‘Therapeutic Landscapes’ should be required reading

9781118231913_cover.inddFifteen years after the pioneering Healing Gardens: Therapeutic Benefits and Design Recommendations by Clare Cooper Marcus and Marni Barnes, here comes an updated and revised version that provides new research, a slew of fascinating case studies and detailed recommendations for those designing gardens in healthcare settings. In his foreword, Roger Ulrich, him of the often-cited article “View through a Window May Influence Recovery from Surgery”, writes that “The knowledge and lessons it offers will be critically important for increasing the quality and success of any healthcare project that provides gardens or other forms of access to nature.”

We could not agree more. This book is compulsory reading for anybody in the field. Telling visitors to this site that healthcare facilities are stressful places where a connection with nature can help patients, visitors and staff is preaching to the choir. But this 300-page seminal book backs up the claim with the latest research and provides detailed guidelines for designing therapeutic gardens in general and for several specific populations in particular (children, cancer patients, frail elderly, those with Alzheimer’s and other dementia, hospice residents, veterans and people in rehabilitation). As the authors explain, their book is geared towards clients and funders of healing spaces as well as landscape architects and other designers so that they may communicate more effectively.

Clare Cooper Marcus and Naomi A. Sachs stress the importance of evidence-based design now backed by 25 years of research and of a participatory design process with interdisciplinary teams and all stakeholders. The two authors, one a professor emerita in the Department of Architecture at UC Berkeley and the other the director and founder of the Therapeutic Landscapes Network, also define the terms they use. On the one hand, healing, therapeutic or restorative gardens are used interchangeably to describe gardens where users “sit, walk, look, listen, walk, meditate, take a nap, explore”. On the other, enabling gardens propose activities “led by a professional horticultural therapist (HT), occupational therapist (OT), physical therapist (PT), and other allied professionals in collaboration with other clinical staff.” Admittedly, the book devotes more attention to restorative gardens than to enabling gardens though Teresia Hazen of Legacy Health in Portland, Oregon does contribute two chapters, including one titled “Horticultural Therapy and Healthcare Garden Design”. In addition, Marni Barnes who co-authored the original book with Cooper Marcus is back for a chapter entitled “Planting and Maintaining Therapeutic Gardens.”

The Olson Family Garden at St. Louis Children’s Hospital is an  8,000-square-foot  rooftop oasis featured in the book.

The Olson Family Garden at St. Louis Children’s Hospital is an 8,000-square-foot rooftop oasis featured in the book.

In the way of an introduction, a chapter about the history of hospital outdoor spaces takes the reader back to Ancient Greece. Among the types and locations of therapeutic landscape with their advantages and disadvantages, the authors describe extensive grounds, borrowed landscapes, nature trails, entry or backyard gardens, courtyards, roof terraces and many more. In closing, the topics of funding and evaluating therapeutic gardens both get some attention. The many case studies with descriptions, plans, photos, key merits and possible problems, some of them chosen outside of the United States, are a key part of this book that should serve as an inspiration for a new generation of garden designers in healthcare facilities.


Therapeutic Landscapes: An Evidenced Based Approach to Designing Healing Gardens and Restorative Outdoor Spaces, by Clare Cooper Marcus and Naomi A. Sachs (Wiley, 2014)