Horticultural Therapy

“Gardens for Recovery” – Excellent article from AHS’ The American Gardener

Witch hazel ‘Arnold’s Promise’ – spring is on the way!

I hope everyone has been having a good Horticultural Therapy Week. Here in the Hudson Valley, we have had unseasonably warm temperatures and we’re seeing encouraging signs of spring. Light at the end of winter’s tunnel!

My hope of posting notes from last week’s talk at the Horticultural Society of New York on linking medical and social science research to HT are not going to get realized this week. Next week, perhaps.

So instead, I am sharing with you an excellent article from the November/December 2009 issue of The American Gardener, the magazine published by the American Horticultural Society. Gardens for Recovery,” by Doreen Howard, focuses primarily on the Oregon Burn Center Garden at Legacy Emanuel Medical Center in Portland, OR* and the Rosecrance Serenity Garden in Rockford, IL. The TLN gets a mention, too. Howard gives some moving examples of how these gardens, and therapy in the gardens, help patients and family members heal. In addition, she lists “five primary design guidelines for any healing garden, including ones for home and backyards.” I know it’s not always easy to take time to read an article, but in this case, it’s worth it, trust me!

Many thanks to the American Horticultural Society and Doreen Howard for permission to link to this article; these articles are usually only available to AHS members, but they made an exception for the TLN Blog, knowing that others would truly benefit from the information.

Oregon Burn Center at Legacy Emanuel Medical Center

Rosecrance Serenity Garden, Rockford, IL

Happy Horticultural Therapy Week!

Photo by Thomas Moore, all rights reserved

This week, starting yesterday, is National Horticultural Therapy Week.

To celebrate, I’m posting the American Horticultural Therapy Association’s Call for Papers for their next conference, In Our Nature, which will be in Chicago from October 13-16, 2010. Proposals are due by April 15, so get your act together soon to submit.

If you’re not quite sure what horticultural therapy, or “HT,” is, here’s a quick definition, courtesy of the Horticultural Therapy Institute: 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.”

The Therapeutic Landscapes Network has a special page devoted to HT, and the American Horticultural Therapy Association (AHTA) has many resources, including links and books to buy, on their website.

It is my personal opinion that any designer who designs therapeutic landscapes should be a member of AHTA. The Journal of Therapeutic Horticulture alone, published by AHTA, is worth the price of admission alone.

I’m working on a blog post about my amazing day at the Horticulture Society of New York’s forum, Food 4 Thought, and hope to have that out before the end of the week.

In the meantime, here’s a nice video form GardeningForLife about HT:

This Friday! Horticultural Society of NY presents Horticultural Therapy Partnership Forum, Food 4 Thought

Image courtesy of HSNY

This Friday, 3/12, the Horticultural Society of New York presents its 4th Annual Horticultural Therapy Partnership Forum, “Food 4 Thought.” What a great line-up! I’m so excited to get to meet and hear from all of these amazing people. Click HERE to link to the HSNY info and registration page.

Morning topics and speakers are:

  • “Horticultural Therapy at the Rikers Island,” with Hilda Krus, HTR, Director of GreenHouse, HSNY
  • “Horticultural Therapy for People Living with HIV/AIDS,” with Liza Watkins of Bailey Holt House and Sandra Power of the Horticultural Therapy Institute

An afternoon panel will be moderated by Ronnit Bendavid-Val, Director of Citywide Horticulture, NYC Dept. of Parks & Recreation. Panelist topics and presenters include:

  • “Urban Farming, Farm Stands, & Markets,” with Jane Hodge, City Farms Manager, Just Food and Rev. Robert Jackson, Co-founder of Brooklyn Rescue Mission
  • “Horticulture Across Generations,” with Arthur Sheppard, Goddard Riverside
  • “Partnering Medical & Social Research,” with Anne Wiesen, Co-founder & Executive Director of Meristem and Naomi Sachs, Founder & Director of the Therapeutic Landscapes Network
  • “Physical Therapy and Gardening,” with Karen Washington, Physical Therapist, President of NYC Community Gardens Coalition, and Co-founder of La Familia Verde Gardens Coalition.

