Wordless Wednesday: 11/10/10 – Autumn Dahlias

Autumn dahlias, Stonecrop Gardens, Cold Spring, NY. Photo by Naomi Sachs

To Rake or Not to Rake? Good Question!

Autumn leaves photo by Allison Vallin,

Photo courtesy of Allison Vallin,

Well, it’s November, and if your yard looks anything like mine, the leaves are starting to pile up. So, do you rake them, do you let them be, does a landscaping crew come with their leaf-blowers and haul them away? This year, I’ve seen several articles suggesting that gardeners not rake. Leaves make excellent mulch and they attract and protect all kinds of beneficial wildlife. And they’re free! Personally, as I live under two giant white oak trees, I feel the need to rake some (in fact, in Ellen Sousa’s recent blog post “Leave those leaves!” in which she advocates for not raking, she makes an exception for oak leaves). Carole Brown of Ecosystem Gardening and co-founder of Beautiful Wildlife Garden posted a good “to rake or not to rake” discussion that touches on many reasons why people do and don’t (and even should and shouldn’t) rake: “I am the Lorax, I Speak for the Leaves.”

Autumn leaves photo by Allison Vallin

Photo courtesy of Allison Vallin

A recent article in Fine Gardening (“Improve Your Soil by Raking Less“) provides lots of ideas about how to turn your leaves into gold. For leaves on the lawn, you can run them over with a mulching mower. Rather than smothering it, the organic matter and nutrients in the leaves will improve turf quality. You can rake leaves into garden beds to create mulch that both protects and feeds. You can even build planting beds with leaves. I highly recommend all three of the above-mentioned online articles for information and inspiration.

If you do choose to rake, think of it as an exercise opportunity rather than a burdensome chore. Who needs the gym when you’ve got leaves! Raking is one of many gardening activities that, if done for 30 minutes a day, can increase metabolic rate, reduce blood pressure, improve cholesterol levels, tone muscles, improve flexibility, and even improve cardiovascular fitness – enough to reduce the risk of heart disease and type-2 diabetes. Raking burns approximately 375 calories per hour (for comparison, jogging burns about 430 calories per hour).

Autumn leaves photo by Allison Vallin

Photo courtesy of Allison Vallin

Many horticultural therapy programs include raking, both for the physical and psychological benefits. It’s something most of us have done at some point in our lives, and it often brings back fond memories (mine are a lot like these pictures, jumping into and playing in big piles of leaves).

So if you’ve got leaves, the decision is yours what to do with them. But whether you rake them up, leave them be (sorry, couldn’t resist) or something in between, try to think of them as yet another gift from the garden.

Many thanks to Allison Vallin and her lovely blog, A Tasteful Garden, for the photos.

HealthcareDesign10 – A Healthy Dose of Evidence-Based Design

HealthcareDesign10 begins a week from tomorrow, and this post highlights some events that I’m looking forward to.

HealthcareDesign, a joint effort of the Center for Health Design, Healthcare Design magazine, and Healthcare Building Ideas, is “the premier conference on advancing the future of healthcare facilities, offering attendees incredible learning and networking experiences,” and it’s taking place this year from November 13-16 in Las Vegas, NV. Vegas! But seriously, it’s THE conference for designers and healthcare providers to talk, network, and learn about all sorts of issues related to the design of healing environments, indoors and out.

I mentioned evidence-based design (EBD) in my recent Garden Designers Roundtable post. In a nutshell, EBD uses quantitative, and sometimes qualitative, research to design environments that facilitate health and improve outcomes. It’s a big part of what the Therapeutic Landscapes Network advocates for. We encourage research, and we urge designers and healthcare providers to use that research to create the best possible environments.

This is by no means a comprehensive list; these are just a few sessions that look especially germane to the subject of therapeutic landscapes. Honestly, there are so many interesting-looking education sessions and roundtable discussions that choosing is going to be a real challenge. Click here for the full schedule.

Sunday, 11/14, 9:00-10:00 a.m.
Toss-up between “Light Health and Human Efficiency–Evidence-Based Design for the Human Animal,” Deborah Burnett and James Benya or “Impact of Art on the ED Patient Wating Experience,” Upali Nanda, Kathy Hathorn, Michael Nelson, Pam Kleba and Robyn Bajema.

Monday, 11/15, 8:00-9:00 a.m.
RIPP to the Rescue–How Researchers in Professional Practice Lead the Way to Better Design,” Mardelle Shepley and Erin Peavey.

9:15-10:15 a.m.
Researching Restorative Landscapes in Healthcare–Evaluative Case Studies and Design Recommendations,” Clare Cooper Marcus.

