 March 2006.

Herbert R. Schaal

Herbert R. Schaal is an American landscape architect, educator, and firm leader notable for the broad range and diversity of his projects, including regional studies, national parks, corporate and university campuses, site planning, botanical gardens, downtowns, highways, cemeteries, and public and private gardens. Schaal is one of the first landscape architects to design children's gardens, beginning in the 1990s with Gateway Elementary, Gateway Middle, and Gateway Michael Elementary school grounds in St. Louis, Missouri, the Hershey Children's Garden at the Cleveland Botanical Gardens, and Red Butte Garden and Arboretum.

Medical ethnomusicology is a subfield of ethnomusicology, which according to UCLA professor Timothy Rice is "the study of how and why humans are musical." Medical ethnomusicology, similar to medical anthropology, uses music-making, musical sound, and noise to study human health, wellness, healing and disease prevention including, but not limited to, music as violence.

References

  1. ↑ Horowitz, Sala (20 April 2012). "Therapeutic Gardens and Horticultural Therapy: Growing Roles in Health Care". Alternative and Complementary Therapies. 18 (2): 78–83. doi:10.1089/act.2012.18205.
  2. ↑ Ulrich, Roger (September 1992). "How Design Impacts Wellness". Healthcare Forum Journal. 35 (5): 20–5. PMID   10121429.
  3. ↑ American Horticultural Therapy Association, Definitions & Positions (2012). "Archived copy" (PDF). Archived from the original (PDF) on 2013-09-08. Retrieved 2015-02-22.{{cite web}}: CS1 maint: archived copy as title (link)
  4. ↑ Sir Geoffrey Jellicoe & Susan Jellicoe. The Landscape of Man: Shaping the Environment from Prehistory to the Present Day, London, UK: Thames & Hudson Ltd, 1975. ISBN   9780500340615
  5. ↑ Reuben M. Rainey, "The Garden in the Machine: Nature returns to the High-Tech Hospital," SiteLines, A Journal of Place, Volume 5, Number 11, Spring 2010, p.15.
  6. ↑ Williams G. The Age of Miracles - Medicine and Surgery in the Nineteenth Century. Chicago, IL: Academy Chicago Publishers, 1981.
  7. ↑ George L. Engel, "The Need for a New Medical Model: A Challenge for Biomedicine", Science, New Series, American Association for the Advancement of Science , Vol. 196, No. 4286, 1977, pp. 129-136.
  8. ↑ Marcus, Clare Cooper and Marni Barnes. Gardens in Healthcare Facilities: Uses, Therapeutic Benefits, and Design Recommendations. The Center for Health Design, Inc. CA, 1995, p. 14.
  9. ↑ George L. Engel, "The Need for a New Medical Model: A Challenge for Biomedicine", Science, New Series, American Association for the Advancement of Science, Vol. 196, No. 4286, 1977, pp. 129-136.
  10. ↑ Roger S. Ulrich. "View through a window may influence recovery from surgery." Science. 1984, 224(4647):420e1
  11. ↑ Dr. Daniel Stokols, "Establishing and maintaining healthy environments: Toward a social ecology of health promotion". The American Psychologist, 1992, Vol. 47, pp. 6-22.
  12. ↑ Nancy Gerlach-Spriggs, Richard Kaufman, Sam Bass Warner Jr. Restorative Gardens: The Healing Landscape: Yale University Press, 2004.
  13. 1 2 3 American Horticultural Therapy Association, http://ahta.org/about/grants-and-awards
  14. ↑ American Society of Landscape Architects, https://asla.org/AwardRecipient.aspx?id=4958
  15. ↑ Steven Cantor, Contemporary Trends in Landscape Architecture: Wiley Publishing, 1996.
  16. ↑ David Kamp. Healing Garden: Images Publishing Dist AC, 2016. ISBN   978-1864706444.
  17. ↑ Steven Kelly & Deanna C Medina, "A Garden of Respite and Nature: The Joel Schnaper Memorial Garden," Landscape Architect and Specifier News, October 2008, Vol. 24, No. 10, p. 62.
  18. ↑ Amy L. Lindemuth. Correctional facilities are often associated with stressful social interactions within stark, imposing institutional settings. Journal of Mediterranean Ecology Vol. 8, 2007. Firma Effe Publisher, Reggio Emilia, Italy: pp87-97.
  19. ↑ Daniel Winterbottom, Amy Wagenfeld. Therapeutic Gardens: Design for Healing Spaces: Timber Press Inc., 2015.
  20. ↑ American Society of Landscape Architects, https://asla.org/awards/2006/06winners/index.html
  21. ↑ American Society of Landscape Architects, https://www.asla.org/awards/2006/06winners/294.html
  22. ↑ Clare Cooper Marcus, Naomi Sachs. Therapeutic Landscapes: An Evidence-Based Approach to Designing Healing Gardens and Restorative Outdoor Spaces, 1st Edition: John Wiley & Sons, Inc., 2014.
  23. ↑ "ASLA 2013 Professional Awards". www.asla.org. Retrieved 2016-11-29.
  24. ↑ "ASLA 2013 Professional Awards | The Crown Sky Garden: Ann & Robert H. Lurie Children's Hospital of Chicago". www.asla.org. Retrieved 2016-11-29.
  25. ↑ "Greenroofs.com Projects - Olson Family Garden, St. Louis Children's Hospital". www.greenroofs.com. Retrieved 2016-12-10.
  26. ↑ "Olson Family Garden | St. Louis Children's Hospital". www.stlouischildrens.org. Retrieved 2016-12-10.
  27. 1 2 Zeisel, John (2014). "Treatment Effects of Healing Gardens for Alzheimer's: A Difficult Thing to Prove" (PDF).
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