Anne Wiesen, my co-presenter, is also the co-editor of the book Restorative Commons: Creating Health and Well-Being through Urban Landscapes,” which you can read a review of on this blog post.

This forum is one of several great upcoming events. I haven’t had the chance to blog about each and every one, so please visit the “Upcoming Events” area (right-hand column, about half-way down) to see what’s going on in your area (geographically or professionally). And as always, if you have events that you want others to know about, contact the TLN and we’ll get it posted.

Image courtesy of HSNY

Tomorrow! Making Space for Therapeutic Horticulture

Image courtesy of Anne Dailey

If you are a horticultural therapist or a designer of healing gardens and other restorative outdoor environments and you live in or near NYC, don’t walk – run – to this tomorrow:

“Making Space for Therapeutic Horticulture”
Therapeutic Horticulture Network Group Meeting
Friday, November 13, 1-4 pm

“Making space for therapeutic horticulture – at our institutions, on our grounds, and in our busy schedules – can be a challenge. Come prepared to share your stories about making space for therapeutic horticulture in your work. There will be lots of time for networking, so don’t forget to bring your business cards!”

At the Brooklyn Botanic Garden, 1000 Washington Avenue between Parkway and Empire Blvd.

The afternoon will feature networking activities and will include brief presentations on local therapeutic horticulture projects. Refreshments will be served throughout the meeting.

Thanks to Anne Wiesen, the beautiful brains behind the Restorative Commons, for sending information about this meeting.

“Defiant Gardens” and Other Resources for Veterans

Image courtesy of Gardening Leave

For this post, on Veterans Day in the United States, I’d like to share some information about resources specifically for veterans.

While many veterans returning home from war have to deal with physical trauma, almost all suffer from emotional trauma and strain. On the extreme end is posttraumatic stress disorder (PTSD), which can be debilitating for not just the individual veterans but for their entire family and community. More and more research has been coming out about gardening, exposure to nature in a safe setting, and horticultural therapy as effective tools for fighting PTSD and other stress-related problems.

Here are some resources about work that is being done around this issue:
Gardening Leave (www.gardeningleave.org) is a UK charity, founded by Anna Baker Cresswell, for ex-Servicemen and women with PTSD and other mental health troubles. The goal is to combat stress through horticultural therapy activities – growing fruit and vegetables – in a walled garden setting, where people feel safe and protected. The program has been developed in accordance with plans by Combat Stress (Ex-Services Mental Welfare Society).

The Acer Institute, founded and directed by P. Annie Kirk, teamed up with the ASLA Healthcare and Therapeutic Design Professional Practice Network in 2005 to host a day-long conference, “Therapeutic Garden Design and Veterans Affairs: Preparing for Future Needs” at the Miami Veterans Affairs Medical Center. You can download most of the presentations, see photos and movies, and even request the CD, on which all of the information is compiled, from Acer’s website. Since that conference, Annie has been creating a list of therapeutic (healing) gardens at VA Facilities. You can access this list from Acer website’s VA healthcare page (you just have to fill out a short form first). You can also add to the list, helping Acer to keep building this knowledge base.

Another great resource is the website Defiant Gardens, which came from Kenneth Helphand‘s book by the same name. I am so impressed with Helphand’s scholarship, and my admiration goes beyond his consistently good research and writing. In this case, it’s truly inspiring.

What are “defiant gardens?” They are, in the words of the author, “…gardens created in extreme or difficult environmental, social, political, economic, or cultural conditions. These gardens represent adaptation to challenging circumstances, but they can also be viewed from other dimensions as sites of assertion and affirmation.” Helphand’s book focuses on “Trench Gardens” on the Western Front in WWI, “Ghetto Gardens” in Nazi Europe, “Barbed-Wire Gardens” created by allied prisoners of war and civilian internees in Europe and Asia in the World Wars, gardens in Japanese internment camps in the United States during WWII, and gardens following WWII.