2:15-3:15 p.m.
Natural Images–The Effects of Patients Undergoing Surgery,” Ellen Vincent and Dina Battisto.

3:30-4:30 p.m.
Nature and Human Nature,” David Kamp, with moderator Mardelle Shepley.

4:45-5:45 p.m.
Evidence-Based Design Boot Camp,” D. Kirk Hamilton, Mardelle Shepley, and Roger Ulrich OR “Data as Proof–Links Between Healthcare Design Strategies and Staff Stress and Productivity,” John Goins and Whitney Austin.

Tuesday, 11/16, 9:15-10:15 a.m.
Regenerative Hospitals,” David Burson, Peter Syrett, Deborah Rivers and Michelle Halle Stern (“Through three primary lenses–resources, materials, and connection to nature–participants will explore the meaning of regenerative design on the delivery of healthcare services at academic-based medical centers and see how the regenerative design framework can inform the design and operations of healthcare facilities.”)

10:30-11:30 a.m.
It’s Not an Accident – How Integrated Stakeholders Make Successful Design Happen,” Jerry Smith, Peter Bardwell, Cheryl Herbert, Janet Beck and Carol Cosler

3:15-4:30 p.m.
Closing Keynote Speaker
Esther Sternberg, author of Healing Spaces: The Science and Place of Well-Being. Click here to read the Therapeutic Landscapes Network Blog’s interview with Dr. Sternberg.

See what I mean? Spoiled for choice. No time for slot machines!

Wordless Wednesday 11/3/2010: Witch Hazel

Witch hazel; photo by Naomi Sachs

Labyrinths as Therapeutic Landscapes

Labyrinth at Burford Priory, courtesy of St. James's Piccadilly

Labyrinth at Burford Priory, courtesy of St. James's Piccadilly

In last week’s Garden Designers Roundtable, the theme was “Therapy and Healing in the Garden” and not one but two posts focused on labyrinths (Jenny Petersen’s “Therapeutic Spaces“) and (Lesley Hegarty and Robert Webber’s “‘Homage to Ariadne’ – Labyrinthine Therapy“). I’ve been meaning to blog about this subject for awhile, so their posts were a good nudge.

Both Jenny and Lesley and Robert distinguish between labyrinths and mazes. Historically, they were much more similar. The Greek mythological labyrinth was designed to confuse the Minotaur, and the dictionary defines “labyrinthine” as “entangled.” The term is often used when describing, say, the process of doing one’s taxes, or dealing with an insurance company, or the U.S. healthcare system.

But, as Robert and Lesley explain, since 430 AD, “a labyrinth has had a single unambiguous path to the centre and back.” And as Jenny further describes, “a labyrinth is a flat surface containing an intricately designed pathway, but it’s important to note that it is not a maze. A maze is a left-brained puzzle, full of different pathways containing tricks and turns. Fun, but not therapeutic! A labyrinth has only one pathway that moves back and forth from side to side until you reach the center–no need to figure out where you’re going; you just walk and the pathway will lead you. In fact, a favorite quote of labyrinth enthusiasts comes from the philosopher and theologian St. Augustine (345-430 A.D.) who said, ‘Solviture ambulando. It is solved by walking.'”

Esther Sternberg, in her excellent book Healing Spaces: The Science and Place of Well-Being devotes a chapter to mazes and labyrinths, and she, too, makes a clear distinction between the two, arguing that the former are challenging and stressful, and the latter generally have the opposite effect, calming and centering us in a form of walking meditation (click here to link to the TLN Blog’s interview with Dr. Sternberg, in which we discuss this and other subjects).

Jenny provides one possible explanation for this effect: “There’s a thought that labyrinths are a calming activity because of something called ‘bilateral movement.’ It’s that back-and-forth movement of the body/brain that is said to have a calming effect–think of other back-and-forth movements/activities that calm you: pacing, knitting/crocheting, reading. The side-to-side motion of the labyrinth path can help ease anxiety and depression, aid people with ambulatory/balance issues and supplement meditation or prayer.”

Labyrinths come in several different styles and can be made from many different materials, including something as simple as the mown pictured above. For some more examples, see Jenny and Lesley and Robert’s posts. They have found their way into hospitals, schools, churches, prisons, public parks, and myriad other places where they are believed to serve a holistic function of bringing balance into our lives.

