Evidence-Based Design (EBD) « Therapeutic Landscapes Network

Call for Papers: The Architecture of the Psychiatric Milieu

January 31, 2012 | by Naomi Sachs

Nautilus. Photo by Henry Domke, http://henrydomke.com/index.htm — Photo by Henry Domke, www.henrydomke.com

Thanks to a member of the EDRA (Environmental Design Research Association) group on Linked In for posting this:

Call for Papers: The Architecture of the Psychiatric Milieu

The editorial team of Facilities, a peer reviewed journal, are pleased to announce a call for papers for a special issue dedicated to an exploration of evidence based approaches to establish the most appropriate architecture for the psychiatric milieu.

Facilities for psychiatric care have a tradition of standardization in design and treatment dating back to the moral treatment paradigm of the 1850s. As normative approaches to psychiatric care have changed, so too do the facilities used to house, treat and manage patients. The shift to evidence-based design (EBD) in hospital
architecture means that the psychiatric milieu must follow suit. The search for evidence to model psychiatric facilities is an important endeavour. But psychiatric illness is not like orthopaedics or cardiology, where the needs and satisfaction of staff and patients can be relatively easy to assess and evidence can be easily measured. Mental illnesses are a heterogeneous group of disorders, and there is a risk in categorizing all psychiatric illnesses together and treating them alike. Environmental influences that exacerbate one condition frequently assist with another. As such, Facilities is soliciting approaches that are specific to:

geriatric psychiatry
mood disorders
the non-affective psychotic spectrum
psychiatric emergencies
substance-related disorders
facilities for forensic psychiatry

This list is not exhaustive… and interested authors are encouraged to contact the Guest Editor with alternative proposals. Please kindly take note of the following requirements if you wish to have your paper
considered for this special issue:

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Effect of Garden Walking on Elders with Depression

January 30, 2012 | by Naomi Sachs

One of our members, a hospice RN, sent me this interview with Dr. Ruth McCaffrey, DNP, Sharon B. Raddock Distinguished Professor in Holistic Nursing at Florida Atlantic University. It was originally published in the digest of the American Holistic Nurses Association.

How have you come to study garden walking for older adults with depression?
I have been working over the last three years on developing an evidence-based program using reflection during garden walking to increase life satisfaction and reduce depression. The work began as collaboration between the Morikami Japanese Museum and Gardens and myself. The Morikami has had many people write letters and tell them that the gardens had a healing quality and helped them in a time of great sadness or in a time when strength was needed. The garden designer has created several gardens in the Japanese healing traditions and uses the idea of nine healing elements in nature. We were able to apply for and receive a grant from the Institute for Museum and Library Services to create a research study with three different interventions, individual reflective walking, guided imagery walking and a comparison group who had art therapy. From that work we developed a book for use in an individual reflective walking program through the garden with a group session at the beginning of the walks, after three weeks and again after six weeks. This program has proved to be very successful and popular…

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Therapeutic Landscapes with The Patron Saint of Architecture

January 19, 2012 | by Naomi Sachs

This week on the blog, “The Patron Saint of Architecture,” Angela Mazzi features therapeutic landscapes through an interview with me. She asked some excellent, thought-provoking questions that get to the heart of what therapeutic landscapes are, how they function, why they’re necessary, and what designers and healthcare providers can do to make sure that they get incorporated into their projects.

Angela is an architect who specializes in healthcare. Her blog explores all sorts of aspects of healthcare-related design, including (of course) design, as well as business strategies, communication techniques, and “thoughts on how to get and stay inspired as a designer.”

Here are a couple snippets, but I encourage you to read the full post on The Patron Saint of Architecture blog.

How Does your Garden Grow? The Role of Therapeutic Landscapes in Design, by Angela Mazzi

What does landscaping mean to you? Most likely, not nearly enough. Too easily, we view it as decorative, a “nice to have” part of a project. However, as we learn more about salutogenic design and the effects of the environment on wellness (everything from healing to better job performance), landscape starts to become a critical element, one which should form the basis of design. With this in mind, I asked Naomi Sachs, Founder and Director of the Therapeutic Landscapes Network (TLN) to share some insights on the power of nature.

What is the difference between landscaping and a garden? Is it only about habitation?

In general, I would say that a “landscape” is any outdoor space, wild or designed, and a “garden” is a designed space. A restorative landscape is simply an outdoor space that makes you feel good when you’re in it. To me, “landscaping” implies decorative elements like a lawn, shrubs, some trees, and is not necessarily intended for interaction. A therapeutic (or healing) garden is a space designed for a specific population (children, cancer patients, people with Alzheimer’s) and a specific intended outcome (stress reduction, positive distraction, rehabilitation). This is not to say that landscaping isn’t important. Well-designed and maintained landscapes communicate to patients and their families that they will receive a high level of care, and this can happen from the moment you cross the property line. Even areas such as parking lots can utilize landscape to provide and reinforce the overall image and mission of the facility.

Maintenance is always a concern when it comes to landscaping- I’ve actually worked with healthcare clients who wanted nothing but grass in the areas they “had” to landscape for ease of maintenance. What kind of recommendations can you make to landscape skeptics about using plantings?

Access to nature just makes good business sense. Studies by Roger Ulrich, confirmed by others, have demonstrated less need for pain medication, improved patient satisfaction, faster recovery rates, and many other examples of improved outcomes for patients and staff. When you really look at the benefits of providing access to nature, the return on investment (ROI) justifies the initial cost and lifetime maintenance. Hospitals need to see landscaping as a strategic investment in the same manner they would the purchase of a new MRI.

Visit The Patron Saint of Architecture to read the full article. Thank you, Angela, for a great conversation and post!

Gimme Shelter! Shade in the healing garden

September 20, 2011 | by Naomi Sachs

Ulfelder rooftop garden, Massachusetts General Hospital. Photo by Naomi Sachs

I’ve been meaning to write this post all summer, and of course now it’s fall and here in the northeast, shade doesn’t seem as important anymore. But plenty of the country is still baking (if not on fire), and half of the world is just now headed into summer. I asked the TLN Facebook group to rate the importance of shade, on a scale of 1-10 (10 being the most important). Two people responded “11,” and one member, from TX, responded with 15. So here we go:

The importance of shade in the healing garden

I’m so tired of seeing “healing gardens” with no shade, or too little shade. I’ve seen many designs that are successful except for this one crucial element. I don’t know about you, but on a hot, bright day in August, the last place I want to be is outside in the sun, sweating and squinting. It’s gotten to the point where lack of shade doesn’t just make me sad, it makes me angry. Because while it’s a nice amenity in any public space, in the healthcare setting, shade truly is a matter of health.

Why provide shade?

1. Sun protection, from UV exposure and glare
For burn patients; the elderly; people with cancer; AIDS; traumatic brain injuries (TBI); psychiatric illnesses which require medications that increase photosensitivity (sensitivity to the sun); and other conditions where direct sun (UV) exposure is hazardous, shade is paramount. In addition, colored concrete is often recommended for outdoor healthcare environments because it reduces glare. This is one of the reasons why we have embraced Scofield as a Wonderful Sponsor.

2. Heat mitigation
Shade provides a cooling effect, thus facilitating use of outdoor space for as much of the year as possible. This is particularly important in regions where high temperatures discourage people from venturing outdoors.

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