What I appreciate most about the website is that it includes information from the book, but also keeps going from there, encompassing prison gardens, community gardens, and gardens in Vietnam, Afghanistan, Iraq, and even Guantanamo. The most recent post is the text from a New York Times article on gardens in Afghanistan.
And here’s another really nice post by my fellow landscape architecture and blogger colleague Rochelle Greayer: “I Gardened for My Life: The Defiant Gardens of POWs on Veterans Day.” Thanks for the mention, Rochelle. Always happy to inspire:)
And finally, here’s a link from the Farmer-Veteran Coalition (Farmers helping veterans, veterans helping farmers”) to a post about Nadia McAffrey, a Gold Star Mother (she lost her son in the Iraq war) who founded Veterans Village “to provide compassionate healing and living environments for returning veterans damaged by their war experience.” They are expanding to sites in Minnesota and New York, “where land is available for farming and gardening – important components for both the healing and the livelihood for the communities.” Thanks so much to Sharon for these links!

Green Walls for Healing Gardens


Patrick Blanc's 'Mur Vegetal' in Paris -Quai Branly

Patrick Blanc's 'Mur Vegetal' in Paris -Quai Branly

One of the key elements of a healing garden – a garden designed to facilitate and even improve people’s health and well-being – is a high ration of plant material (“softscape”) to paving, walls, stairs, etc. (“hardscape”). More plants, less paving.

And especially if we’re talking about hospitals and other healthcare facilities, which is where healing gardens are needed most, people like a lot of softness and greenery to balance out the hard, sterile surfaces indoors. People also prefer a feeling of enclosure – it makes them feel safe and secure, and can delineate spaces for private reflection and conversation.

So, what better design element than a green, living wall? Patrick Blanc made a big splash with his (absolutely gorgeous) vertical gardens a few years ago, and since then, the market for green walls has exploded. I’ve been surprised at how slowly it’s catching on in the healthcare environment. Seriously, wouldn’t it be great if all of the hospitals and clinics and hospices and nursing homes had soft, green, living vertical surfaces instead of concrete walls and vinyl fences and strange partitions that don’t really work in delineating space?

Image courtesy Annabel Harrold from Echo Studio's post on Blanc

Image courtesy Annabel Harrold from Echo Studio's post on Blanc

Another plus about vertical gardens: They are easily accessible to just about everyone. Whether you’re standing on two feet or wheeling in a wheelchair or a stroller, the plants are at your height where you can reach out to touch and smell, or even to garden in. What a fantastic tool for horticultural therapists!

Here’s an example of a custom-designed wall by Hitchcock Design Group for a continuing care retirement community (CCRC) in Hyde Park, Chicago:

Hitchcock Design Group green wall. Photo by Naomi Sachs

Hitchcock Design Group green wall. Photo by Naomi Sachs

If you’re interested in the confluence of plants and architecture, definitely check out Jason King’s blog Veg.itecture (their tagline is “investigating green architecture.”).

And if you know of any healthcare facilities with vertical green walls – fixed or freestanding – please leave a comment. We’re trying to build a list for the Therapeutic Landscapes Network.

Here’s one last image, from a new company called Woolly Pocket Garden Company. Check out their blog. I especially like the posts about the Edible Staircase and the Edible Schoolyard, two programs with kids in Los Angeles schools.

Green wall image courtesy of Woolly Pockets

Image courtesy of Woolly Pockets

Therapeutic Outdoor Spaces in Senior Housing Communities

Image of aspens courtesy Henry Domke Fine Art

Here’s a letter that I received this week, along with my response. I’m posting our exchange partly to share some resources in this area of our field, and partly in hopes that you will have more ideas and information to add. Please leave comments! The more information that we can offer people on the Therapeutic Landscapes Network, the better, so please help us build our knowledge base.