I had a chance to walk the labyrinth on the rooftop garden at the American Psychological Association this summer, where Holly Siprelle gave ASLA Healthcare and Therapeutic Design members a tour. Theirs is a 7-circuit Santa Rosa labyrinth designed by Dr. Lea Goode-Harris, an active member of The Labyrinth Society. It’s a joint effort between the APA, the World Resources Institute, and the TKF Foundation and is used often by staff and visitors as a way to take a break and decompress. The garden also has a neat finger labyrinth, shown below (this one was custom-made, but you can find finger labyrinths at this website,

Finger labyrinth at the American Psychological Association. Photo by Naomi Sachs

Finger labyrinth at the American Psychological Association. Photo by Naomi Sachs

My colleague Randy Eady is a big proponent of labyrinths and their benefits. He has written, spoken, and consulted extensively on the subject and his website,, is a wealth of knowledge.

We are still building the Therapeutic Landscapes Network’s Labyrinths page, where we list resources (in print or online), research, and images. We would love to expand this list, so please, leave your comments here!

Garden Designers Roundtable: Thoughts and Evidence on Therapy and Healing in the Garden

I go to nature to be soothed and healed, and to have my senses put in order.
~ John Burroughs

Autumn crocus, The High Line, New York City. Photo by Naomi Sachs

This blog post comes courtesy of the Garden Designers Roundtable, who invited me to be their first-ever guest blogger. I’m honored and excited to be participating in today’s roundtable discussion, the theme of which is “Therapy and healing in the garden.” All photos are by Naomi Sachs.

Some Thoughts and Evidence on Therapy and Healing in the Garden

The idea that gardens and landscapes foster good health seems like a no-brainer, especially to gardeners and garden/landscape designers/architects. It’s like telling Newton that apples really do fall down. Sadly, though I’m preaching to the choir here today, many people still haven’t grasped this concept, and we can find all too many examples of landscapes that are anything but healing (picture, if you will, a parking lot at the mall…). At the Therapeutic Landscape Network, we focus a lot of our attention on the design of hospitals and other healthcare environments because – oddly enough – they tend to be so far behind as places that facilitate health and well-being on a holistic level. We’re getting there, but we still have a long way to go.

For today, since a big part of the TLN’s mission is to connect designers and health and human service providers with the research they need to design beautiful, nurturing, successfully restorative spaces, I thought I’d highlight some of the evidence that we’ve blogged about over the years. In this case, research that “proves” that being in and interacting with nature is, indeed, restorative for body and soul. This research is important because it’s positive ammunition. It’s what makes CEOs, and policy makers, and grant funders and our clients sit up and take notice (and change the laws and sign the checks!). I’ve provided a one-sentence summary of the research, with the title of each related blog post that you can link to for more information and full citations.

But first, for background, the seminal ‘View Through a Window’ study:
In 1984, Roger Ulrich studied two sets of patients, both in the same hospital, both recovering from the same surgery. The key difference: One group’s view from their window was of nature – grass, trees and sky; the other’s was of a brick wall. Ulrich found that the patients with the nature view complained less, required less pain medication, and made a faster recovery. Here, finally, was empirical proof of the salutary benefits of nature. Ulrich’s paper, published in the journal Science, got the attention of the medical community and legitimized the field of evidence-based design. Evidence-based design being the use of quantitative, and sometimes qualitative, research to design environments that facilitate health and improve outcomes. Since then, hundreds of studies have been published. Some, like those cited below, continue to demonstrate that contact with nature is good for people; some explore how people benefit, and what conditions are best for specific groups, needs, and situations (e.g., children; seniors with dementia; gardens for people who are immuno-compromised).

Innisfree, Millbrook, NY

The evidence since ‘View Through a Window.’ A few good examples:

Trees, greenery, and other vegetation make neighborhoods safer and more desirable. They even play a role in boosting students’ grades and reducing the risk of domestic violence.
See “Healing the Neighborhood: The Power of Gardens.”

Plants in an office setting improve worker satisfaction, creativity, and productivity.
See “I Demand Satisfaction! The Role of Nature in Job Satisfaction.”

As little as 10 minutes spent outside improves attention in children with ADHD; neighborhoods with more green space improve body mass index of children and youth.
See “Nature Deficit Disorder: Getting Kids Outdoors.” For many more resources on nature-based learning and play for kids, visit our Get Out and Play! page.

Uma, picking serviceberries. Photo by Naomi Sachs

Gardening improves health and happiness, including reducing heart rate and blood pressure.
See “Horticultural Therapy in the Wall Street Journal.” Horticultural Therapy is “a professional practice that uses the cultivation of plants and gardening activities to improve the mental and physical health of its participants,” (definition courtesy of the Horticultural Therapy Institute). Hort therapists often work with occupational and physical therapists in a garden setting; gardens that are designed specifically for this kind of therapy are called rehabilitation gardens. For more information, see the horticultural therapy page on our website and for a really inspiring post about the power of horticultural therapy, see A Life Worth Living: The Garden as Healer.