Hi, I am an assistant social worker at a residential community for seniors in northern New Mexcio. We are looking to transform our courtyards and our outside acreage into a wonderful space for our elderly residents. One of the spaces needs to accommodate our physical therapies. I’m looking for designs and templates to guide our process

Thanks for your email. That’s wonderful that you’re looking to transform your courtyards and outside landscapes into healing gardens for elderly residents. Facilitating contact with nature is so important, and people benefit from it physically, mentally, and emotionally. Here are some excellent books:
  • Clare Cooper Marcus and Marni Barnes’ Healing Gardens: Therapeutic Benefits and Design Recommendations, especially the chapters 8 (Nursing Home Gardens, by Deborah L. McBride), 9 (Alzheimer’s Treatment Gardens, by John Zeisel and Martha M. Tyson, and 11 (Getting it Done, by Marni Barnes and Clare Cooper Marcus).
  • Martha Tyson’s The Healing Landscape: Therapeutic Outdoor Environments – this is the most “how-to” book that I know of, with nice drawings and helpful scenarios, mostly focusing on senior populations.
  • A new book that just came out, by Pauline S. Abbott, Nancy Carman, Jack Carman, and Bob Scarfo, Re-Creating Neighborhoods for Successful Aging, which has a lot of case studies and useful guidelines.
  • Joann Woy’s Accessible Gardening: Tips and Techniques for Seniors & the Disabled.
  • Diane Carsten’s Site Planning and Design for the Elderly: Issues, Guidelines, and Alternatives.
  • For more research-oriented study, I’d recommend Susan Rodiek and Benyamin Schwartz’ The Role of the Outdoors in Residential Environments for Aging.
I also urge you to seek out a horticultural therapist who could really link the physical therapy with using outdoor spaces and other aspects of nature. You could contact http://www.ahta.org to see if they can put you in touch with a local HTR.

Best of luck, and keep in touch to let us know how it all turns out. We’re always looking to add good examples of therapeutic spaces to our list of gardens on the Therapeutic Landscapes Network’s site (http://www.healinglandscapes.org/sites.html).

Upcoming Conference: AHTA’s “Sustaining Health & Wellness Through Horticultural Therapy.”

Fall is conference season, and the American Horticultural Therapy Association‘s 2009 “Sustaining Health & Wellness Through Horticultural Therapy,” in October, looks like one to attend, for sure. My only problem is that there are too many concurrent presentations that I want to attend. The AHTA is cruel to make me choose between, for example, “HT in a Rehabilitation Setting: A Case Study of the Royal Talbot Centre Horticultural Therapy Program” and “St. Joseph’s Rehabilitation Motion Garden: An Innovative and Unique Garden Design,” both between 2:15-3:15 p.m. on Saturday. Sigh. Still, I’m looking forward to it.
We landscape architecture snobs don’t mix enough with horticultural therapists, and that is a shame, as these professionals are often doing more innovative research and work than we are (sorry, fellow LAs, no disrespect, but you know it’s sometimes true). That’s one of the goals of the TLN: To bring together professionals and laypeople, across disciplines and areas of interest, who care about gardens, landscapes, and other green spaces that facilitate health and well-being.
Click HERE for more information and access to the online registration form, and see you in Pasadena!

Nature as Therapy for Hypertension and Other Stress-Related Disorders

Image of dogwood leaves courtesy Henry Domke Fine Art

I met several members of the American Society of Hypertension yesterday, and they were intrigued by the idea of nature as an antidote to stress and, specifically, hypertension. As someone who works in this field every day, I forget that there are lots of people who don’t make the connection, other than intuitively (“well sure, every time I work in the garden, I feel better!”), that interaction with nature facilitates good health.

For example, these ASH members were surprised to learn that clinical studies have shown, on a quantitative rather than simply qualitative level, that gardens and other natural landscapes lower blood pressure and heart rate, speed up recovery in hospital patients, increase people’s ability to concentrate and recover from stressful situations, and generally increase people’s sense of well-being. Many of those positive benefits have to do with lowering stress. And guess what one of the leading causes of hypertension is? You guessed it: Stress! Therefore, it stands to reason that interaction with nature could be an excellent prescription for hypertension and so many of its associated illnesses.

Hypertension is the clinical word for high blood pressure; it is a medical condition in which blood pressure is chronically elevated. It is one of the leading risk factors for a slew of other serious health problems, including strokes, heart attacks and other heart failure, arterial aneurisms, and renal failure.

So just as stress sets up a chain reaction that adversely affects our health, interaction with gardens and other landscapes initiates a positive chain reaction that can ameliorate stress and its domino effect. If that’s too simplistic, you can refer to some of the research below for more detailed explanations. And if you have references that aren’t below or on the Therapeutic Landscapes Database’s References page, we’d love your input. And as always, your comments are welcome.

In Sweden, gardens and horticultural therapy are being used clinically to treat patients with stress-related illnesses such as burnout and chronic fatigue syndrome. Here are two articles about these programs:

Clare Cooper Marcus, “Gardens as Treatment Milieu: Two Swedish Gardens Counteract the Effects of Stress.” Landscape Architecture Magazine, Vol. 96, No. 5, May 2006.

Patrick Millet, “Integrating Horticulture into the Vocational Rehabilitation Process of Individuals with Fatigue, Chronic Fatigue, and Burnout: A Theoretical Model.” Journal of Therapeutic Horticulture, Vol. 19, 2009, pp. 10-22.

In almost every article and presentation on the benefits of nature, Roger S. Ulrich refers to reduction of stress. Here are just a couple of examples:

Roger S. Ulrich, R. F. Simmons, B. D. Losito, E. Fiorito, M. A. Miles, and M. Zelson, “Stress Recovery During Exposure to Natural Urban Environments.” Journal of Environmental Psychology, Vol. 11, 1191, pp. 201-230.

In a blog post from a while back (“How the City Hurts Your Brain – and what you can do about it”), I discussed Stephen and Rachel Kaplans’ Attention Restoration Theory (ART), which is one explanation about how interaction with nature reduces stress. Here’s a good article about that: “The Cognitive Benefits of Interacting With Nature,” by Mark G. Berman, John Jonides, and Stephen Kaplan in Psychological Science, Vol. 19, No. 12, pp. 1207-1212.

More on scent and memory – Guest post by Wendy Meyer

Image courtesy Henry Domke, http://henrydomke.com

Photo by Henry Domke, www.henrydomke.com

Wendy Meyer, a recent MLA graduate of the University of Texas at Arlington left such an informative comment on the last blog post, on scent as an emotional memory trigger, that I thought it was worth printing in its entirety, especially since she provides a link to her thesis, “Persistence of Memory: Scent Gardens for Therapeutic Life Review in Communities for the Elderly.”

Aha, I finally figured out how to post a comment! I wrote my master’s thesis in landscape architecture on this subject–specifically, on using fragrant plants in gardens for elderly people to help conduct reminiscence therapy. There is a ton of new brain science being done on the links between smells, emotions and memories. It turns out that early, emotional autobiographical memories are strongly related to smells, because of the way the brain evolved. I looked at how reminiscence helps older people come to terms with their lives, historic use of scent in gardens as well as history of therapeutic gardens. I also interviewed a group of practitioners for their advice and insights on using scent for therapy in gardens. I got different perspectives from landscape architects who design therapeutic gardens, nurses/therapists who work with elderly populations and horticultural therapists who work in all kinds of settings. One of the recurring themes was the need for everyone involved to work together in creating these gardens–not just garden designers and hospital/nursing home administrators, but the therapy staff, families, patients and (not to be forgotten!) the maintenance staff. I spent two and a half years reading and could have spent lots longer (but I needed to graduate)! You can see the thesis at this link:
http://dspace.uta.edu/bitstream/10106/550/1/umi-uta-1697.pdf. Or if that doesn’t work, I’m sending a PDF to the Therapeutic Landscapes Network website.

When I asked Wendy for permission to post this, and mentioned I might use a rose for the image, here’s what she had to say:

“Roses were probably the flower that came up the most–particularly rugosas, because the hips have a distinctive scent–but also lavender, gardenias, rosemary and lilac. People mentioned a lot of scents outside the garden as well–firs in the Northwest, sagebrush after a thunderstorm in the Southwest, crabapple blossoms in Wisconsin. I have a bunch of plant lists in the appendices–that was one of the fun parts to put together!”

Thanks so much, Wendy!