Exposure to nature makes people more altruistic and generous.
It’s true, Nature Makes Us Nicer!

Autumn leaves. Photo by Naomi Sachs

I hope that now that you’ve been introduced to the Therapeutic Landscapes Network Blog, you’ll stay awhile and read some of our older posts, and that you’ll visit us again for new ones (you can also sign up to have posts emailed to you). I welcome your comments, which can often lead to great dialog on the TLN Blog.

Many thanks again to the Garden Designers Roundtable for the invitation and warm welcome as a guest blogger. Visit the GDRT website (, or click on the links below, to read other bloggers’ posts (and to see some great pictures) – it’s an excellent group, and each blogger has something interesting to say on the topic.

Genevieve Schmidt, North Coast Gardening: Designing a Landscape for Colorblind People
Ivette Soler, The Germinatrix: Plant a Garden, The Life You Save Might Be Your Own
Jenny Petersen, J Petersen Garden Design: Therapeutic Spaces
Lesley Hegarty & Robert Webber, Hegarty Webber Partnership: Homage to Ariadne: Labyrinthine Therapy
Rochelle Greayer, Studio “G”: A Tale About What Makes a Garden Healing

Planting the Healing Garden: Plant Bulbs Now for Spring Joy

Siberian squill (Scilla siberica). Photo by Naomi Sachs

Siberian squill. Photo by Naomi Sachs

The growing season may be winding down, but the gardening season is still in full-swing (and I don’t just mean raking!). Fall is a great time for planting many shrubs, trees and perennials (it’s a good time to divide those perennials as well). It’s also the only time to plant most spring-blooming bulbs. After enduring a long winter with few signs of life in the garden, is there anything more exciting than seeing the first snowdrops appear? They are a sorely needed sign that spring – and more importantly, the end of winter – is imminent. Spring bulbs cheer up any landscape, and they give interest to a garden when most plants are either still dormant or just starting to leaf out.


Daffodils in April. Photo by Naomi Sach

Just like it’s hard to bring ourselves to buy a wool sweater in summer, even if it’s on sale, it’s a challenge to think about spring bulbs when summer is in her full glory. Which is fine, since that’s not the time to plant them anyway. If your garden is like mine, then its major bloom-time is now over, and you’re starting to see some holes, which is also what you’ll see in early spring. The perfect time to assess your garden and decide where to plant the earliest bloomers.

Some of my favorite bulbs are snowdrops (Galanthus nivalis), crocuses, daffodils (Narcissus spp.), Siberian squill, and early iris (Iris reticulata), but there are many more. The Better Homes and Gardens website has a nice slideshow of early bloomers, and BBC Gardening Guides has a good primer on bulb basics. So go ahead, get some bulbs in the ground – you’ll be delighted in the spring!

Postscript: I got this wonderful comment from a member on the TLN’s Facebook page and would like to share it here, because I think she summed it up so perfectly: “I think bulbs are especially important in healing gardens because of their early awakening in the gray thaw of early spring; always the promise of renewed life!”

Wordless Wednesday: Autumn Crocuses

Autumn crocuses at Kew Gardens in London. Photo by Naomi Sachs

Autumn crocuses, Kew Gardens, London. Photo by Naomi Sachs

Bloggers do this thing called “wordless Wednesday.” It’s pretty much what it sounds like. Just pictures. I thought that might be nice for this blog, too. Here’s the first one, some autumn crocuses from Kew Gardens in London. I know, I know, that’s a lotta words for Wordless Wednesday! Fewer next week.

“A Running, Hollering, Skipping, Playing Place,” guest blog post by Addie Hahn

Topiary at Legacy Emanuel Children’s Hospital Garden. Photo by Max Sokol

Legacy Emanuel Children’s Hospital Garden, Portland, OR Photo by Max Sokol

In the following interview, Teresia Hazen answers questions by Addie Hahn, a writer who is also working towards her Child Life credential, about the Legacy Emanuel Children’s Hospital Garden, which won the American Horticultural Therapy Association Therapeutic Garden Award in 2000. Below are excerpts from the interview, and images of the garden by Max Sokol. To read the full interview, visit the Therapeutic Landscapes Network website.

Teresia Hazen, M.Ed., HTR, QMPH is the Coordinator of Therapeutic Gardens and Horticultural Therapy for Legacy Health System in Oregon.

“A Running, Hollering, Skipping, Playing Place: A Conversation with Teresia Hazen on the Legacy Emanuel Children’s Hospital Garden.”

AH: Could you briefly describe the design process that led to the creation of the Emanuel Children’s Hospital garden?

TH: We did our design work in 1996. Then it was a three-stage process to develop all this, between 1997-99. Two major elements we wanted to address in this garden for kids and their siblings were a therapeutic focus and a restorative focus, or unstructured, independent time. To develop our list of therapeutic requirements, we needed to involve the clinicians. And in these meetings, we needed to hear about the dreams, the aspirations and the clinical goals of each team. We had Physical Therapists, Occupational Therapists, Speech and Language Therapists, Child Life, Spiritual Care, Managers, Horticultural Therapists and our Landscape Architect. All of those people had very specific goals and needs for the garden setting.

The second reason we have the garden is to provide a restorative setting for every patient, visitor and employee 24-7. So we had to be thinking about some of the elements that were needed for that. One of those turned into the 3-5 niche spots, or bump-out areas where a small group can gather to socialize, provide emotional support or grieve together.

Legacy Emanuel Children’s Hospital Garden, Portland, OR Photo by Max Sokol

Benches provide a place for privacy and social support. Photo by Max Sokol

AH: What are a few of the ways the garden is used clinically now?

TH: Physical Therapists needed walking rails for adults and for children, as well as some inclines, because you have to learn to walk in settings like this first if you’re going to go back out in to community settings.

Speech and Language Therapists needed items that would lead and encourage children around the garden. So, having a curved pathway encourages them now to go, “What’s around that corner?” A dragonfly sculpture in a tree might be something to watch for and “tell us when you see it.” The dragonfly starts the communication task.

We needed places where kids could maneuver—inclines, declines and a variety of surfaces that they need to manage while working on mobility skills. Kids ride their trikes and scooters for therapy, and we even have a Seguay now that kids with vestibular disorders ride to work toward meeting their treatment goals.

Yellow Brick Road, Legacy Emanuel Children’s Hospital Garden. Photo by Max Sokol

The "yellow brick road" pathway winds through the garden. Photo by Max Sokol

AH: What do you suggest for hospitals that may not have the funds to hire a Horticultural Therapist, or where staff may at first be resistant to the idea of bringing a professional on board? Are there ways a Child Life Therapist or other staff member could slowly introduce staff to the idea?

TH: Any therapist can add nature-based activities. They could say, “We’re going to integrate nature into our programming.” Anyone can do that. Integrate what you can manage. Consider a 12’ X 12 niche. Do only what you can maintain, and maintain with quality year-round. Therapeutic gardens need to be four season environments.

AH: Can you talk about what you believe is behind the growing interest in incorporating ‘healing gardens’ or smaller-scale, natural elements into hospitals and other healthcare environments?

TH: Programs everywhere are looking for cost-effective ways to help client therapeutic programs do their work most efficiently and effectively.  We’re all working leaner these days–a reflection of the economic setting. These gardens provide choices for all therapeutic programs to help patients connect in whatever ways they need to to aid rehabilitation and recovery and discharge as soon as possible. These gardens are a coping resource and if well designed, can assist patients in their treatment and recovery.

We can also provide that kind of care and honoring even to families that have a baby or a child who is in hospice. The clinical team has assisted parents in supporting the child’s death in the garden. Two nurses will come with the parents. Parents initiate this request and they want their child to experience the fresh air or the sunshine before they die.  Nature is a place of spirituality for many family groups.

Clematis and roses at Legacy Emanuel Children’s Hospital Garden. Photo by Max Sokol

Clematis and roses at Legacy Emanuel Children’s Hospital Garden. Photo by Max Sokol

Addie Hahn is a freelance writer who is also working on obtaining her Child Life certification. She lives in West Linn, Oregon and can be reached at

Max Sokol is a freelance photographer based in Portland, Oregon. He can be reached at

Many thanks to Addie, Max, and Teresia for this excellent post! To read the full interview, visit the Therapeutic Landscapes Network’s References page.

Nature as Healer

California poppy, Felbrigg Hall, Norfolk, U.K. Photo by Naomi  Sachs

Photo by Naomi Sachs

I go to nature to be soothed and healed, and to have my senses put in order.

~ John Burroughs

Path at Felbrigg Hall, Norfolk, U.K.

Path at Felbrigg Hall, Norfolk, U.K. - Photo by Naomi Sachs